Here's how we can vaccinate the world against COVID-19

To a citizen of a rich country, it may feel like the vaccination programmes are going well.

In a few months, it’s reasonable to expect that more than 75% of the adult population of the US and the UK will have had a first dose of the vaccine. The EU, Japan and other developed nations will be not far behind; most likely they will reach that milestone in the latter part of the year.

But this is not fast enough. Billions of people will still be unprotected, mainly in the developing world. India and China have made impressive strides, but it is unlikely that the whole world will have been vaccinated until the end of 2022 – and even that date is optimistic.

This is too slow; much too slow. We need to speed the process up, enormously. The costs and the risks are too great.

There is an obvious humanitarian cost. Already, more than two million people are dead, with many more dying each month. On top of that, there have been at least 100 million confirmed cases, many of them causing severe, lasting illness.

This is worsened by economic damage. The International Monetary Fund estimates that the cost of the pandemic is $28 trillion. Even medium-sized economies, such as Britain or France, are losing more than $1 billion every day that it continues. Nobel-prize winner Michael Kremer estimates that every month that we shorten the pandemic is worth $500 billion. It is worth spending billions of dollars just to speed up our recovery by a single day.

Most alarmingly, as long as the virus is still out there, it is still mutating. We have warned for months of this threat and it is now obvious that the virus is getting better at evading vaccines. Every extra infection is a risk – the billions more infections we will likely see over the next two years are a huge gamble.

The only way to solve this is to accelerate our plan to vaccinate the world. None are safe until we are all safe.

We must do two things:

An annual programme to vaccinate billions is possible.

Just as with flu, we need to be ready to develop new vaccines every year, and distribute enough to vaccinate the world. It will need a larger-scale program – we give about 1.5 billion people the flu vaccine per year; this would be several times more, but it’s possible.

Producing enough vaccines, quickly enough, is a challenge. Even if every manufacturer delivered on their projections, most calculations predict that it will take two years to vaccinate everyone on the planet.

We propose a global-scale public-private partnership to build a network of seven interoperable RNA vaccine factories capable of producing sufficient doses for the entire human population quickly.

Created by building, or converting, pharma-grade manufacturing plants – most antibiotics factories capable of microbial fermentation would work. These factories should be distributed across the world so that most of the world’s population lives within a few days’ travel of at least one.

In pandemic surge times, these units would support one another if demand exceeded capacity at a particular unit. By building local research capability, each unit would adjust vaccines for prevalent new variants in pandemic times.

To justify the expense and maintain activity outside pandemic times the research and production capability of each unit will address diseases of local relevance with mRNA therapies now only available to wealthy patients in wealthy countries.

This is a project of great ambition that no individual company or country could undertake alone. By addressing this challenge with a thoughtful public-private partnership approach, relevant advanced therapeutics can be brought to all parts of the world as we prepare for the next pandemic.