Rich countries will take up the initial COVID-19 vaccines. We need to look at Indian generic vaccine as a model to help the poorest
The announcement by Moderna this week that they are close to developing a COVID-19 vaccine that can be stored at 2 to 8 degrees Celsius (rather than Pfizer that should be kept at -70 degrees) was particularly important in the developing world. The cooling chain transport for Pfizer’s vaccination would always be excessively expensive for the poorer countries in the world.
Although the Moderna vaccine is more promising for a real global deployment, it is only through India’s generic pharmaceutical sector that the needy around the world can quickly receive a vaccine and the barriers (of limited stock and high cost) that the brands are equated, circumvent.
Apart from the problem of deliverability (which is mainly solved by Moderna’s vaccine), there is also the issue of availability. Given limited supplies, the vast majority of vaccines will initially be secured by the world’s richest countries, although some developing countries, such as India, will be hit the hardest by the pandemic. And even once it is available, affordability can be an obstacle for many health authorities.
Without solving these problems and making vaccines available and affordable (as well as deliverable) to everyone, it can take years or decades until they are rolled out to the poorest in the world, if at all.
This is exactly what has happened to other infectious diseases such as polio, measles and tuberculosis (the latter took 1.4 million lives last year, mostly in the developing world, despite the fact that a vaccine has been available for almost a century).
On the current trajectory, we are heading for a global two-tier system where rich countries are likely to have enough vaccination to return to normal at some point next year, and not the poorest parts of the world.
The rich world often talks about a vaccine for ‘everyone who needs it’ without necessarily thinking of the billions of people in towns, cramped towns or refugee camps in the global south who need it just as much as those in London or Los Angeles. . .
There are some global solutions to this problem. COVAX, led by Gavi, the vaccine alliance, aims to ensure equitable access to vaccines around the world. However, it is unclear how they can force vaccine manufacturers to say as much to Uganda as the US or the EU.
It is important to remember that vaccine manufacturers are profitable businesses. There is no obvious way to influence who they choose to sell their products to, and their executives are obligated to pursue their shareholders. Since COVAX has raised only $ 2 billion so far, it is a modest budget in this commercial environment.
In addition to COVAX, there are efforts by the World Bank to finance $ 12 billion to enable poorer countries to buy vaccines at market rates, focusing on the poorest two billion people in the world.
Although it is unclear whether the budget is realistic and whether countries will take the funding, plans such as these also accept an unlimited and immediate supply of vaccines.
There must be a solution to both problems: affordability and availability. The only way to do that is through India’s generic medicine industry. India has a long record of manufacturing treatments that violate patents of pharmaceutical companies, often located in Western industrialized countries. The industry is protected by India’s 1970 patent law, which does not recognize most drug patents, and has grown exponentially and is a major export sector for the country.
Last month, India, along with South Africa, asked the World Trade Organization (WTO) to suspend all patents for any COVID-19 vaccine (in accordance with local patent law). Although the WTO resisted it, the countries will try again at Friday’s WTO meeting.
I believe that India should consider continuing regardless of the outcome. Although the major pharmaceutical companies that have invested in vaccine development will oppose it, it will save millions of lives and livelihoods, within India and beyond its borders.
As the only country with a significant generic medicine sector, India has not only an opportunity but also the obligation to create and distribute the vaccines that the world needs. To prevent the allegations that it improperly benefits from this, a generic vaccine can be offered at cost, and only to those who demonstrably need it and are excluded from other supply agreements.
Besides a humanitarian imperative, it would be in India’s own interest. The image has been damaged in recent years amid allegations of human rights violations and sectarian divisions. A generic vaccination may be exactly what the decision makers in Delhi need as well as exactly what the poorest in the south worldwide need.
Any views expressed in this opinion piece are from the author and not from the Thomson Reuters Foundation.
Shaz Memon is the founder of Wells on Wheels, a charity that works in impoverished rural communities in India.