• Current manufacturing capacity may not be enough to supply a global COVID-19 vaccination programme.
  • Public funding arrangements often restrict vaccine access at present.
  • More partnerships between researchers and manufacturers are needed.

Numerous coronavirus vaccine development programmes are currently being run at a fast pace, with some promising candidates going into phase 1 (dosage and absence of toxicity), some advancing into phase 2 (efficacy on small groups of individuals), and some arguably with the potential to move into phase 3 before the summer (use across groups of thousands of patients, across multiple countries).

That said, there is a strong possibility that when closer to licensing and approval, the manufacturing capacity of the programmes with the most promising candidates won't be enough to deliver a global vaccination programme that would meet the principle of universal access, equity and prioritization of supply to benefit the most vulnerable populations.

It is possible that this dilemma will be further exacerbated by the type of public funding arrangements that have been put in place to support vaccine developers in their research and development efforts. Such funding usually comes with obligations for the manufacturers to produce on the territory of the country providing financial resources, which may in turn result in restriction of exports, and limited availability of the vaccine beyond the population of the countries in question.

With no less than 10 vaccines progressing fast along the clinical pathway, the current global market for vaccines is estimated to be 3.5 billion doses (excluding the seasonal flu vaccine). Diphtheria and tetanus (D&T), and measles-containing vaccines represent close to 50% of that overall volume.

The current supply, even if the world were suddenly to switch en masse from manufacturing existing vaccines to manufacturing one for COVID-19, is not commensurate with the need to vaccinate populations in their billions in order to end the present crisis.

Vaccine development is a complicated and lengthy process
Vaccine development is a complicated and lengthy process
Image: Sanofi

Judging by the manufacturing solutions currently being designed for COVID-19 vaccination, the best-case scenario for vaccine delivery outside of the G7 countries is in the magnitude of a few hundred million doses, when up to 4 billion doses could be required to address the needs of the most vulnerable populations on the planet.

There must be a better way.

The Developing Countries Vaccine Manufacturers Network (DCVMN) accounts for the majority of vaccines produced at more than 65% in each WHO region except the European Region (EUR). This network of 40 manufacturers, located in developing countries such as India, Indonesia, South Korea, Brazil, China, South Africa, needs to be put to work.

The World Economic Forum proposes creating a pairing mechanism for vaccine innovators and vaccine manufacturers. It aims to protect both innovators, who will find capacity to produce, and manufacturers, who will access vaccine candidates at the right clinical development pathways – i.e. when they reach phase 3 and no earlier, hence averting the need for innovators to unilaterally and exclusively secure large capacities from individual manufacturers while their vaccines are yet unproven.

Vaccines, Health and healthcare, Gavi

What is the World Economic Forum doing about access to vaccines?

In 2000, Gavi, the Vaccine Alliance was launched at the World Economic Forum's Annual Meeting in Davos, with an initial pledge of $750 million from the Bill and Melinda Gates Foundation.

The aim of Gavi is to make vaccines more accessible and affordable for all - wherever people live in the world.

Along with saving an estimated 10 million lives worldwide in less than 20 years,through the vaccination of nearly 700 million children, - Gavi has most recently ensured a life-saving vaccine for Ebola.

At Davos 2016, we announced Gavi's partnership with Merck to make the life-saving Ebola vaccine a reality.

The Ebola vaccine is the result of years of energy and commitment from Merck; the generosity of Canada’s federal government; leadership by WHO; strong support to test the vaccine from both NGOs such as MSF and the countries affected by the West Africa outbreak; and the rapid response and dedication of the DRC Minister of Health. Without these efforts, it is unlikely this vaccine would be available for several years, if at all.

Read more about the Vaccine Alliance, and how you can contribute to the improvement of access to vaccines globally - in our Impact Story.

A mechanism like the one described in the above would represent a departure from the way traditional market forces are traditionally shaping the vaccine manufacturing landscape, by encouraging bilateral agreements between vaccine researchers and manufacturers. The Great Reset requires those types of mechanisms where the interest of all prevail over the ones of an elite. In the words of President Macron: “A vaccine is a global public good, which is not submitted to market forces."