‘Equitable access’ the main concern in race for Covid-19 vaccine

 



Researchers are confident that they will soon crack the code for a coronavirus vaccine, but the major global health concern is whether politics and wealth will be a barrier to universal and equal access to this critical vaccine.

“Vaccines under these circumstances must be described as what’s called a ‘global public good’. That means that they should be equitably made available to everyone in the world, irrespective of whether you’re a big or a small country or a rich or a poor country,” said Professor Helen Rees, chairperson of the South African Health Products Regulatory Authority (SAHPRA) and executive director of the Wits Reproductive Health and HIV Institute.

Rees and Professor Shabir Madhi joined Maverick Citizen editor Mark Heywood for a compelling webinar on Sunday 28 June, on the race for a coronavirus vaccine.

Madhi, who is leading the charge in South Africa’s first Covid-19 vaccine trial, is the incoming dean of the Faculty of Health Sciences at the University of the Witwatersrand and director of the South African Medical Research Council Vaccines and Infectious Diseases Analytical Research Unit.

The Ox1Cov-19 Vaccine VIDA-trial began on Wednesday 24 June and is a collaborative effort between Wits University and the University of Oxford. 

This is the continent’s first and only clinical vaccine trial. 

According to Madhi, there are six vaccine trials (including this one) that are now being tested on humans, largely occurring in developed countries.

If high-income nations monopolise vaccine production, Madhi said, it may cause a delay in the vaccine’s introduction to lower-income countries due to a lack of information on the efficacy of the vaccine in those regions.

“There’s a number of reasons that can influence why vaccines work differentially between different settings. So, if we don’t generate evidence right now, we will never know just how well this vaccine will or will not work in our local context.”

He also mentioned that the World Health Organisation (WHO) doesn’t recommend introducing a vaccine into a developing nation until there’s proof that it works in that context.

Rees spoke about the proprietary and industrial power dynamics linked to the vaccine and warned against “vaccine nationalism”.

This happens when a country procures vaccines for its citizens ahead of anyone else, commonly through pre-purchase agreements between a government and a vaccine manufacturer.

“This cannot be all for some and none for others. This has to be an equitable distribution of vaccines,” said Rees.

We need to be able to prioritise small numbers of vaccines at the beginning, increasing numbers over time, but as a world, we need to be able to say who gets it first, in an equitable manner.

Madhi pointed out that sub-Saharan countries have not invested in building capacity and capability to produce vaccines. 

“That is why we are always at the mercy of every other pharmaceutical country.”

He said the onus was on these governments to stimulate production capacity.

Madhi, who is confident that a vaccine will be developed, said the rapidly increasing infection rate in South Africa may speed up how soon they get an answer whether the vaccine works, possibly by November.