In May 2020 the US government struck a deal 1.2 billion dollars will go to British drugmaker AstraZeneca to speed up their Covid-19 Vaccine research. In exchange, AstraZeneca promised the US 300 million doses. Earlier that month the UK signed a similar deal with the same company to secure 90 million doses. These types of transactions where a country makes a direct deal with the company are bilateral deals. And in 2020 rich countries made a lot of them.
Those billions of dollars helped us fund research that brought us the world’s leading Covid vaccines in record time, but that money also determined where these vaccines go. By January 2021, 96% of the Pfizer-BioNTech vaccine doses that were scheduled to be produced by the end of the year had already been bought and 100% of Modern. Countries representing 16% of the global population held over half of the doses from the most successful vaccine developers. Basically, rich countries got vaccines and poorer countries didn’t.
In Brazil and India, the health system has been pushed to at the same time the US is quickly opening up vaccinations for everyone. The same deals that helped develop vaccines are making it harder to get them around the world. What’s happening now with the Covid 19 vaccine inequality isn’t all unprecedented. For years we have seen how technology is rolled out in rich countries and it takes decades for them to trickle down to poorer countries.
The problem starts with the vaccine market itself, getting a vaccine from development, to manufacturing, to distribution is a multi-step process.
With making Bilateral deals with developers and suppliers early on Rich countries got in line ahead. But there was no guarantee that any given vaccine would work or get past regulators to reach the market, if a vaccine fails shortly after funding those billions of dollars are lost. So to offset that risk countries invested in multiple options, often securing enough doses to cover their population several times.
As of March 2021, Canada had secured over 300 million doses i.e. 8.7 doses per person.
Most countries cannot afford to make multiple high-risk investments early on, so they wait until the vaccine is further in the approval process, and by then they are already at the back of a very long line. Those who have invested in research and development are standing at the front of the line which is why the US has 240 million doses so far and most poorer countries don’t even have 240 million doses combined. This is making the pandemic last longer, It is allowing infections to rage and new variant’s to arrive and at the end of the day, more people are dying than need to be. Peru made a bilateral deal with AstraZeneca but won’t see those doses until September 2021. Vaccines have reached a huge number of counties but nowhere near enough to even cover frontline health workers or other essential workers.
Vaccine inequality is bigger than just bilateral deals; it's in every step of the process, from limited manufacturing to cold-chain distribution. Our current system is not a well-oiled machine; there is a lot of work to do if we want to be better prepared for the future.
This article has been written by Siddhesh Patil for The Paradigm
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