Vaccine Race: Who Will Recover from Covid-19 First?

by Begüm GÜVEN

Nobel winning biologist Joshua Lederberg once stated that “The single biggest threat to man’s continued dominance on the planet is the virus.” But for a long time, scientists had believed that the upcoming threat would be because of influenza viruses. So accordingly, the pharmaceutical industry was prepared for that type of viruses. Influenza, known as flu, was well known and some countries had sleeping contracts for possible treatments when the 2009 ‘bird flu’ pandemic hit the world. However, nobody had foreseen that the next pandemic would come from coronavirus; hence nobody signed a contract nor researched for coronavirus vaccine. Yet, companies have acted quickly and are now in competition with each other in the so-called ‘COVID-19 vaccine race.’

According to WHO, Oxford University has made an agreement with AstraZeneca for a vaccine by the end of 2020. There is also the COVAX pillar which focuses on collaboration between countries not only for development but also for manufacturing the vaccine. COVAX facility is created by Gavi, the vaccine alliance, and its aim is to distribute vaccines as equally as possible. They want to protect 20% of self-financing countries, which is debatable given the urgency and spreading rate of COVID-19. Some of their partners include Bill & Melinda Gates Foundation, UNICEF, WHO, and The World Bank. (1)

(vaccine development according to GAVI) (2)

In order for vaccines to be public, they need to go through developmental and clinical phases. There are possible candidates for the vaccine at the moment, and each is varied in their distance to the finish line.

EU countries signed a contract amongst themselves and also organized a pledge with countries outside Europe such as Canada, Japan, and Saudi Arabia. Related to their collaborative work, Oxford University is known to be in Phase 3 of its research, which means the ChAdOx1 vaccine has started its trials. China has already started to use the Ad5 vaccine, limitedly in its military; since it is still in Phase 2 and hasn’t finished its development yet. North Korea also claims that it has started its clinical trials, and company Pzifer received  $1.95 billion from the Trump administration on July 22 (3). Turkey is also collaborating with Russia for the coronavirus vaccine and it is said that the vaccine has passed animal testing so far. Hacettepe University is one of the centers working on vaccines in Turkey as well.

However, supposing that a vaccine will be handed to the world, ready to use, by the end of 2020; another question related to the accessibility of the presumed vaccine comes to mind: who will get the vaccine first? And who should get the vaccine first? It is easier to determine the high-risk population within the country; but when the situation becomes international, politics start to interfere in the distribution of vaccine and thus ranking countries’ urgency accordingly. US officials are considering to put Black and Latino people as first to get vaccinated since they were affected unproportionally by the pandemic. It is also advised to get health-care workers and elderly people vaccinated first. But the rest lies in the contract of governments: which countries will be the first to offer their people a proper vaccine, depend on their contract with companies and other governments.

Scott Gottlieb, the former Food and Drug Administration Commissioner of the US, stated to Wall Street that "The first country to the finish line will be first to restore its economy and global influence. America risks being second". Yet, companies that the US has an agreement with, such as Biontech and Pfizer are not doing bad on their human trials. China is also working on its existent vaccine and trying to reach phase three. Australia with Clover, the UK with Oxford are also seeing progress in their research. The Gates Foundation has been one of the non-profit organizations funding the researches. (4) (5) (6) (7)

Yet, it is always a concern that countries that cannot afford such development programs can be left behind. UN organizations Red Crescent and Red Cross stated that it was a moral duty to make the vaccine available for everyone. Britain and the US spent millions of dollars to such companies and are expecting priority treatment in return. On the other hand, AstraZeneca and Johnson & Johnson are considering to make the vaccine available at no profit during a pandemic for every country. Other than that, we cannot say by certain how transparent the process of distribution (both that of knowledge and of possible vaccine candidates) will be worldwide. It took almost 10 years for HIV/AIDS treatment to reach low come countries, which is worrying in the COVID-19 context. Dr. Soumya Swaminathan, the WHO's chief scientist, said that "We don't want to be in a situation where there are doses of a vaccine but they're just available to some countries. We need to have a consensus on that so we can agree to share the vaccine in a way that protects the most vulnerable. " (8) (9)

On an interview with Gavi’s CEO Seth Berkeley, he pointed out that “the challenge here is there is an assumption that if I can just get enough vaccine for my country, my populations, I’m fine,” and warned that “if you want to go back to normal, what you’ve got to have is a situation where you’ve really suppressed the disease around the world. And that’s going to be critical if we ever want to go back to having a trade, commerce, tourism, and movements around the world.” (10)

If we want to achieve herd immunity, meaning that if we want it to stop spreading so easily, we would need 60-70% of people to be immune to the virus. In worldwide, it amounts to billions of people. (11)

It is no doubt that this waiting for a treatment for coronavirus is one full of anxiety. And similar to most expectations we have from the future, it is doubtful that it will go according to what we know today. As to leave it on a hopeful mindset, we can end with Gavi’s vision of Phase 5. With Gavi 5.0, they want to “leave no one behind with immunization” within the years 2021- 2025. It would be best for everyone to acknowledge that efforts should be international, and otherwise, it would amount to nothing in this globalized world of ours.

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