Home ›› 31 May 2022 ›› Editorial
Over the past two and a half years, we have seen unparalleled innovation and private-public collaboration in the global fight against Covid-19. The rapid development and roll-out of new vaccines, diagnostic tests and therapeutics have saved millions of lives.
However, these developments have not benefited everyone equally. Although more than 67 per cent of the global population has received at least one dose of the Covid-19 vaccine, disparities between the higher and lower income countries are wide. As of this month, 72 per cent of people in high-income countries have received one dose, compared to 18 per cent in low-income countries, according to the United Nation’s Development Programme’s Global Dashboard for Vaccine Equity.
This disparity is a pattern that extends across the three most critical medical countermeasures against the pandemic: vaccines, tests and therapeutics. While high-income countries have conducted 42 tests for every 1,000 people per day in May, low-income countries have conducted just 1.95 tests for every 1,000 people, according to the Global Covid-19 Access Tracker. The use of therapeutics, while limited across the globe, is almost non-existent in poorer countries.
In fact, equity is not just a moral imperative; it safeguards our collective global health. The emergence of the Delta and Omicron variants saw the virus running unabated in low-income countries and quickly spreading to the rest of the world. Unless we take bold steps to change how we produce and allocate these life-saving tools on a global scale, we risk repeating the same mistakes in the future.
Meanwhile, the markets for vaccines, tests and therapeutics are fragile; the emergence of a new disease or variant in one area of the world can upend demand and supply in another. In order to be more prepared for the next global health emergency, we must design supply chains that are built to cope with demand uncertainty and balance effectiveness with equity.
Also this month, the US co-hosted the second Global Covid-19 Summit to increase global access to vaccines, tests and treatments while building preparedness for future health emergencies. The summit yielded $3.2 billion in financial commitments from public, private and nonprofit organisations and contributed to the new pandemic financing fund. This week, at the 75th World Health Assembly, creating a “new architecture for health emergency preparedness, response and resilience” is one of the five priorities to achieve “health for peace, peace for health”.
However, financial pledges and aspirational goals are not enough. Vaccines, tests and therapeutics require hundreds of inputs produced in countries across the globe. Therefore, we need a global governance structure to oversee the flow of these critical medical supplies. But co-ordination is easier said than done.
Now, we must get three components of the supply chain right: better sharing of market risks across public and private actors; flexibility in manufacturing to allow timely change in product mix; and geographical diversity of production facilities for global supply resilience.
Typically, around the world, vaccines, therapeutics and diagnostic tests are developed by private companies, with private capital and government funding for upstream research. Setting up large production plants, however, requires additional investments, which may not be as forthcoming when demand is highly uncertain. Incentives between private companies, governments and international organisations have to be aligned to maximise production and ensure sustainable supply. To put it simply: private companies are unlikely to produce billions of medical supplies when demand can change any moment.
Therefore, governments and multilateral organisations must pay producers to take on risks for the benefit of all. How? Through advance purchase agreements that guarantee a minimum order over a defined time period, regardless of market demand.
While some governments implemented advance contracts for vaccines, they had not done so with diagnostics and therapeutics. For example, last fall in the US, as hopes soared for a return to “normal life”, mass testing and vaccinations sites closed. But when Omicron hit, self-test kits were out of stock and appointments at test centres were filled to capacity. When US President Joe Biden announced that the government would purchase one billion rapid tests to distribute for free to Americans, manufacturers could not ramp up production fast enough. Similarly, the demand and supply for the oral antivirals Paxlovid and Molnupiravir have been volatile, alternating between low supply or sufficient supply but limited demand.
thenational.ae
