- Pablo Ochoa
There is a major positive step amid the chain of negative events brought about by the Corona pandemic.
We have moved from the stage of discovering a deadly virus and declaring a pandemic, to manufacturing two billion doses of the Corona vaccine in record time, in an attempt to curb the spread of Covid-19.
If the predictions are correct, there will be enough vaccines to vaccinate the world’s adults – 5.8 billion people – by the end of this year.
But there is a problem related to the geographical concentration of manufacturing sites, in addition to the small number of countries that provide the vaccine, which threatens the idea of distributing vaccines fairly among everyone.
How does this issue crystallize? Here we review some of the factors that affect the global availability of the vaccine.
Experts predict the acceleration of the vaccine manufacturing process in the third and fourth quarters of this year, after the beginning of a turbulent start.
More than 12 billion doses are expected to be produced this year, according to estimates by the Duke International Center for Health Innovations.
Irfinity, which monitors the production and provision of Corona vaccines, estimates that the number of manufactured doses will reach about 11.1 billion doses by the end of 2021.
The company believes that this will be enough to deliver the 10.82 doses required to vaccinate 75 percent of the world’s population over the age of five years.
Andrea Taylor, assistant director of the Duke Centre, tells the BBC that the pandemic has shown “the absence of a sound and effective distribution network around the world”.
He adds, “The location of the manufacturing is very important. The manufacturing capacity of many companies is concentrated in the United States and Europe, which are the regions that got the vaccine first because they manufacture it, and they can use tools such as export restrictions to make sure that their people get the vaccines before the global market.”
supply chain challenges
Vaccine manufacturers are facing difficulties in providing raw materials, as well as the time required to share expertise and manufacturing technology between countries.
Therefore, many of the sites that were supposed to carry out the manufacturing process (as shown on the map) were closed.
The ways in which vaccines are affected by this kind of restrictions vary.
Irfinity predicts that three vaccines will dominate the global market this year: Pfizer-Biontech with 2.47 billion doses, Oxford-AstraZeneca with 1.96 billion doses, and Sinovac with 1.35 doses.
So far, Pfizer and Sinovac have maintained their core manufacturing goals.
As for AstraZeneca, it announced its plan to manufacture three billion doses this year. The company needs companies that rely on them to manufacture this quantity in different locations, which means the need to share expertise and technology.
“It took AstraZeneca a lot longer to deal with these things,” Taylor says.
“And I think this is happening with other vaccine manufacturers, they are also working to transfer expertise and secure global partnerships. But it takes more time.”
In contrast, Pfizer and Sinovac produce their entire vaccines.
Export restrictions also affect the geographical spread of vaccines.
These problems are exacerbating the crisis in developing countries, says Matt Linley, senior analyst at Irfinity.
“It is expected that most of the doses will be produced by Pfizer, but all of them will be for the rich countries that can afford them. AstraZeneca is manufactured on a large scale in Europe and India, but these doses remain there.”
According to Irfinity, China is the only country that exports vaccines on a large scale, as it has exported about 263 million doses globally, which exceeds the international Kovacs initiative to distribute vaccines.
Linley says that “China certainly has a big influence in the distribution of vaccines,” while Russia “promised a lot and did not deliver.”
According to Irfinity, Russia had manufactured just over 42 million doses of the Sputnik vaccine as of May 17, and had exported only 13 million of them.
The Sputnik vaccine faces the same limitations as technology sharing agreements. Russia has initially identified 18 global manufacturing centers, but only one factory in Kazakhstan manufactures the vaccine outside Russia.
India announced that it will manufacture the Sputnik vaccine, starting next August, with the aim of producing 850 million doses.
‘No Plan B’
The majority of developing countries rely on the Indian Serum Institute, which used to produce 60 percent of the world’s pre-pandemic vaccines, to obtain the AstraZeneca vaccine.
But India imposed restrictions on the export of vaccines to confront the recent wave of Corona injuries, which affected the share of middle-income and poor countries.
“The over-reliance on India has made the global supply chain very vulnerable,” says Taylor.
He adds, “The failure of this plan would be severe, especially in the absence of an alternative plan. There is no other serum institute in the world to transfer manufacturing operations to.”
The Kovacs initiative was also affected by these obstacles, which means that the process of providing vaccines to poor countries will be affected and the balance of vaccine distribution around the world will be affected.
Kovacs seeks to provide two billion doses of vaccines by the end of 2021, allowing at least 20% of the peoples of the participating countries to be vaccinated, with priority given to those most vulnerable to infection, such as health workers.
But according to the United Nations Children’s Fund (UNICEF), the initiative has so far provided only 72 million doses to 125 countries.
Despite talk of “vaccine policies” and “vaccination synergies,” not many countries were willing or able to send shipments of vaccines.
Irfinity estimates that by the end of 2021, there will be 2.6 billion doses in stock, exceeding the world’s need for vaccines, and an amount that exceeds Kovacs’ distribution targets this year.
The European Union, along with five other countries, the United States, Japan, the United Kingdom, Brazil and Canada, will have more than 90 percent of the global surplus.
Linley says that sharing these vaccines through Kovacs will certainly strengthen the initiative’s position, and help ensure that the most vulnerable are protected in all countries.
But he believes that it is difficult to ascertain what may happen, because the governments of some rich countries have already begun to consider giving booster doses to their citizens, and expanding the umbrella of vaccine recipients to include adolescents.
“A lot of countries that are in advanced stages of vaccinating their citizens have done bilateral deals over population,” Anne Ottosen, director of the vaccine center in UNICEF’s supply division, told the BBC in an email.
According to the Duke Center, 21 rich countries have signed orders that account for 54 percent of orders signed this year, despite representing only 19 percent of the world’s population.
“Rich countries should quickly share their vaccine doses with poor countries in the short term to fill supply chain gaps,” Otosen says.
Countries have been slow to respond to these demands.
The United States announced that it will share 60 million doses of the AstraZeneca vaccine, which has not yet been approved for use. President Joe Biden also said that his country will distribute another 20 million doses of vaccines approved by the authorities.
France also said it will donate 500,000 doses to the Kovacs Initiative by the end of June.
“We are at the heart of the largest and fastest growing, production and distribution of vaccines in history,” says Otosen. “Access to vaccine supplies is our biggest challenge.”
Global health leaders are discussing ways to diversify the vaccine manufacturing process, especially in poor or middle-income countries, to meet the needs of global distribution. But options are limited in the short term.
“Stopping the pandemic requires improving the distribution of the currently scarce vaccines to ensure equal distribution,” says Otosen.