What’s behind the slow Covid-19 vaccine rollout?

The rich nations just got a taste of their own medicine.  

Late last month, officials from the European Union and the UK were embroiled in a tussle over who’d get the vaccine jabs made by AstraZeneca that has faced hurdles in ramping up supply. 

European Union leadership is facing a public backlash as its vaccination drive lags behind that of the US, UK, Israel and a few other countries. 

Some European officials alleged that AstraZeneca, which is headquartered in Cambridge, UK, was diverting EU-bound supplies to Britain. There were even calls for the EU to block vaccine export. 

“It’s absolutely shameful what has happened between the UK and EU,” said Ellen ‘t Hoen, director at the Medicine Law and Policy, an NGO which advocates affordable drugs. 

A rush by wealthy countries to secure supplies without giving much thought to equitable distribution has led to vaccine nationalism, she told TRT World in a recent interview.  

AstraZeneca, which developed its vaccine in collaboration with Oxford University, has production facilities in the UK, Belgium, Netherlands, Italy and Germany. 

The company said it has contractual obligations to meet British needs first since the UK government signed an agreement months ahead of the EU. 

The EU recently started receiving AstraZeneca vaccines but production bottlenecks at its Belgium plant meant that authorities had to revise its vaccination target. 

Initially, the EU was supposed to get 81 million doses in the first three months of 2021. But now it will get 31 million shots, down 60 percent. 

Pascal Soriat, AstraZeneca’s CEO, said the EU was still getting 17 percent of what his company was producing every month even though the bloc accounts for only 5 percent of the global population. 

Rich countries have mopped up most of the world's vaccines. Besides AstraZeneca, two other companies - the Pfizer-BioNtech duo and Moderna - have signed multiple agreements with wealthy nations in exchange for investment. 

More than 150 million doses have been administered so far around the world - most of them to people in advanced economies (it’s unclear in how many cases the two-dose course has been completed). 

A way out

Now it’s becoming apparent that despite paying hundreds of millions dollars, supply bottlenecks can slow down vaccination drives. 

The EU has vaccinated only 4.32 people out of every 100 - far behind Israel, UAE and Chile, which are buying vaccines from other countries, according to Our World in Data, a project of the University of Oxford. 

For months global health activists have argued that the only way to speed up vaccination against the Covid-19 pandemic is to make vaccine know-how widely available. 

Led by South Africa and India, a group of developing countries are seeking a waiver of the World Trade Organisation’s (WTO) treaty that protects medicine patents including those on Covid-19 vaccines and treatments. 

But rich countries including EU member states, UK, US, Canada and Japan have opposed the proposal even as the pandemic continues to kill thousands of people every day. 

“It’s extremely short-sighted given the nature of a global pandemic, that the longer it takes to reach global vaccine herd immunity the greater the risk of less treatable or more lethal variants, and the worse the ongoing economic recession,” said Ronald Labonte, a global health researcher. 

The World Health Organisation, UNAIDS, China and a few EU lawmakers have lent support to the India-South Africa push, which experts said can greatly improve vaccine delivery. 

Western pharmaceutical companies said protection of intellectual property was important to protect their investments. Vaccine development generally takes years, but for Covid-19 the entire process including the expensive three-tier trials was completed in a matter of months. 

But Pfizer-BioNTech, Moderna and AstraZeneca have either received direct government financing or made use of publicly-funded research. 

Left on their own, developing countries are now looking toward China and Russia, which are distributing their vaccines free of cost.

There have been a few examples in the past where governments have stepped in and forced multinationals to share patents so generic makers can increase production of a drug.

One high profile case involved South Africa, which in the late 1990s decided to introduce generic drugs to treat HIV/Aids in a bid to counter the high-priced treatments sold by multinational companies. 

Despite Aids killing millions of people in sub-Saharan Africa, 39 companies took South Africa to court. But the legal action had to be abandoned because the companies realised their position was leading to negative publicity. 

For the Covid-19 vaccines, pharma companies have evaded similar scrutiny by keeping vaccine prices low and striking deals with governments, which are desperate to revitalise their economies. 

Supply constraints mean that it won’t be until 2024 before a sizable part of the population in low-income countries is vaccinated, said Labonte. 

“The worst case projection I’ve seen thinks it might be 7 years before we reach global herd immunity.”