The next COVID challenge – mass immunization

In the past few days, German-US company Pfizer BioNTech and US company Moderna have separately announced that the COVID-19 vaccines they have been developing have tested ninety five percent effective. Both subsequently said they will now apply to regulators to produce and introduce the vaccines.

Both were among the 48 candidate vaccines worldwide that the World Health Organization (WHO) identifies are at different stages of development using different methods of combating the virus. There are also a number of bio-pharma products that are being developed, being trialled, or already in limited use, that enable many critically ill patients with COVID-19 to improve.

The announcements and others expected soon are a sign of hope. They raise the obvious questions about which countries will have early access to the vaccine; the extent to which the nationalism of money and vaccine will determine how whatever is available will be distributed; and how will the Caribbean, a region already suffering economic hardship as a result of the pandemic, thrive in the global competition for entry?

Thankfully, almost all Caribbean states now have arrangements and support measures to purchase quantities of COVID-19 vaccines as soon as they become available in 2021.

Unlike the difficulties faced in 2019 during the H1N1 pandemic when the poorest countries of Latin America and the Caribbean had access to a vaccine six to eight months after the region’s richer countries, such problems are not expected to arise this. Instead, the WHO COVAX facility will ensure that the Caribbean and other similar regions are treated fairly.

COVAX is a co-operative involving the World Health Organization and other global partners. By encouraging wealthier nations to commit to funding and purchasing Coronavirus-related vaccines, it is able to generate a critical mass of orders from suppliers in a way that ensures low and middle income countries can receive one of a number of vaccines. linked to at a lower price. So far most rich nations except the US and Russia have offered their support as have many vaccine producers.

COVAX also supports capacity building and manufacturing procurement with the overall aim of making 2bn doses available for ‘equitable distribution’ globally by the end of 2021 with one or more nine COVID vaccines being made available develop globally it supports.

Speaking recently about the facility for an online ‘COVID Talk’ organized by the Jamaican Ministry of Health, Assistant Director of the Pan American Institute of Health (PAHO), Dr Jarbas Barbosa, said that arrangements have been put in place for countries in the region where you do not have the spending power to negotiate with multiple pharmaceutical companies, to ensure access to vaccines when available. He also said that the region should not worry about safety and effectiveness as the WHO COVAX mechanism requires purchased vaccines to be “over-applied” as an additional guarantee that they are “the best available vaccines”.

His assurances follow earlier statements by the Caribbean Public Health Agency (CARPHA) and PAHO that, with EU financial backing, they have secured the lower payment required to support a number of Caribbean states to buy proven proven vaccines through the WHO facility.

According to a statement, the EU recently agreed to use € 2m (US $ 2.3m) of a much larger grant to CARPHA, for the purchase of vaccines or treatments as they become available. The amount is for a lower payment to cover about 15% of the value of the vaccines required by seven of CARPHA’s top twelve middle-income member states that have agreements with Gavi-the Vaccine Alliance and the COVAX facility administrator.

The funding is intended to enable Antigua, Barbados, the BVI, Cayman, Jamaica, Turks and Caicos, and Suriname to acquire vaccines to cover between 15% to 33% of their populations. CARPHA also noted that all but Suriname will be supported with funding passed through PAHO and Gavi with 100% deposit of what is required by the COVAX Facility.

Other countries that have agreements with Gavi are The Bahamas, Belize, St Kitts, and Trinidad. Haiti is already included as a low-income country in the Gavi-COVAX higher market commitment mechanism, while Guyana, Dominica, Grenada, St Lucia, and St Vincent qualify for International Development Assistance according to a recent presentation by the GAVI board.

In the meantime, Cuba is developing its own vaccine and is in discussions with France and the World Health Organization about vaccine cooperation. Its Finlay Vaccine Institute and representatives from PAHO and WHO recently met to discuss progress on its candidate vaccine Soberana-01, and Cuba is drawing up an industrial strategy to allow millions of doses to be initially produced for national use once clinical investigations have done that. successfully concluded.

The country is also according to BioCubaFarma the management group that brings together the country’s advanced biotechnology research and production facilities, overseeing the development of three other candidate vaccines undergoing clinical trials as well as other planned products to strengthen the immune system in those. at risk of death from the disease.

In the case of the Dominican Republic, which is viewed by Gavi as self-financing, it is not clear what arrangements have been put in place, although earlier this year its President, Luis Abinader, said the Government will deposit money to buy 1m doses of the vaccine being developed by AstraZeneca and the University of Oxford. According to the World Health Organization, the Dominican Republic is also one of 80 countries that have submitted expressions of interest to the COVAX Facility.

This means that hopefully, sometime soon, the challenge of halting the tide of the pandemic will be overcome in the region by the complex logistical problems associated with delivering national vaccination programs, issues such as who will have primary access And, just as importantly, granular issues such as the availability of reliable IT systems to ensure accurate electronic immunization records exist for all citizens.

As hope for the end of the pandemic can be at hand what is also needed if effective vaccine delivery, equitable and global, is international leadership. The next steps in the fight against the pandemic will mark the place of multilateralism and fairness in a world that desperately needs consensus.

David Jessop is a consultant to the Caribbean Council

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