Regional vaccine production is key to ensuring equity

Ensuring equal access to vaccines for rich and poor countries is of utmost importance to humanity.1 Standing by as millions of people succumb to “preventable death” is unethical.

When the pandemic began, millions of people died (including in rich countries) as the result of a lack of emergency preparedness and inadequate investment in public health infrastructure.2 Now, millions of people are dying in poorer countries as the result of insufficient access to vaccines. Meanwhile, the virus continues to mutate, endangering all nations, even the wealthy ones.

Soon after the World Health Organization declared the pandemic, it established a global collaborative initiative to accelerate the development of diagnostics, treatments, and vaccines (called Covax) and ensure equitable access. Although vaccine development was successful, access to vaccines has been uneven and unfair owing to vaccine nationalism.3

Recent developments do not look promising for global health security. A group of countries led by India and South Africa has urged the temporary removal of intellectual property protection from vaccines at the World Trade Organization, supported by the United States but opposed by Germany.4 Now more than ever, we need a strong and independent WHO to keep the world safe and protect the vulnerable. Unfortunately, it has been plunged into severe financial difficulty. It is unrealistic for member states to expect WHO to perform its mandate without providing sustainable, predictable, and conflict-free funding. Moreover, WHO’s dependence on voluntary contributions has created conditions in which external donors dictate the organisation’s agenda.5

Patents, complexities of technology transfer, funding, and sustainability issues are barriers for establishing regional vaccine manufacturing hubs.36 Vaccine donations, even if well intended, only continue to perpetuate the reliance of developing countries on wealthy nations, which seriously threatens global health security. The only way to ensure equitable access to vaccines, at least in the next pandemic, is by strengthening regional production capacity. Regrettably, in the 12 years since the last pandemic, there has been much rhetoric but little progress in this regard.