How do we prevent such a pandemic from happening again? As we ask this question, there will inevitably be a review of the mistakes made with COVID-19, and rightly so. But it’s also important to learn from the things we did right because this pandemic could have been worse, much worse. So if we are to make sure this is the last pandemic to wreak havoc on this scale, then not only do we need to build on these successes, the time to do so is now.
One of the greatest of these successes has been, without question, the unprecedented speed with which vaccines have been developed, approved, and introduced, and not just for those who can afford to pay. This has already saved countless lives and made the end of this global crisis tangible. However, to avoid a repetition of this catastrophe, we still have to figure out how to avoid delivery bottlenecks so that we can get there faster; According to some people, this means being ready to deliver vaccines within 100 days of a pandemic being declared. Solving this doesn’t have to reinvent the wheel. In addition, we already have a model of how we fight the flu.
To understand how, you should first consider what we need: the ability to rapidly and at breakneck speed to develop and approve vaccines that protect against an as-yet-unknown threat; Increase and globalize the production of vaccines by outsourcing them from the global north and building capacity in the global south, and by increasing the use of technology transfers so that we are able to produce extremely large quantities quickly – more than normally worldwide in a certain year – this is how people are protected everywhere; and we need a global distribution network and supply chains to actually get these vaccines to the people.
With COVID-19, the scientific and vaccine-making community and new organizations like the Coalition for Epidemic Preparedness Innovations (CEPI) have rallied and got us not just one, but more than a dozen approved vaccines at record speeds – just 327 days for the first . Even so, we didn’t get enough doses, or at least we won’t get them quickly enough. In a pandemic, speed is of the essence; It is not enough to just protect people in some parts of the world and keep the rest of the world waiting. To stop the transmission, people at high risk must be given priority everywhere.
This is all the more frustrating as COVID now gives us an opportunity to ensure equal access so that people in countries that cannot afford these vaccines can still get them. Compared to the last pandemic in 2009, we were able to deliver vaccines to people in lower-income countries twice as quickly, four times as many countries and with seven times more doses in a comparable period of time. Of course, that’s not good enough. What is noteworthy, however, is that, unlike the flu, we did this without approved coronavirus vaccines and without a dedicated global pandemic network already in place.
This was made possible because 193 economies came together to support the COVAX Facility, an initiative launched to provide quick, fair and equitable access to COVID-19 vaccines. Founded as one of three pillars of the Access to COVID-19 Tools Accelerator, COVAX draws on the already existing strengths of the three leading organizations, the World Health Organization, the Coalition of Epidemic Preparedness Innovations (CEPI) and Gavi. The latter, which I lead, is itself a vaccine alliance made up of a number of global health partners, including UNICEF, the World Bank, and a global network of civil society organizations, all of whom are involved in this effort.
While we didn’t have the capacity or funding to begin with, we were able to build on these pre-existing strengths to bring together all of the pieces needed to not only accelerate COVID-19 vaccine development and availability, but also to ensure that compensation, Liability and compensation guaranteed. Safety nets were in place, quickly securing more than 1.3 billion doses to people in 92 low-income countries who may not be able to afford them and may therefore be left behind. All of this allowed us to start rolling out to these countries and ensuring that all logistics, personnel, monitoring and data systems were in place just 39 days after people in high income countries received their first vaccination.
By far the biggest missing piece is how we get cans faster. More than 1.5 billion have been produced, but we are still seeing the same kinds of vaccine nationalism and export restrictions that plagued us during the 2009 swine flu pandemic, when we just own almost the entire global supply of cans a handful of wealthy countries, few of which are left for the rest of the world.
With COVID, we are trying to accelerate equal access so people can get them even faster by encouraging governments to donate their excess doses to COVAX until more deliveries go online, but in the long run we cannot assume that future pandemics will Governments will no longer put national interests first. Technology transfers have also made a major contribution and are one of the reasons we have been able to get vaccines so quickly in the amount we have. Here, vaccine developers share both their intellectual property and the know-how necessary for the manufacture of vaccines with other manufacturers, especially in emerging countries. But there aren’t enough of these transfers; we need more, including more geographical diversity at the production sites.
So the only watertight solution is to increase and globalize the global supply. One way to do this is to increase manufacturing capacity around the world; the ability to suddenly produce large quantities at high speed during a crisis, without leaving factories idle for the rest of the time, is to be inspired by our pandemic flu preparedness.
Influenza has been the focus of pandemic preparedness so far, and for good reason. There have been four influenza pandemics in the last century. So we’ve had a global network of suppliers ready to make pandemic flu vaccines on demand for decades, but the rest of the time these facilities are busy making seasonal flu vaccines to protect the most at risk from non-pandemic strains of flu . If a pandemic flu breaks out, these facilities can quickly move production to make vaccines against the pandemic strain. It’s a system that works largely, but we need to replicate that model now for a wider range of pandemic threats.
The way to do this is by building on our existing global supply chains, such as the routine vaccination programs that currently vaccinate 90 percent of children worldwide against vaccine-preventable diseases. We already have a global supply and distribution network here, and in the last 20 years organizations like Gavi have helped expand and enlarge this from five manufacturers to 17 only for developing countries. If we continue to expand and build capacities, especially in emerging markets, and ensure that the supply chains for equipment and materials are robust so that the Global South is able to manufacture its own vaccines, we can not only supply these vaccines, but with Technology transfers can be used in the same facilities to increase the global supply and access to pandemic vaccines as needed.
Most of what we need to avoid repeating this crisis already exists, especially now that we have a connected solution like COVAX. We just need to make sure that the partners have the capacity to grow quickly and that there is emergency funding in place so that efforts are adequately resourced to meet the sudden needs caused by a pandemic. But we also urgently need to invest in additional manufacturing capacities in the Global South. It won’t happen overnight. But if we start now, we can be sure that we are prepared for the next, because there is an evolutionary certainty that there will be another.
This is an opinion and analysis article; the views of the views Author or authors are not necessarily those of Scientific American.