To address vaccine inequity, boost regional manufacturing capacity — International Vaccine Institute

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The world makes two billion coronavirus disease 2019 (COVID-19) vaccine doses a month, yet 95% of people in low-income countries have yet to receive a single dose, said Dr. Jerome Kim, director general of the non-profit International Vaccine Institute.  

“Manufacturers deserve a lot of credit for developing vaccines within 11 months of the identification of a pathogen,” Dr. Kim said in a Nov. 22 discussion at the Future of Healthcare Week Asia event organized by The Economist. With the uneven global distribution, however, “there’s something about making regionally that we have to work on in order to achieve the kind of equity we’ve been talking about.”  

To prepare for the next inevitable pandemic, issues on equitable distribution — including strengthening manufacturing and diagnostics capacities on the regional level — have to be addressed. 

Funding for COVID-19 treatments, diagnostics, and equipment is short by $13.7 billion as of October, according to the World Health Organization (WHO). 

“When you look at the map of where variants are being sequenced, when you look at the map of where COVID-19 diagnostics are being done, they’re not being done in countries with the burden of the highest number of unvaccinated people,” Dr. Kim said. “What’s emerging in those areas and what have we really done to address this?”  

Omicron, COVID-19’s latest variant, was first reported to WHO from South Africa on Nov. 24Only five of Africa’s 54 countries are on track to reach the target of fully vaccinating 40% of the population by end-2021.  

Asian countries, said Dr. Kim, have done well on keeping people alive while having reasonably functioning economies.  

“It’s hard to say there was a country with a playbook that everyone knew was going to work,” he said. “I don’t want to say cut them some slack, but it is very difficult to devise policy in the middle of the pandemic.”   

Taiwan, which had a streak of 253 days without a single reported infection between April to December 2020, was earlier hailed as one of the world’s COVID-19 success stories. 

“We have done to the extent possible the best we could,” said Kung-Yee Liang, president of Taiwan’s National Health Research Institutes, adding that government transparency helped gain public trust. “We learned from SARS, MERS, and influenza. I think the public has been well-educated on wearing masks and washing hands.”   

WATCH OUT FOR AMR 
Not to be discounted is the looming threat of antimicrobial resistance (AMR), which was also tackled at the Nov. 22 event. AMR refers to drug resistance that is driven by the misuse and overuse of antibiotics, which encourages bacteria to evolve to survive and develop new ways of beating the drugs.  

“The current crisis has reinforced the need to develop medicines now — to prepare for the next public health,” said Pierre Gaudreault, Pfizer Biopharmaceuticals Group’s president of Asia (emerging markets). “Unlike COVID-19, AMR is a threat that we’ve seen coming for years.”  

The World Bank’s 2016 research shows that AMR could cost 3.8% of the annual global Gross Domestic Product by 2050.  

China, Mr. Gaudreault said, has a very strong antibiotic stewardship program. The said program was created in synchronization with the pharmaceutical industry, and encompasses physician training, tracking systems, as well as the deployment of educational tools for patients.  

“It’s a good example of what we could replicate in some other countries in Asia,” he added.  

In Taiwan, a survey found that 85% of individually acquired AMR in came from the farm system.  

“There were constant talks between the Ministry of Health and the Ministry of Agriculture on whether we could have better regulation to prevent this,” Mr. Liang said. The balance between farming for profit and human health is not easy, he added. “I am hopeful that this crisis will draw attention to this [concern].” — Patricia B. Mirasol 

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