The COVID ‘vaccine war’ that everybody loses

This is a story about the coronavirus vaccine. But not about the vaccine itself. (It doesn’t exist.) Nor whether it will be efficacious. (We simply don’t know yet.)

It’s about how the quest for a vaccine is getting caught up in a political tangle at the heart of the world’s response to the pandemic: the tension between the obviously international scope of COVID-19’s public-health challenge, and national governments’ urge to prioritize their own agendas and their own citizens.

This struggle – a kind of vaccine war – is playing out in real time. Its resolution could go a long way to determining who actually gets a vaccine, if and when a safe and effective one does emerge.

At least so far, it’s the nationalists, not those pushing for a coordinated international plan, who seem to be winning.

A host of countries with major economic clout, sophisticated vaccine labs, or both – including the United States, Britain, European Union countries, Japan, India, China, and Russia – have been pouring billions of dollars into research on a range of possible vaccines and pre-purchasing many hundreds of millions of doses.

But people in the poorer countries in Africa, Asia, and Latin America, with vulnerable populations and overtaxed public health systems, could find themselves last in line, or simply ignored.

There lies the potential peril of the “vaccine nationalism” that the World Health Organization warned of last week.

Baby steps toward cooperation

There have been some signs of internationalism. Scientists and researchers across the globe have been in unprecedentedly close contact in the search for ways to limit the spread of the virus. A number of the companies developing potential vaccines have pledged to supply less developed countries. Even some of the countries rushing to pre-pay for their own stocks have devoted at least some funds for that cause. 

Central to that effort has been a 20-year-old organization called Gavi. It’s a partnership among bodies like the United Nations, the WHO, and the World Bank, national governments, private businesses, and philanthropists, including the Bill and Melinda Gates Foundation.

A Gavi “virtual summit” hosted earlier this summer by British Prime Minister Boris Johnson launched a fund, initially worth $500 million, to purchase COVID-19 vaccines for developing countries. The major U.K.-based pharmaceutical company AstraZeneca pledged to participate by providing doses of the vaccine it has been working on with Oxford University.

Just last Friday, the Gates Foundation gave $150 million to the Serum Institute of India, the world’s largest vaccine manufacturer, to produce 100 million doses of the Oxford vaccine for less-developed countries.

Yet all of this falls short of a coherent international plan for how COVID-19 vaccines might best be bulk-purchased, produced, bottled, verified as safe and effective, and then distributed worldwide – in both wealthy nations and poorer ones.

The argument in favor of such a plan would seem strong. While scientists are working on some 160 candidate vaccines around the world, and subjecting a few to advanced testing, there’s no way of knowing yet how effective, or safe, any of them will prove, or whether there will be an adequate supply.

There will also be a need for billions of high-standard vials, mainly produced in European countries and China – giving those countries potential leverage if, for instance, an eventually successful vaccine were produced somewhere else and a free-for-all to get hold of it broke out.

Politics prevail, for now

Some degree of “vaccine nationalism” is inevitable and understandable. But the assertive, at times virulent, brand of nationalism in today’s world, and growing tension between its key powers, are making international coordination difficult.

That’s particularly true of the United States. U.S. leadership has been critical to past responses to worldwide public health challenges.

The Trump administration has effectively ruled out pandemic response cooperation with the world’s second-largest power, China, blaming Beijing for the spread of the coronavirus. Far from signaling a readiness to participate in an internationally coordinated plan, President Donald Trump recently announced his decision to withdraw the U.S. from the WHO.

He has also held out the hope of a successful vaccine becoming available to Americans by Election Day on November 3.

Both China and Russia – with domestic political imperatives of their own – are pushing to develop early vaccines. Russia this week actually became the first country formally to approve its vaccine, even before it had completed clinical trials. India is sprinting ahead as well. To the public alarm of health experts there, the government has accelerated normal testing procedures and said it can start rolling out a vaccine by August 15, the country’s Independence Day.

The concern for organizations like the WHO and Gavi is that, since early supplies of any effective vaccine will be insufficient to meet global demand, wealthy states will spend whatever they can afford to buy doses of apparently promising candidates, making them unavailable to the rest of the world.

Proponents of a coordinated international response hope to convince decision-makers – in governments, as well as in pharmaceutical companies – that a far greater degree of international cooperation is a matter of simple enlightened self-interest.

However much national governments have been spending on candidate vaccines, after all, a large number may end up failing. National competition could also snarl global supply chains of vials and other items, not to mention stymie the reopening of borders and reinvigoration of trade if not all countries are equipped to suppress the virus.

Seth Berkley, CEO of Gavi, made the point at its recent summit. “One thing that has been made all too clear over the past few months is that this [pandemic] does not respect borders,” he said. “This global problem requires a global solution.”