This section collates recent developments impacting the health sector in India.
View All
A new initiative aims to shift the dangerous imbalance in access to medicines, laid bare by the COVID-19 pandemic. It deserves support.
Scientists developed vaccines against a new disease
in less than 12 months. And yet, 18 months after the first of these vaccines, against
COVID-19, were rolled out, just 15% of people in low-income countries have been
fully vaccinated. Such inequity costs lives and unmasks a long-standing
problem: that some regions of the world have been compelled to rely on others
for life-saving science and technology. It is unacceptable, for example, that
in Africa, a continent of 54 independent countries and 1.2 billion people, 99%
of vaccines are imported.
The World Health Organization (WHO) is searching
for a way to get vaccines to more people more efficiently. Last year, the WHO
launched a radical initiative called the mRNA vaccine technology transfer hub.
The aim of the initiative is to set up a system that develops and produces mRNA
vaccines and treatments (for COVID-19 and other diseases) from the technology
used in Pfizer and Moderna’s highly successful COVID-19 vaccines.
Crucially, the ambition is to achieve this through
collaborations between universities and companies based in low- and
middle-income countries. In a significant move, on 8 July, the US National
Institutes of Health, where much of the foundational research on mRNA vaccines
was conducted, joined this mission to build capacity in lower-income countries.
However, as Nature reports
in a Feature, the hub must overcome challenges presented by the global
vaccine market, world trade rules and an intellectual-property (IP) system that
often benefits established corporations, universities and governments in
high-income countries.
One hurdle will be convincing governments and
organizations to buy locally made vaccines: such products might initially cost
more than those made by established companies that produce at larger scales and
can afford to drop prices. But for this initiative to be viable over time,
local manufacturers of mRNA vaccines and therapeutics need to be assured that
there will be demand for their products. For this to happen, up-front contracts
will be needed from buyers.
A key buyer is Gavi, the Vaccine Alliance, a
public–private global health partnership that procures vaccines for dozens of
lower-income countries, funded largely by high-income countries and the Bill
& Melinda Gates Foundation, a non-profit organization based in Seattle,
Washington. Gavi has said that it is committed to supporting vaccine
manufacturing in Africa; however, it has not specified how much extra money it
would spend on regionally made vaccines, and it has not yet promised to buy
vaccines from the companies working with the mRNA technology transfer hub.
In May, the leaders of a number of African Union
(AU) member states called on Gavi to commit to buying at least 30% of all
COVID-19 vaccines produced in Africa as new manufacturers come online. Such a
commitment will be essential to reaching the AU’s ambition for 60% of Africa’s
vaccines to be produced on the continent by 2040.
Adjusting the
scales
Barriers created by IP rights represent yet another
hurdle in the hub’s path. Earlier this year, the company at the core of the
hub, Afrigen Biologics and Vaccines in Cape Town, South Africa, successfully
reproduced small quantities of Moderna’s mRNA vaccine. But Moderna has not
agreed to license its IP or share data that could help Afrigen to ensure that
its vaccine candidate meets similar safety and efficacy metrics.
Sadly, last month, the World Trade Organization
(WTO) ended some 20 months of negotiations on a waiver proposed by South Africa
and India covering IP on COVID-19 vaccines, drugs and diagnostic tests, which
would have allowed faster knowledge sharing. The campaign, which Nature supported,
faced strong opposition from the European Union and the pharmaceutical
industry.
The WTO members instead agreed on a deal to amend
existing rules on IP sharing in emergencies; however, these will be cumbersome
to implement and do not amount to a waiver. Many researchers who have devoted
their careers to studying mRNA want to see it save more lives, rather than
widen inequality, and question whether the current IP regime is, in fact,
stifling the kind of innovation that could see the mRNA hub succeed.
The hub is a refreshing, ambitious alternative to
the existing model for vaccine research and development (R&D). With
collaboration and knowledge sharing at its core, it aims to create and boost
home-grown R&D and innovation in low- and middle-income countries. But it
is clearly a threat to a system in which companies are able to claim IP rights
on lifesaving products that are often created using findings from publicly
funded research.
As economists Mariana Mazzucato and Jayati Ghosh,
with innovation-policy researcher Els Torreele, have argued, there is something
wrong with a system in which people’s taxes pay for science, yet, in the middle
of a pandemic, relatively few companies and governments are permitted to
control who has access to lifesaving products derived from research, and on
what terms (see go.nature.com/3ixz3dd).
The WHO and its partners are right to seek to
adjust the scales. In addition to the justice imperative, outbreaks would end
sooner if every region of the world could rely on its own defences, stifling
the spread of emerging pathogens and viral variants. As Larry Brilliant, an
epidemiologist who helped to eradicate smallpox, told Nature:
“Equity is often thought of as a burden, but it is a strategic need in the
battle against pandemics.”
Article sourced from nature.com
Nature 607,
211-212 (2022)
doi:
https://doi.org/10.1038/d41586-022-01895-6
Categories
COVID-19