We have major bottlenecks with producing the vaccines, but the WHO say that it doesn't have to be like this. We already have millions of extra doses of COVID today because of the early technology transfer by AstraZenecs at the end of last year. This empowers the rest of the world to make the doses, which greatly increases vaccine supply and helps to end the pandemic fast. Novavax is also in the process of transferring technology in the same way, ready for when it gets approved. However most vaccine manufacturers are not doing this and as a result we are missing out on many millions of doses the world could have if they did facilitate technology transfer.
Skip to next section: WHO calling on wealthier countries to empower weaker economies to make vaccines
The WHO are calling for the wealthier countries to assist technology transfer to help end the pandemic fast It is within our power to do this, for instance similar methods were used for H1N1 flu in the mid 2000s.. The vaccines were publicly funded, and the vaccine manufacturers took no financial risk. They knew that if their vaccines failed they would still come up positive on the ledger, and billions of dollars worth of vaccine doses would have needed to be disposed of unused.
Brazil is a great example here. Before the vaccine was approved, Brazil already started to build a new factory specifically to make AstraZeneca doses under the AstraZeneca technology transfer agreement. It started making its first doses in the second week of march and will make 100 million doses by July. This will have a huge impact on its current desperate medical emergency. They couldn't have done this without the technology transfer. This has added 100 million doses to the world inventory of doses by July which wouldn't exist without technology transfer.
This factory in Brazil will make 100 million doses of AstraZeneca by summer 2021.
WHO call on wealthy countries for similar technology transfer for other vaccines.
So far only Novavax will follow AstraZeneca's example.
Technology transfer benefits everyone and the vaccines were developed using public funding.
Notes: Work started on this factory in Brazil in July 2020, when a consortium of Brazilian companies funded it, based on technology transfer from AstraZeneca. The background image is an artist's impression. More artist's impressions from the company that produced the design here
News story about the 100 million doses by July here: Fiocruz receives first registration for a Covid-19 vaccine produced in Brazil
India, and South Korea are also making the AstraZeneca vaccine already, at cost under this voluntary licensing by AstraZeneca, and Australia, Japan, and South Africa all have had the AstraZeneca technology transferred to them so they can start making it too. India is making millions of doses in addition to the ones it exports to the wealthy countries, half of which it donates for free to its neighbours Bangladesh, Sri Lanka etc.
This technology transfer makes no difference to profits of the companies in the wealthier countries. Although AstraZeneca provides its vaccine at cost for the duration of the pandemic, even in wealthier countries, this is because its agreement with Oxford University requires it. Other vaccine companies that wish to export their technology to the weaker economies can make it a condition of exporting the technology that they can't sell their low cost doses back to the wealthier countries. If Pfizer, for instance, exports its technology to India, South Korea, Brazil etc, the UK, USA, EU etc would still pay the full price for the Pfizer vaccine. Meanwhile it benefits the entire world to stop the pandemic fast and make many doses worldwide of the most effective vaccines we have available.
Yet, the other vaccine manufacturers, J & J, Moderna, Pfizer, are not yet facilitating technology transfer and as a result are seldom used by weaker economies. Other countries are not permitted to make them and most can’t afford the prices of the wealthy countries, and also can’t compete for the limited supply of doses. Again this benefits nobody not even the drug companies. Meanwhile, these vaccine manufacturers took no financial risks; the funding was provided by the governments.
The WHO say we can manage a major boost in vaccine production capacity a few months from now if other companies followed the example of AstraZeneca and Novavax, and if we worked together as the world to make the vaccines. Many countries could make their own vaccines and make them for their neighbours if we facilitated this transfer to show how to do it.
We already have doses pre-ordered enough to vaccinate 5.45 billion in 2021, but most of those doses won't be available until the second half of the year. What is happening is that right now the majority of vaccines are going into the arms of people in wealthy countries. This leaves few of the early doses for anyone else, so the vaccine roll out is very slow in other countries.
If all or nearly all the vaccines in clinical trials are approved, as seems likely by the track record so far, we have 21 billion doses on their way in 2021. That is enough for everyone to be fully vaccinated at least once, and two billion people to be vaccinated twice over in 2021, so long as we fund the manufacture of these vaccines, and distribute the vaccines equitably.
By the time we reach 2022, we have the capacity projected already, even without technology transfer, to vaccinate everyone in the world at least every three months.
So the future is bright so long as we keep funding the vaccines. Meanwhile though there is an acute shortage of vaccines in most countries. While the US / EU / UK etc fully vaccinate all their adult population well before summer, COVAX will only be able to vaccinate 3.3% of the population of the weaker economies in the same timescale. That figure is from the WHO
But that’s just with the existing capacity. With technology transfer, there are many countries worldwide with the capacity to make these vaccines. I follow the WHO and have watched almost every press briefing since January 2020. Over the last week or so representatives from weaker economies have featured as guest speakers, pleading to the world to let them make the vaccines themselves. But this isn't getting into mainstream news in the UK or US and few seem to realize this is going on.
There are plenty of experts in universities worldwide that have the necessary know-how and there are many factories that can provide the technology or they can build new factories fast as Brazil did for AstraZeneca. But what they lack are the intellectual property rights to make these specific vaccines and the detailed technological know-how to start making them fast. With technology transfer, just transfer of knowledge, the world could make many more of the vaccine doses.
A more coordinated response including investment by the wealthier countries and boosting the entire worldwide supply chain for vaccines, a "global operation warp speed" could increase the vaccine manufacture capacity worldwide just as Trump's "Operation Warp Speed" did for vaccine capacity in the USA. It could also empower countries worldwide to work on new vaccines too
This is something we can change. These vaccines were made with tax payer dollars underwriting all risks. It normally costs around a billion dollars to make a new vaccine and a company risks losing all of that if it fails and has to recoup their investment. But these vaccines were developed by the vaccine companies through public funding at no financial risk to themselves.
The public surely have a say in what happens to them, and what is happening right now is unethical, illogical, and harms the wealthy countries too, economically and adding to the risk of new variants. This is not rational, and I think few in our populations would agree to what is being done in their name if they fully understood what was happening. I think few of the politicians fully understand either.
There are many ways of doing this including the WHO's "ACT accelerator" but these tools are only being used by a few companies.
This is why the WHO issued a call to action in a recent statement. Covid-19: A call for global vaccine equity. Also, having tried everything else first with no success, they are also talking about invoking a provision in the World Trade Organization rules called TRIPS which permits compulsory licensing during an emergency. As Dr Tedros said:
Those provisions are there for use in emergencies. If now is not a time to use them, then when? This is unprecedented time, and WHO believes that this is a time to trigger that provision and waive patent rights.
Please share this with others to try to spread awareness, and explain it in your own way if you are an influencer or journalist. Be sure to use reliable sources and link to reliable sources such as the WHO when you do so. Thanks!
It's the same situation for therapeutics, the generic drug dexamethasone is widely used but not many countries will be able to afford more expensive drugs such as the antiinflamatory antibody tocilizumab (promising new drug from a UK trial). Then we have over 400 therapeutics in clinical trials, some of them very promising. Even if less than 1 in 10 pass phase 3 we may well have several dozen new therapeutics to use with COVID by the end of the year.
As more drugs are approved for therapeutics then some will be new expensive drugs that may be very effective, but not be available to the weaker economies. This happened with the AIDS therapeutics which eventually did get to the weaker economies but much later than for the wealthy countries. The WHO are concerned it may happen with COVID therapeutics too, and again this benefits nobody.
This article is based mainly on the excerpts about technology transfer from my longer article:
[This article is around 8000 words. At an average reading speed of 200 words per minute it will take 40 minutes to read it all - but you can get a good idea of it by reading this introduction and the headers, then focus in on any section that interests you]
WHO CALLING ON WEALTHIER COUNTRIES TO EMPOWER WEAKER ECONOMIES TO MAKE THEIR OWN VACCINES
Skip to next section: Actions by CEPI, GAVI and COVAX to scale up global production
Here I am summarizing the WHO call to action published in the British Medical Journal here:
AstraZeneca is the wonderful example here to the world. Through its agreement with the Oxford University it promised to make its vaccine with zero profit for the duration of the pandemic. Its books are audited to make sure it makes no profit from the vaccine.
Remember the vaccine companies had zero risk and invested zero of their own finance to make these vaccines.
AstraZeneca also committed to technology transfer. India and South Korea are already making the vaccines and Japan, South Africa, Australia and Brazil also have had the AstraZeneca technology transferred to them and will soon be making its vaccines.
However sadly none of the other funding agreements had a requirement like this, e.g. the funding by Germany for Pfizer or operation Warp Speed in the UK, both let the companies can charge the same price for their vaccine to weaker economies as for the wealthy countries and they include no commitment for the drug companies to transfer their technology to the weaker economies so they can make their own drugs for the duration of the pandemic.
The EU is benefiting from this technology transfer when it buys its doses of AstraZeneca from the Serum institute in India. The Serum institute can make AstraZeneca and its own native doses but can’t make J & J, Pfizer, Moderna, Novavax or any of the other vaccines.
We see the value of the AstraZeneca approach acutely in Brazil.
Brazil has its own vaccine manufacture plant and they built a new huge vaccine factory which opened in early 2021 to make the COVID vaccine as well as other vaccines.
Brazil’s planned new vaccine factory which opened in early 2021 to make Astrazeneca’s vaccine. It is designed to make the AstraZeneca vaccine, and they started the project already, before the vaccine was approved.
This factory is already making vaccines for Brazilians and will make 100 million vaccines by July 2021.
This will let them vaccinate nearly a quarter of their population by July, or half if they do a first dose and then follow up with a second dose three months later like the UK is doing.
This will have a huge impact on the current desperate situation in Brazil.
. COVID-19 vaccine doses administered per 100 people
Brazil also has vaccines from other countries and using them has vaccinated 8% of their population already. They reached 4% already at start of March so should see a fall off in the deaths amongst the vaccinated by about mid April - it's about a six weeks delay from the vaccination first dose to the effect on deaths once you factor in the time to get protected, and then the time it takes from incubation to symptoms to the first deaths.
It's a really rough time in Brazil. Cases still rising fast, cases per day - and many not taking precautions and intensive care beds full and it's going to get worse for a month or so but then then deaths and the hospitalizations / intensive care should start to ease off a bit. But with cases rising and rising - it's a very difficult situation.
However this is one chink of good news.
"The expectation is to reach the end of March with a production of about one million doses per day. With this, the Foundation expects to deliver 3.8 million doses to the Ministry of Health by the end of March. In April, the delivery estimate will increase to about 30 million doses, and by July Fiocruz should complete the delivery of the 100 million doses resulting from the technology order agreement with AstraZeneca. "
. Fiocruz receives first registration for a Covid-19 vaccine produced in Brazil
What Brazil and Australia did, the EU could have done too, they could have had an extra factory making AstraZeneca doses and add an extra 100 million doses by July if they had been as far sighted as Brazil.
Though none of the current vaccines have followed AstraZeneca’s example yet, we have one more that should be approved soon that is using the same model, Novavax.
Like AstraZeneca, Novavax has been a CEPI funding recipient partnering with Takeda in Japan, SK Bioscience in South Korea, Baxter in Germany, and Biofabri in Spain if its vaccine is approved.
Novavax should be approved soon with good early results. It has 86% efficacy and like the Johnson and Johnson vaccine, it is effective against the variants too, including the South Africa variant. It works in a new way from the other vaccines, instead of triggering the cells to make the protein spikes, the vaccine actually consists of the protein spikes already sufficiently stabilized to be able to trigger the antibodies and immune reaction to fight COVID. It is the first vaccine nearing approval to use this new technology - and the results suggest it works well.
. exploring Novavax's Covid-19 results
ACTION OF CEPI, GAVI, AND COVAX TO SCALE UP GLOBAL PRODUCTION
Skip to next section: Four ways to increase vaccine supply worldwide and stop this pandemic fast
The Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, and the COVAX facility have already done a lot to help scale up global production, with seed funding and match-making efforts.
It’s not just the vaccines, it’s also fill and finish (putting vaccines into syringes) and supply of the ingredients to make the vaccines.
Many other countries want to make the vaccines and have the capability to do that. Not just the vaccines, they can make therapeutics too. As an example, dexamethasone can be used worldwide because it is a generic drug. But Remdesivir is too expensive for the poorer countries and it could be made available to them if they were permitted to make it themselves. Bangladesh is making its own Remdesivir under a compulsory license, which it can do as such a poor country, has a precedent of doing this, but most countries have to import it at high cost from the manufacturer.
The WHO give the example of the Durban Declaration where leading scientists and public health experts called on world leaders to share effective treatments for AIDS in this way. They did do this eventually but the response was so slow that millions died of AIDS before the medicine got to them that was already saving lives in the wealthier countries.
The WHO say that we can’t repeat this. We must remove this artificial scarcity.
The WHO point out, as I have already explained here, that much of the vaccine development was publicly funded. Billions of dollars from the UK, US, Germany etc went into these vaccines, taking away the risk that a manufacturer usually has developing a new vaccine - it was all paid for up-front.
The WHO say that it is time to use all the legal and public health tools to get them to the people who need them.
The WHO are asking for:
- The US to immediately fund urgent renovation and expansion of factories in Africa, Asia and Latin America, and incentivize Moderna, J & J and Pfizer to share the knowledge of how to produce the vaccines with the rest of the world - which they developed with significant public funding.
- European and other countries to do the same.
- COVAX partners to agree that vaccinating 3% of the world population in the first half of 2021 and 20% by the end is not acceptable or sufficient. They need COVAX to back a global push to do all this, including the TRIPS waver.
The conclusion is:
In a world where there are enormous inequalities COVID vaccinations offer us the opportunity to provide everyone globally, regardless of income, race, or nationality, immunological equity to be protected from SARS-CoV-2.
The covid-19 pandemic will not be over for us until it is over for everyone.
FOUR WAYS TO INCREASE VACCINE SUPPLY WORLDWIDE AND STOP THIS PANDEMIC FAST
Skip to next section: Method 4, the TRIPS agreement
There are four approaches to increase vaccine supply that Dr Tedros described in a recent WHO presser:
- To connect companies that produce vaccines with ones that can do "fill and finish" as for the agreement between Johnson and Johnson and Merck in the USA. The WHO can provide a match-making service to help achieve this.
- bilateral technology transfer through voluntary licensing from a company that owns the patents to another company who can produce them. AstraZeneca has done this, transferring the technology for its vaccine to the Serum institute in India and SK bio in South Korea.
- Coordinated technology transfer with universities and manufacturers licensing their vaccines through a global mechanism co-ordinated by WHO who would also facilitate training of staff and coordinate investments in infrastructure. This provides more transparency and a more coherent global approach. It would increase production capacity for this pandemic and for future pandemics as well as for routine immunization programs.
The WHO did this already for H1N1 in the mid 2000s
- Invoking TRIPS to waive intellectual property rights.
As Dr Tedros said:
Those provisions are there for use in emergencies. If now is not a time to use them, then when? This is unprecedented time, and WHO believes that this is a time to trigger that provision and waive patent rights.
We need to get the governments of the wealthier countries to start talking about this as a matter of great urgency. The world will be hugely better as a place for us all to live in, at the end of 2021, if the weaker economies are empowered to make their own vaccines.
The WHO has already attempted all those first three things. But with no success. The ACT accelerator was an attempt to solve the problem using the second method, voluntary licensing by the drug and vaccine companies of vaccines and therapeutics to weaker economies following the example of AstraZeneca, but they didn’t get much uptake.
The Access to COVID-19 Tools (ACT) Accelerator
WHAT THE WHO ARE TALKING ABOUT IN METHOD 4 - THE TRIPS AGREEMENT
Skip to next section: Weaker economies are fully entitled to use TRIPS under WTO rules but fear sanctions from wealthy countries
How many of you have heard of TRIPS? This has been huge news in the weaker economies but I have yet to see it mentioned on the BBC news in the UK.
I think few people in the UK, EU, Canada, or USA even know that their countries are actively blocking the rest of the world from making their own therapeutics and vaccines under this agreement. when they are fully entitled to do so during an emergency, under the rules of the World Trade Organization.
What they are talking about here is a special provision called TRIPS to temporarily suspend intellectual property rights.
- In emergency situations such as a pandemic, under World Trade Organization Rules, countries can grant themselves a compulsory license to make patented drugs.
They must give fair remuneration to patent owner but don't need permission, They can also export it to others who grant themselves compulsory licenses. Compulsory licensing of pharmaceuticals and TRIPS
This is a provision under the World Trade Organization called TRIPS. Most countries are members of the WTO - the ones shown as green in this map.
Bangladesh is already producing Remdesivir under this arrangement, and as a least developed country they don’t need to pay anything to Gilead.
WHY COUNTRIES AREN’T DOING IT ALREADY - FULLY ENTITLED TO UNDER WTO RULES BUT SCARED OF TRADE SANCTIONS, LEGAL CASES AND WITHDRAWAL OF OTHER VITAL DRUGS IF THEY USE IT
Skip to next section: Details about the TRIPS agreement
However although technically any country could do this, could declare that they will do compulsory licensing under TRIPS - in practice they don’t because when countries try, the developed countries retaliate. The drug companies can withhold other drugs from them, the developed countries can threaten trade sanctions, and drug companies can also take out -legal cases against them such as patent infringement lawsuits in their domestic legal system.
Here are some examples from the past (from this paper)
"After Thailand issued a compulsory license for Abbott’s HIV drug, Kaletra, Abbott stated it would not sell certain drugs in Thailand and withdrew seven new drug applications from Thailand."
"Threat of trade sanctions by the United States, which is Thailand’s biggest export market, forced Thailand to stop producing a generic version of the HIV drug, didanosine, and amend its domestic laws to restrict compulsory licenses and parallel importation"
"Indian generic manufacturers Cipla and Natco face separate patent infringement lawsuits in the Delhi High Court by Bayer Pharmaceuticals for its patented cancer drug Nexavar"
With that last example, Bayer lost their legal case.
This is why there are calls for a global waver. The US, EU, Canada, UK so far oppose this waver. South Africa and India are leading in the proposal to put it in place.
How many of you in the US, EU, Canada or the UK even know your governments are doing this? This is a major story in India but it's not running as headline news in the US or UK etc. This is how the Times of India is reporting it:.
DETAILS ABOUT THE TRIPS AGREEMENT
Skip to next section: Proposal for a global "operation warp speed"
- Patent holder still has rights over the product including right to be paid compensation
- Countries are free to decide for themselves what counts as a national emergency as grounds for granting a compulsory license
- Countries can buy cheaper versions of the product made in other countries if they can’t make the product themselves - the producing country also has to issue a compulsory order in this case.
- The license only lasts for the duration of the emergency and in the region affected, and the patent holder can continue to produce,
- The mechanism covers pharmaceutical products, including medicines, vaccines and diagnostics, needed to fight an epidemic.
There I’m paraphrasing parts of this post on the WTO website about TRIPS:
They must give fair remuneration to patent owner but don't need permission, They can also export it to others who grant themselves compulsory licenses. Compulsory licensing of pharmaceuticals and TRIPS
The USA, EU, Canada and the UK could immediately empower this by agreeing not to sanction countries in any way that invoke TRIPS during the pandemic.
Or we could add - if not TRIPS - let's ask our governments, what is YOUR solution?
There is an alternative solution proposed in the USA, a “GLOBAL OPERATION WARP SPEED” which could be worth considering if they are still resistant to TRIPS and to the other three approaches outlined by the WHO
ECONOMIC POLICY FOR A PANDEMIC AGE - USA PROPOSAL FOR A GLOBAL “OPERATION WARP SPEED”
Skip to next section: Boosting vaccine doses can end the pandemic ultra fast
This is an article by Chad P. Bown (PIIE) and Thomas J. Bollyky (Council on Foreign Relations)
They propose a global “operation warp speed” modeled on Trump’s program for the USA. It would leverage COVAX,
They say that
There is little question that US intervention helped scale up inputs and unlock input bottlenecks to expand production overall. Furthermore, it is also hard to argue that the tens of billions of dollars of US federal expenditures were too large, given the pandemic’s ongoing human costs (hundreds of thousands of lives lost) and economic costs (trillions of dollars of lost gross domestic product). The same would be true with regard to resources needed to expand manufacturing to meet global demand for vaccines and the critical inputs needed to make them.
Making vaccines involves a complex supply chain which they outline here:
They propose a global initiative which they call CVITA
A COVID-19 Vaccine Investment and Trade Agreement (CVITA) is needed to create the incentives to ensure the timely and sizable scaling up of output and input investments to respond to this pandemic and future pandemic threats. Baby steps toward such an agreement are found in the Trade and Health Initiative that a small, but influential, group of World Trade Organization (WTO) members proposed in late 2020. But much more is required.
There are four components to such a global “operation warp speed” that they outline.
- It must link with COVAX which already has the transparency and the links to existing networks of regulators needed for global confidence, to reduce development costs and to give better access to the poorer markets
- Investment must create a framework to subsidize the full supply chain including “bioreactors, bags, cellular materials, vials, stoppers, syringes, and other ancillary supplies”. As with COVAX, governments would pay on a subscription basis and poorer countries would be heavily subsidised or free.
- As members of CVITA governments would commit not to impose export restrictions on supplies of vaccines and related materials to participating countries.
- This needs unprecedented transparency. They suggest as a model the Agricultural Market Information System (AMIS) which was developed by the G20 to “improve transparency and coordinate policy in the event of sudden scarcity”
- CVITA needs an “effective and transparent administrator who is one part general contractor and one part ombudsperson.”
Shortages will occur. Tensions will rise. Because of scarcity problems, difficult choices will need to be made, and some may be asked to wait. Those challenges have to be resolved quickly, fairly, and transparently.
They conclude:
If global policymakers fail to launch and implement an enforceable COVID-19 Vaccine Investment and Trade Agreement, it will be a lost opportunity. If they succeed, lives will be saved.
You can read the details of the proposal here:
. Here's how to get billions of COVID-19 vaccine doses to the world
Some quotes from the article:
The United States needs to do something new: Devote resources and engage both domestic and international sources in coordinated, targeted investments to build on the existing global infrastructure of labs and manufacturers that produce specialized inputs for the vaccines, whether the drugs or syringes or vials that contain them. The vaccine manufacturing supply chain is already global. But it needs to be better organized and subsidized at multiple levels.
Governments and philanthropists have worked together to scale up HIV medicines and pediatric vaccines, but the level of policy cooperation needed for COVID-19 vaccine production is, admittedly, unprecedented. That’s why a global coordinating body will also be needed to help some countries scale up the production of early stage ingredients and critical equipment, knowing they can incentivize other countries to subsidize expansion of later steps in the manufacturing process that will also need to be scaled up. Skillfully combining those inputs into vaccine output and then guaranteeing access to the final doses and related supplies through international trade will require trust among governments that is currently in short supply. But without guarantees and coordination, individual governments will revert to self-defeating vaccine nationalism
One way to accomplish this goal would be to set up a new and enforceable COVID-19 Vaccine Investment and Trade Agreement (CVITA). Such a CVITA can draw some lessons from the US subsidization and coordination of its domestic vaccine manufacturing supply chain under Operation Warp Speed. It was not easy to get so many competing entities to work together in the United States. But its success is already clear. The even more complex policy challenge now is to get the rest of the world vaccinated.
BOOSTING VACCINE DOSES SO EVERYONE CAN GET THEM MUCH FASTER - AND END THE PANDEMIC WORLDWIDE ULTRA FAST
Skip to next section: To donate vaccines is rational, logical, sensible and ethical
It will benefit everyone to vaccinate everyone fast. In this scenario, the world economy recovers faster, and the better health care and fewer dying in the weaker economies leads to a better world for everyone. They are the people who grow the food and make many products that many of the wealthier countries depend on. If they are healthy too we all benefit.
It also means that holiday destinations, conferences, travel is safer because worldwide there won’t be raging epidemics in the weaker economies. Also very importantly, it means less risk of new variants arising. And less risk of the virus jumping into animal reservoirs like the mink, and now, mice too.
The variant first identified in South Africa has also developed the new capability to infect unmodified mice. This opens up the possibility that the virus as it evolves and transmits worldwide may find new animal reservoirs in those countries and could become like Yellow fever, a virus that often jumps back to humans from other animals.
There has to be an animal reservoir, perhaps of pangolins, somewhere in China, but if so the leap to humans is very rare and hasn’t happened again since China controlled their outbreak. We don’t yet have any other confirmed animal reservoirs - Denmark’s cull of the entire mink population in their fur farms was to prevent a new reservoir being established in wild mink in their country. By stopping the pandemic fast we can reduce the risk of new reservoirs or reduce the number of countries they get established in if they do this.
TO SHARE VACCINE TECHNOLOGY AND DONATE VACCINES IS RATIONAL, LOGICAL, SENSIBLE AND ETHICAL
Skip to next section: Plenty of vaccines for the future
These vaccines were made with tax payer dollars underwriting all risks. It normally costs around a billion dollars to make a new vaccine and a company risks losing all of that if it fails and has to recoup their investment. But these vaccines were developed by the vaccine companies through public funding at no financial risk to themselves.
The public have a say in what happens to these vaccines developed with their own funding, and what is happening right now is unethical, illogical, and harms the wealthy countries too, economically and adding to the risk of new variants.
This is not rational, and I think few in our populations would agree to what is being done in their name if they fully understood what was happening. I think few of the politicians fully understand either.
PLENTY OF VACCINES FOR THE FUTURE
Skip to next section: Summary and call for action
Some people will tell you we can never vaccinate the whole world, in less than several years (like the smallpox vaccine which was a very slow rollout over the entire world). But this is nonsense, fails basic fact check.
We will have plenty of vaccines later in the year for most of the world population already in 2021.
- World total - enough to vaccinate 5.45 billion people in 2021 leaving only 2.45 billion unvaccinated.
If the US and EU fully vaccinate everyone twice over, their excess doses are still enough to increase the COVAX total from 2.03 billion to 3.63 billion people in the rest of the world.
Even if the EU, UK, USA, entire G7 and in total a billion people are fully vaccinated a second time in the fall the world total becomes 4.95 billion out of 7.9 billion or 62.7% of the world population fully vaccinated at least once in 2021.
That’s with pre-orders alone.
But we can make many more than these advance orders suggest. Remarkably all vaccines that get through phase 1 so far also pass phase 2, phase 3 and are approved. Four vaccines were abandoned in phase 1 but they all could have been developed further, if the competition wasn’t so effective and, with a small tweak in the case of the Australian vaccine, would surely have passed phase 3 eventually too.
So - it is reasonable to suppose all the vaccines in phase 2 and 3 will be approved. Even the inactivated whole vaccines - none have yet passed WHO emergency use authorization but the early results show they are safe and effective too.
- Total vaccine capacity if all the vaccines are approved - 11.15 billion.
That’s enough to fully vaccinate the world population of 7.9 billion and then fully vaccinate 2.25 billion people a second time - e.g. a second vaccination in the fall for new variants.
Then by 2022 we will have enough vaccine capacity, as long as it is funded, to vaccinate the entire world population every three months and still have some to spare at the end of the year.
For the background, cites and the calculations see my
SUMMARY AND CALL FOR ACTION
Skip to next section: Perspective of our future civilization 100,000 years from now
The COVID vaccines have been a great scientific success, and now it's time to turn then into an ethical, logistical, practical and economic success. First we must immediately supply COVAX with the 10 million doses that Dr Tedros has called for and save the lives of doctors like Professor James Gita Hakim who are dying for the lack of a few thousand doses for their countries, when the USA is hoarding tens of millions of doses it may not even need. For details see my previous article:
Then in addition, many countries worldwide have the technology and the ability to make these vaccines, but they need permission, and transfer of detailed knowhow of how to make these specific vaccines. AstraZeneca have already done this and have committed to make no profit from the vaccine during the pandemic as part of their agreement with Oxford University. As a result, manufacturers in India and South Korea are already making millions of doses of their vaccine, and will be making billions of doses for the world, and will be joined by manufacturers in Brazil, South Africa, Japan etc.
None of the other vaccine companies are doing this yet. The wealthy countries used public funds from the tax payer to develop the vaccines. The vaccine companies like Moderna, J & J, Pfizer, Novavax took no significant financial risk to develop the vaccines. These companies would still have made a profit from the arrangements if none of their vaccines had worked.
India donate half their own doses with neighbouring countries like Bangladesh and Sri Lanka - this is in addition to ones they export to fulfill pre-orders. France is sharing 5% or 1 in 20 of its early doses and is asking other European countries to do the same.
It is of course a priority for any country to vaccinate all their most vulnerable, elderly and frontline workers especially doctors. However, after that, to donate 1 in 20 doses to the weaker economies like France did is surely a minimum.
This makes sense. The vaccines are also effective in stopping transmission. By vaccinating the world fast we help countries stop community spread. Every new case is another opportunity for the virus to develop new variants.
We already have three variants of concern, first identified in Brazil, the UK, and South Africa. They are all more transmissible, and the variant identified in South Africa has started to evade the AstraZeneca vaccine.
This is not out of our control. We can stop this happening.
Stopping the pandemic worldwide stops new variants that
- transmit faster
- evade the vaccines
- can jump back to more animal reservoirs
It also affects the world economy. A country that is fighting the pandemic and has to go into frequent lockdowns is not going to recover from the recession so quickly and its recovery may be delayed for a long time. The world is so connected this impacts us all worldwide.
We also need to protect the vulnerable and the medical workers worldwide, not just in our country. A few thousand of the over 28 million vaccinations a week in the UK, EU and USA would make a huge difference to a country like Zimbabwe with only around 7000 doctors for the entire country.
Let’s do this. For us in the wealthy countries, our governments used tax payer’s dollars to make these vaccines. It is to the benefit of us too, as well as the rest of the world,. to use these dollars to vaccinate the whole world at once, not just us.
Please - if any of you reading this are good at communication, try to explain this to your readers and followers. I don’t think many people would support this, if they truly understood what was happening and our governments represent the people, and they will listen if public opinion changes.
We have moved on hugely since the time of the AIDS pandemic but we aren’t there quite yet and we can do this at almost no cost to the wealthier countries, by empowering the weaker economies to make the same vaccines we are making. Either through TRIPS or by incentivizing the vaccine companies to follow the example of AstraZeneca to make their technology available to manufacturers worldwide for the duration of the pandemic.
PERSPECTIVE OF OUR FUTURE CIVILIZATION LOOKING BACK AT OUR TIMES 100,000 YEARS FROM NOW
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This is another way of thinking bout it. Our generations great, great, great … grandchildren, 3000 generations in the future likely still have access to the historical records of our time. For them our technology will seem more primitive than paper tape and punched cards seem to us. We will seem to be little advanced beyond stone axes and the early technology to be able to make a fire by rubbing two sticks together.
They won’t call us a civilization for our technology.They won’t be impressed by our technology.
What they will call civilized is our ethics, human rights, and our basic rationality and logic. They will see our response to the COVID pandemic and to the climate crisis as the first beginnings of true civilization and of true species wide rationality.
Let’s help make this happen soon!
MANY PROMISING VACCINE DEVELOPMENTS
Skip to next section: Need to #DOITALL and make pandemic history
We will likely have the pandemic largely over later this year, with the very effective vaccines or through to 2022, when, so long as we continue the funding, we'll be able to fully vaccinate everyone in the world four times.
The Pfizer vaccine which is first generation is already 94% effective at stopping transmission of the B 1.1.7 variant in Israel. This is far more effective than flu vaccines, typically 40 to 60% effective. This is our first ever experience of a coronavirus vaccine, an unrelated virus to flu, and it seems to have an effectiveness closer to a measles vaccine than a flu vaccine.
Also remember a fifth of the world population has already eliminated it locally without a vaccine. This has never been achieved for flu pandemics.
. 20% of the world population is like this already - without a vaccine - what can we learn from them?
Future generations of vaccine will be more effective, e.g. the hexapro modification should end up with the mRNA from the Pfizer vaccine producing ten times as many stabilized spikes once it enters a cell and the vaccine will be stable at fridge temperatures for at lest several days, able to be heated to 55 C and able to survive three freeze thaw cycles.
. The 2P tweak - Why Pfizer and Moderna are so effective as vaccines - this tweak could be used by other vaccines like AstraZeneca - and 2nd generation vaccines may use the even more effective Hexapro tweak published July 2020
Other things we can do include mix and match of vaccines with a different vaccine for the first and second dose. This has worked with other vaccines in the past and is expected to work with the COVID vaccines with several trials underway including mixing Pfizer with AstraZeneca and the AstraZeneca with Sputnik V. All the medical evidence we have from mixing vaccines suggests it boosts immunity. It’s a rare thing to do mainly because most diseases only have one vaccine in regular use. This situation his unprecedented with so many vaccines for a single disease. But it likely makes the immune system response far stronger.
Ross Kedl, PhD, a vaccine researcher and professor of immunology at the University of Colorado in Aurora, says that mixing is likely a better option, as interviewed by Medscape:
"Each vaccine has a number of components in it that influence immunity in various ways, but between the two of them, they only have one component that is similar. In the case of the coronavirus vaccines, the one thing both have in common is the spike protein from SARS-CoV-2. In essence, this gives you two shots at generating immunity against the one thing in each vaccine you care most about, but only one shot for the other vaccine components in each platform, resulting in an amplified response against the common target."
He agrees that it’s best to stick with one manufacturer for now but adds
"I would be very surprised if we didn't move to a mixing of vaccine platforms for the population," .
. Vaccine Mismatch: What to Do After Dose 1 When Plans Change
The UK trial will also study mixing other vaccines as they are approved for the UK.
. Covid trial in UK examines mixing different vaccines
Health reporter Smitha Mundasad for the BBC describes it like this:
The Oxford vaccine, for example, uses a harmless virus - almost like a viral postman - to deliver the key part of the vaccine (the bit with coronavirus's genetic code) into the body.
This bit of code helps train the body's immune system to recognise coronavirus and prepare defences to fight it off in the future.
When a second dose of the same vaccine is given, there is some evidence to suggest that our immune systems can shift a bit of their focus onto the viral postman - rather than coronavirus itself.
Approaching the challenge using various vaccine combinations may strengthen results.
We also have many more vaccines on their way and it’s unlikely the first vaccine to be approved, Pfizer, is the best of all the first generation vaccines or that the specific doses and interval used for Pfizer is optimal for that vaccine.
As for the variants then we can use vaccines with multiple variants in the same vaccine shot.
Moderna, Pfizer, and AstraZeneca are already testing various mixes including a booster to stop a variant after the original full vaccination, a second dose for a variant after a first dose of the original, and multiple variants in the same shot.
. COVID-19 vaccines vs. variants: The state of play
Novavax will be testing a “bivalent” vaccine with vaccinating against the original variant and then the South African variant in April.
. How the different Covid vaccines will handle new variants of the virus
And the UK is also saying that by the fall they will have trivalent vaccines, able to vaccinate against three variants in a single shot.
. Booster jabs for over-70s from September
Then we have over 400 therapeutics in clinical trials, some of them very promising. Even if less than 1 in 10 pass phase 3 we may well have several dozen new therapeutics to use with COVID by the end of the year.
WE NEED TO DO PUBLIC HEALTH MEASURES TOO, #DOITALL AND WE CAN MAKE THIS PANDEMIC HISTORY
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As Dr Mike Ryan says, if we follow the example of Australia, and add vaccine equity as well, we can make this pandemic history.
As the WHO said in one of their earlier Social Media Q/As, we can all be super heroes - we already have practical solutions we can use to bring down this pandemic quickly. We have a tool kit full of these, not magical but practical solutions we can apply right now, and now we have vaccination too, to add to our toolkit.
COVID-19 TOOLBOX - Face coverings, Contact tracing, Vaccination [when ready], Hand Hygiene, Quarantine, Mass Testing, Physical distancing, Stay Informed.
#DoItAll - Not magic - Practical
Spiderman graphic from here
This is a WHO tweet about the need to #DOITALL as we vaccinate:
tweet here#COVID19 vaccines are part of the solution, but alone they won’t end the pandemic. Please keep:
— World Health Organization (WHO) (@WHO) March 18, 2021
↔️ physical distancing
�� masking
�� cleaning your hands
�� opening windows
✖️ avoiding crowds
Do it all to lower your risk! pic.twitter.com/eDXQ3DZj9T
See also my articles:
RELEASED INTO PUBLIC DOMAIN TO THE FULL EXTENT POSSIBLE IN THE UK - PLEASE SHARE AND RE-USE THIS ARTICLE TO HELP RAISE AWARENESS, THANKS!
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Please share this with others to try to spread awareness, and explain it in your own way if you are an influencer or journalist. Be sure to use reliable sources and link to reliable sources such as the WHO when you do so. Thanks!
Also do share the WHO videos and other material on this topic to spread awareness with your friends. Let's all try to support our governments to be more logical, rational and ethical in their COVID decision making. Thanks!
I release this article under the creative commons license CC by 0. Anyone can re-use any of the material, and you are permitted to modify it as you please, for any use including commercial. You are not required to credit me. Details of the CCBY0 license here.
To the extent possible under law, Robert Walker has waived all copyright and related or neighboring rights to "US Urged To Loan From AstraZeneca Hoard As Health Workers Die In Africa & Assist Technology Transfer To Stop Pandemic Fast". This work is published from: United Kingdom.
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