Challenges in ensuring global reach of COVID-19 vaccines.
Piece of duct tape sticking a note to the slide. 1. Introduction 2. Main barriers to global provision of vaccines 3. Implications & Solutions.
The development of COVID-19 vaccines does not imply the end of the global pandemic..
“None are safe until all are safe”. Share of people who received at least one dose of COVID-19 vaccine, Oct 18, 2021 Total number of people who received at least one vaccine dose, divided by the total population of the country. No data 0% Our World in Data World 100% Source: Official data collated by Our World in Data - Last updated 4 November 2021, 08:40 (London time) OurWorIdInData.org/coronavirus • CC BY.
2. Main barriers to global provision of vaccines.
Development and Production Recognition by global institutions is a vital step (the WHO only recognises 5 vaccines so far). Political barriers are prevalent and slow down the development and production process. Scaling up production is challenging- no existing technology for mRNA vaccines, strain on production of syringes and glass vials. Collaborative production agreements between developers and states hinders production and distribution in excluded nations ..
[Audio] Another challenge lies in a huge divergence in affordability of vaccines between high and middle-low income countries which are resourced-constrained and lack sustainable funding. Vaccine prices can range from the lowest $ 5 per course( AstraZeneca) to the highest $ 62 per course( SinoPharm) depending on differences in technological platforms and associated development and manufacturer cost, the amount of public funding and funders' political demands and the extent to which COVID- 19 vaccines fit into pharmaceutical companies' overall profit-making strategies. The purchase of vaccines could become recurring expenses because of the limited duration protection of vaccines and the potential need for modified vaccines against new variants. The cost of vaccinating 40% of the population already amounted to nearly 1.5% of GDP for low income countries like Congo, Zimbabwe and Sudan even though they paid the lowest prices per dose. It is these variations making these vaccines potentially unaffordable for many governments due to a lack of sustainable funding. Also, there are concerns over some manufacturers planning to sell COVID-19 vaccines at a premium in private markets in countries such as Bangladesh, Brazil, and India that might intensify vaccine access to the marginalised and poor population..
(source:https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2900306-8).
[Audio] Another challenge lies in a huge divergence in affordability of vaccines between high and middle-low income countries which are resourced-constrained and lack sustainable funding. Vaccine prices can range from the lowest $ 5 per course( AstraZeneca) to the highest $ 62 per course( SinoPharm) depending on differences in technological platforms and associated development and manufacturer cost, the amount of public funding and funders' political demands and the extent to which COVID- 19 vaccines fit into pharmaceutical companies' overall profit-making strategies. The purchase of vaccines could become recurring expenses because of the limited duration protection of vaccines and the potential need for modified vaccines against new variants. The cost of vaccinating 40% of the population already amounted to nearly 1.5% of GDP for low income countries like Congo, Zimbabwe and Sudan even though they paid the lowest prices per dose. It is these variations making these vaccines potentially unaffordable for many governments due to a lack of sustainable funding. Also, there are concerns over some manufacturers planning to sell COVID-19 vaccines at a premium in private markets in countries such as Bangladesh, Brazil, and India that might intensify the unequal vaccine access to the marginalised and poor population..
Vaccine distribution. Data infrastructure is vital; this includes making appointments, accessing medical records, supporting disability needs etc. Vaccine deployment- certain vaccines have to be kept in particular conditions e.g. specific temperatures, or for specific lengths of time Administering the vaccine- there may be limited trained workers to administer the vaccine which could increase waiting times and could lead to improper delivery of vaccinations without correct training..
Individual hesitancy: definition and reasons. Vaccine hesitanc y: “the reluctance or refusal to vaccinate despite the availability of vaccines” (Ten health issues WHO will tackle this year, 2021) Reasons behind vaccine hesitancy can be explained by neoliberalist structures Reasons behind vaccine hesitancy Widespread distrust in health organisations and national governments (Hou et al., 2021) Individual factors: risk-benefit perception, vaccine safety, vaccine efficacy (Biswas et al., 2021) Demographic factors (Biswas et al., 2021; Soares et al., 2021).
Individual hesitancy: the root causes. Neoliberalist thinking Individualisation of health: focus on individual health (Wiysonge et al., 2021) Contradictory to discourse on collective responsibility and public health benefits Social exclusion Higher vaccine hesitancy amongst ethnic minorities (Momplaisir et al., 2021) These groups have faced historical mistreatment in research and medical care Racial and economic disparities still prevalent, also in other domains Tackling deeper issues in the current global system is needed to decrease vaccine hesitancy.
3. Implications & Solutions to Minimise Challenges.
[Audio] To avoid ineffective nationalistic responses, we need a centralized, trusted governance system to ensure the appropriate flow of capital, information, and supplies. 1) More innovative mechanisms like AMC, which is adopted already by Bill Gates Fundation and Gavi,whereby public funds would be necessary during development to invest in manufacturing capacity, secure vital raw materials, and start enabling the transfer of technology from the lab to a distributed network of global manufacturers. So there will be a agreement among shareholders that future vaccine should be treated as a global public good, made available on public health grounds to those that need it most rather than limiting supply to those countries that make it or can afford to pay the highest price for it..
[Audio] Harvard reference style. References. Biswas, M., Alzubaidi, M., Shah, U., Abd-Alrazaq, A. and Shah, Z., 2021. A Scoping Review to Find Out Worldwide COVID-19 Vaccine Hesitancy and Its Underlying Determinants. Vaccines , 9(11), p.1243. Hou, Z., Tong, Y., Du, F., Lu, L., Zhao, S., Yu, K., Piatek, S., Larson, H. and Lin, L., 2021. Assessing COVID-10 Vaccine Hesitancy, Confidence, and Public Engagement: A Global Social Listening Study. Journal of Medical Internet Research , 23(6), pp.1-11. Momplaisir, F., Kuter, B., Ghadimi, F., Browne, S., Nkwihoreze, H., Feemster, K., Frank, I., Faig, W., Shen, A., Offit, P. and Green-McKenzie, J., 2021. Racial/Ethnic Differences in COVID-19 Vaccine Hesitancy Among Health Care Workers in 2 Large Academic Hospitals. JAMA Network Open , 4(8), p.e2121931. Olivier J Wouters, Kenneth C Shadlen, Maximilian Salcher-Konrad, Andrew J Pollard, Heidi J Larson, Yot Teerawattananon, Mark Jit, 2021. Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment Soares, P., Rocha, J., Moniz, M., Gama, A., Laires, P., Pedro, A., Dias, S., Leite, A. and Nunes, C., 2021. Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines , 9(3), p.300. Wiysonge, C., Ndwandwe, D., Ryan, J., Jaca, A., Batouré, O., Anya, B. and Cooper, S., 2021. Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future?. Human Vaccines & Immunotherapeutics , pp.1-3. World Health Organization. 2021. Ten health issues WHO will tackle this year . [online] Available at: <https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019> [Accessed 31 October 2021]..