• Shashwat Upadhyay

The Global Race for a COVID-19 Vaccine



It has been more than 7 months since the coronavirus outbreak was declared a pandemic by WHO. With more than 42.7 million cases and 1.15 million deaths worldwide as of 25 October 2020, the human suffering it has ensued is unparalleled in peacetimes. The lockdowns and shutdowns used to control the spread of the virus, on the other hand, have plunged the global economy into the single worst crisis since the Great Depression of the 1930s.


Nations around the world continue to contain the virus’ spread.



Clearly, this pandemic has impacted societies, cultures, economies, and politics of nations in unthinkable ways. There does not seem to be an end in sight unless a vaccine is approved, distributed, and given to the world’s population. All of this, however, possess a plethora of questions regarding the vaccine’s development, what roles various nations are playing, and how it will be distributed around the globe. Let us attempt to find out.



Vaccine Development


The development of any vaccine has been incredibly complex and prone to market failures. Pharmaceutical companies had little incentive to develop cheap vaccines for outbreaks which existed primarily in poor countries and as a result, its development had mostly relied on funding from non-profit organizations or the government. Even when the outbreaks took place in richer nations, its effective development and deployment were not guaranteed due to the incredibly complex nature of the virus, something we saw with HIV/AIDS.


The current pandemic however has changed all of this. While there were doubts regarding the development of a coronavirus vaccine in a reasonable amount of time, currently, given the exceptional global scientific effort, all indicators suggest that a vaccine is on the way. The only question remains - when?



The release of the coronavirus’ genomic sequence in late January 2020 has allowed companies and governments to start developing an effective vaccine. These are the stages involved in its development. (TOI)



Geopolitics of the Vaccine Race


Broadly speaking, currently, the US appears to be leading the global race for vaccine development, with various companies and institutes from the European Union, China, India, and Russia playing key roles too.



Vaccines currently undergoing or approved for Phase-3 trials. (NYT)


The US also happens to be locked in a cold war of various conflicts with China. The Trump administration has repeatedly accused China of meddling at the WHO and warned that the country will have to “pay a big price” for the spread of the virus globally. Initially, China responded by blaming the US Army for starting the virus but has since moved to independently develop its vaccine.


Both the nations in a lot of instances have made use of unfair means to secure their respective vaccines. The US has utilized its deep pockets to ensure priority access to potential vaccines (threatening the accessibility of poorer nations) while China has resorted to hacking and stealing crucial data from labs around the world (including the US).


Both the nations are investing in the R&D for potential vaccines too.


The US has already poured more than $10 billion into Operation Warp Speed, a public-private partnership that aims to accelerate the development, manufacturing, and distribution of coronavirus vaccines. Vaccine developments from major players like Johnson & Johnson, AstraZeneca-Oxford, Pfizer-BioNTech, and Moderna are being funded through this program only. There have been criticisms, however, namely the program’s unwillingness to partner with the WHO or the European Commission. Health experts have also raised concerns and criticized the program’s unrealistic goal to develop, manufacture, and distribute hundreds of millions of doses by the end 0f 2020.


President Donald Trump formally announced Operation Warp Speed on May 15, 2020, in the White House Rose Garden.



Xi Jinping on the other hand has given the WHO full backing and vowed to share China’s vaccine with the world once it's developed. Critics note, however, that this is part of a broader effort to defuse criticism of his government for the initial handling of the virus which allowed it to spread across the world. China is also increasingly being scrutinized by major entities like the US, European Union, Japan, India, Australia, etc. for its military expansion across its borders in Hong Kong, Eastern Ladakh, and the South China Sea. All of this indicates that the mass adoption of a vaccine developed in China is unlikely in the nations criticizing it.


The same holds true for Russia too, which recently approved its “Sputnik-V” vaccine. One of the leading figures of the US’ coronavirus task force Anthony Fauci ‘seriously doubts’ that the Russian vaccine is safe and effective, given its secretive and rushed development.



India - The Pharmacy of the World


Serum Institute of India, Pune



As the largest manufacturer of generic drugs and vaccines, India has long been called the “pharmacy of the world”. It is the producer of 60% of the world’s vaccines and has previously worked with other nations to successfully eradicate many epidemics (including polio and smallpox). In the current pandemic, the country has managed to not rely on imports and indigenously ramped up the development of its testing kits and ventilators.


Rest assured, it is set to play a key role in both the development and manufacturing/distribution of vaccines.

In the development sector, India is both collaborating and indigenously developing vaccines. As per government sources, roughly 30 candidates are developing vaccines, out of which 3 have shown very promising results and entered advanced stages - Covaxin (Bharat Biotech/ICMR), ZyCoV-D (Zydus Cadila), and ChAdOx1 (AstraZeneca-Oxford in partnership with Serum Institute of India). Notably, Bharat Biotech’s Covaxin recently got approved for Phase-3 trials.


Adar Poonawalla, billionaire CEO of Serum Institute of India


In the manufacturing and distribution sector, the country is a clear global leader. It is home to the Serum Institute of India (SII) in Pune, the single largest vaccine producer in the world. According to estimates, 65% of the world’s children have received a vaccine made by it. The company has an annual output of 1.5 billion doses and has already secured five partnerships, with the biggest deals being with AstraZeneca-Oxford and the Bill & Melinda Gates Foundation. Notably, SII’s CEO Cyrus S. Poonawalla has said that “50% of whatever quantity we manufacture will be kept for India and the remaining will go to low- and middle-income countries”.


Health experts and scientists have also applauded the Indian government for allowing its pharmaceutical companies to export domestically manufactured vaccine stocks to other nations. This was reiterated by the country last month when at the UN General Assembly PM Modi said that India's vaccine production and delivery capabilities will be made available globally to "help all humanity in fighting coronavirus crisis." A lot of these initiatives will also give the country a bargaining chip in getting priority access for a vaccine. As per recent reports, a sum total of 50,000 crores INR (6.8 bn $) has been set aside too by the government to vaccinate the country.



Setbacks Mounting Globally


Eli Lily’s ACTIV-3 antibody treatment, which was undergoing Phase-3 trials was paused in mid-October due to safety concerns. The news came in less than 24 hours after Johnson & Johnson confirmed it was pausing advanced late-stage trials of its vaccine over similar concerns. A more adverse setback occurred on 21st October when Brazilian health authorities confirmed that a volunteer for the clinical trials of AstraZeneca-Oxford’s vaccine had died.


Many health experts and industry observers however believe that the setbacks are happening in an environment of heightened scrutiny and that these developments are routine. “I’m not surprised at all that these pauses are happening. Where I would be surprised is if they weren’t happening” says Greg Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minnesota.



A Measured Approach


It goes without saying that a very calculated and measured approach is needed to effectively deploy a vaccine in every corner of the world. As we have seen recently with the rise of ‘vaccine nationalism’, richer nations like the US and UK have pre-ordered hundreds of millions of doses of multiple vaccines still under development, enough to vaccinate their entire populations many times over. This poses a challenge for economically backward nations and a holistic approach has to be considered to ensure everyone gets a vaccine.


With the US, we also saw how mixed messages from various officials and politicians resulted in face masks and social distancing becoming a political issue. Constant and truthful communication therefore is needed by the world's governments to its citizens to avoid a mass anti-vax movement when a vaccine is finally deployed. With China, we saw how its failure to communicate with the WHO initially and haphazard handling of the virus resulted in it spreading to other unprepared and unaware nations. Hence, a line of communication needs to be there between nations and the WHO.


Ideally, a race between friendly nations shouldn't be the way forward and collaborations will ensure faster development and deployment of a vaccine.




References

https://web.archive.org/web/20080921163050/http://www.hhs.gov/asl/testify/t050504b.html

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.6.1642

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https://www.youtube.com/watch?v=byW1GExQB84


Photos

https://commons.wikimedia.org/w/index.php?curid=87378121

https://commons.wikimedia.org/w/index.php?curid=87740671

https://commons.wikimedia.org/w/index.php?curid=88671004

https://commons.wikimedia.org/w/index.php?curid=90816712

https://commons.wikimedia.org/w/index.php?curid=87485567

https://www.reuters.com/news/picture/workers-bury-the-dead-in-mass-grave-on-n-idUSRTS38M8U

https://news.sky.com/story/coronavirus-brazil-becomes-second-country-to-pass-100-000-deaths-12045787

https://www.outlookindia.com/photos/people/Adar-Poonawalla/17865?photo-146815



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