The author is chair of the board at the Global Alliance for Vaccines and Immunisation
The virus is winning. Global cases of coronavirus continue to climb as the disease spreads into poorer nations with fragile health systems. The lessons from the world’s previous pandemic are sobering. During the H1N1, or swine flu, outbreak in 2009, rich countries bought up virtually all available supplies of vaccine, leaving poorer nations high and dry. This time, the stakes are far higher.
New treatments and vaccines could provide humanity with an escape route — but this requires resources to go where they are needed most, since Covid-19 recognises no borders. The disease can only be defeated at a global level. It is in everyone’s interest to ensure that medical products are available to rich and poor alike. Wealthy countries racing to secure early access to vaccines, drugs, diagnostic tests and protective equipment for their own populations must wake up to this reality.
The window for governments to change tack is closing. The world will soon learn if any of the vaccines advancing through late-stage clinical tests are safe and effective. We have only a short time to set up an equitable system for allocation and distribution.
Pursuing a distribution strategy based on healthcare needs, rather than the ability to pay, is the most efficient way to defeat Covid-19, and the best way to protect people in all countries who are still susceptible to infection. It will underpin the global economy and avoid geopolitical tensions inflamed by “vaccine nationalism”. The go-it-alone alternative would leave people in poorer countries unprotected, extend the pandemic and jeopardise decades of development gains. It would increase the risk of the virus flowing back to wealthier countries, creating more economic shocks. Fresh bailouts might dwarf the $10tn already spent on stimulus packages.
Fortunately, there is a fully costed mechanism for achieving the global co-operation needed. The Access to Covid-19 Tools Accelerator, launched in April, unites governments, health bodies, scientists, businesses, civil society and philanthropists to speed the development and rollout of tests, treatments and vaccines. In three months, it has built a portfolio of products and created an advanced purchasing system to get them to the places they are needed.
ACT-Accelerator offers an exit plan for the worst health crisis in more than a century. It promises to be excellent value for money. Developing the suite of medical tools needed would cost less than a tenth of what the IMF estimates the global economy is losing every month due to the pandemic. The scheme would not only benefit poor countries. All participants would receive guaranteed access to successful vaccines for 20 per cent of their countries’ populations.
At the same time, the world must establish and enforce robust global trade rules for healthcare products. A worrying feature of Covid-19 has been the readiness of governments to ignore trade rules in a short-sighted rush to put their own country first. More than 90 countries have imposed temporary export restrictions due to the pandemic, often ignoring their obligations under World Trade Organization rules.
For now and the future, the multilateral trading system should balance access and affordability for all with the need to protect intellectual property to spur research and innovation. There are positive precedents. During the HIV/Aids crisis of the 1990s, expensive medicines were made available in public health emergencies in developing countries, and the intellectual property rights of patent holders were protected.
Governments face a choice: to invest in a global response by providing the ACT-Accelerator with the $31.3bn it needs for tests, treatments and vaccines, or to stick with domestically focused measures, risking millions of lives and still more economic damage. Public health and trade rules can be mutually supportive. World leaders must act to make that a reality.