Over 80% of doses already sold to world’s richest countries

The pharmaceutical giant and its German partner BioNTech intend to manufacture a total of 1.3 billion doses throughout 2021, yet the vast majority of these have been pre-ordered by the likes of the UK, Japan, the US and the European Union.

Pfizer has already sold 82 per cent of its vaccine stocks to some of the world’s richest countries, analysis shows, raising concerns that people from poorer nations will be unable to access the life-saving doses.

These countries, which have bought up hundreds of millions of doses between them, represent just 14 per cent of the global population.

The analysis was conducted by Global Justice Now, a health and social justice campaign group based in the UK, which warned that the lack of equitable access to the Pfizer vaccine – along with many other candidates in development – was endangering thousands of lives across the globe.

Scientists hailed a major breakthrough in the fight against Covid-19 after Pfizer and BioNTech this week announced that their vaccine appears to be 90 per cent effective in preventing disease.

Yet as governments now rush to get hold of doses for their own populations, there is mounting fear that the world’s poorest countries will be forced to the back of the queue.

Heidi Chow, a senior policy manager at Global Justice Now, said the Pfizer/BioNTech vaccine announcement was “good news for just a small fraction of humanity”.

“We need to break the monopoly over this vaccine so that more manufacturers can make it,” she told The Independent.

“This could be through Pfizer sharing the vaccine with the WHO’s global pool so that the technological know-how and patent rights are shared to enable as many companies to produce it, as fast as possible. And if they won’t, the World Trade Organisation needs to act to suspend patents on all Covid-19 medicines, as South Africa and India have proposed.

“Otherwise, we are heading towards an artificially created scarcity which is completely unacceptable during a global pandemic and will cost even more lives.”

The US can acquire up to 600 million doses under the agreement terms it reached with Pfizer. The UK has pre-ordered 40 million doses, while Japan and the EU have secured 120 million and 300 million shots respectively.

The threat of vaccine nationalism has been ever present throughout the pandemic, with richer countries moving quickly to secure a large portfolio of vaccine doses, leaving lower- and middle-income nations short on supplies.

Research by Airfinity, a data-based science analysis agency, shows that the British government has secured 380 million doses from a variety of global manufacturers, equating to 5.7 shots per person.

In contrast, low and middle-income countries operating through the World Health Organisation’s Covax facility project — which aims to buy and fairly distribute vaccines — had yet to surpass the one dose per capita mark by early September. To date, 700 million doses have been secured for the programme.

Access to the Pfizer/BioNTech vaccine is also likely to be complicated by the logistical challenges that come with transporting and storing doses at -80C – the so-called “cold chain”.

Many of the world’s poorer nations do not have the technology and facilities to meet this requirement, meaning they will be unable to roll out any doses of the Pfizer vaccine they do receive on the same scale as their richer counterparts.

Toby Peters, a professor of energy storage and cold economy at the University of Birmingham, said “little attention” had been given to the difficulties involved in rapid worldwide distribution.

“The new two-shot vaccine from Pfizer has to be maintained at -80°C – nowhere on the planet does the logistical capacity exist to distribute vaccines at this temperature and volume without massive investment,” he said.

“The problem is particularly acute in the global south where many rural villages don’t even have a working vaccine fridge.

“Temperature management at -80C is a tough challenge but we cannot allow this to become, by default, a divided solution.”

Professor Robin Shattock, who is leading development of the Imperial College London vaccine, said that jabs such as Pfizer’s may never reach some low- and middle-income nations.

“Technologies that require very low temperature cold chains and are very expensive by all accounts, we may not see in these countries,” he told The Independent.

“The challenges in lower and middle incomes is that a lot of the populations aren’t in an urban setting. You imagine it’s going to be a logistical problem to get a vaccine to all the vulnerable population in the UK. But if you’re in a South American country and you’ve got people living up in the Andes or very rural communities, it presents so much bigger challenges.”

Other vaccines in development do not need to be stored at temperatures as low as Pfizer’s. The jab produced by Oxford University, which is nearing the end of its large-scale efficacy study, can be transported and maintained at fridge temperature – between 2C and 8C.

“This will be better suited for wider population coverage, and especially in the developing world,” Prof Peters told The Independent. “But that doesn’t change the need for a robust cold chain and it doesn’t change the need for equitable distribution.”

Although the Pfizer jab is expected to be approved by regulatory authorities next month, it has not been included in the portfolio of vaccines put together for the Covax facility project – led by the WHO and Gavi, the Vaccine Alliance.

The programme was established to procure and equitably distribute vaccines between member nations, ensuring that the world’s poorest people would have access to supplies. It has identified and pre-ordered millions of doses from a variety of manufacturers – yet the Pfizer candidate was initially overlooked.

The Independent understands talks are undergoing between Gavi, the WHO and Pfizer to add the vaccine to the Covax facility, but it’s unlikely doses will be made available for the programme in the immediate future.

A Gavi spokesperson said that Pfizer and BioNTech, along with other manufacturers, have “expressed interest” in supplying doses to the Covax facility, which has so far enrolled more than 180 countries across the globe.

As it stands, Pfizer and BioNTech will only be able to produce 50 million doses by the end of the year, having this week cut its initial projection in half. The majority of this supply is expected to be delivered to those countries like the US and the UK which already have bilateral deals in place.

Tania Cernuschi, team lead for the WHO’s global access, immunization, vaccines and biologicals department, said that lower-income countries were facing a number of issues beyond simply storing doses of future vaccines.

“You also need to operate the infrastructure, which includes the number and ability of supply chain and health care professionals, the custom’s officials, the warehouse providers,” she told The Independent.

“Linked to that there’s the consideration of data systems to generally monitor the vaccine delivery, where again systems may be weaker in lower-income countries.

“Then as well there are the regulatory processes. The national regulatory authority of each country has an important role to play in terms of how the vaccines are imported and tracked. There are different levels of expertise in different countries.

“These are all important factors that we need to consider that may see lower-income countries at a disadvantage.”

A Pfizer spokesperson said: “In addition to engagements with governments, Pfizer and BioNTech have provided an expression of interest for possible supply to the Covax facility.”

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