Access & affordability key to coronavirus vaccine

As various pharma giants across the world race towards developing a vaccine for coronavirus, the biggest challenge could be ensuring an equitable distribution. An Indian vaccine, currently under development, could be a solution, if it comes in time.

Last month four European nations – Germany, France, Italy and the Netherlands signed a deal with Anglo-Swedish pharmaceutical giant AstraZeneca that guaranteed them a supply of 300 million doses of a vaccine against coronavirus should AstraZeneca develop one.

Meanwhile, in May, Paul Hudson CEO of French drug maker Sanofi pledged that should his company be successful in bringing a vaccine against the deadly virus to the market, it would first be given to the United States, even before France, where the company is located. There have been numerous other similar attempts by leaders of various developed nations to corner supplies of the promised inoculation for their own citizens, in clear detriment to the rest of the world, especially against the poor countries and against the poor citizens of middle and even high-income nations.

Access to medicines and health is one of the key barometers of the rapidly growing inequality across the world today. Indeed, health is listed third on the list of the 17 Sustainable Development Goals or SDGs of the United Nations, just after poverty and hunger. That indicates the severity of the problem across the world. According to the World Health Organization, there are over two billion people in the world who lack access even to basic health care like a bare minimum medical facility and medicines that are easily available in most countries and this leads to millions of easily preventable deaths, notably those of infants, children and women, especially during child birth.

For long, equalizing access to health has been one of the biggest challenges for all governments, political leaders and international organisations like the WHO or the other UN institutions. At the core of the debate surrounding access to medicines is one of the price. Currently, the biggest pharmaceutical companies in the world all belong to the developed nations and they enjoy a certain monopoly in their home markets due to the high prices that they can charge in those markets. Over the past many years, they have lobbied hard and proactively resisted any efforts to cut prices even in face of healthcare becoming unaffordable many citizens of those countries as well and mounting social security deficits in many European countries becoming the main headache of most finance ministers.

The high prices and a protected market where there is no real competition from the cheaper drugs, notably generics, lead the Big Pharma companies to seek roll over of the patents with minor tweaks that don’t deserve any patent protection. Notwithstanding their ever-increasing profit, the Big Pharma has always defended its love for patents by saying that they invest billions of dollars in their research & development and that they need the patent protection to be sure to reap the benefits of drug discovery and hence continue to invest in their R&D.

While this may have been true at some point, the Big Pharma’s ballooning profits over the past two decades have not just robbed them of their principal argument over high prices, but also led to a serious global debate over the responsibility of the Big Pharma in the sharp rise in unequal access to healthcare and the blame for millions of preventable deaths due to lack of basic medicines in poor countries has been laid primarily at the door of the drug manufacturers.

The debate has resurfaced again since the coronavirus pandemic began late last year. Healthcare experts have been warning that the pandemic which has managed to bring even the most developed nations with a robust healthcare infrastructure to their knees would cause a havoc in vast parts of the developing nations which have a rickety healthcare system and suffer from a permanent penury of even common medicines, let alone a vaccine to counter the advance of the pandemic. This point was highlighted at a global meet organised by the United Kingdom recently where global leaders pledged USD 2 billion to fund the development of a vaccine for the coronavirus but with a clear precondition that the drug would be fairly distributed all over the world and especially to the poor countries.

At the meet, the Global Alliance for Vaccines and Immunisation (GAVI) presented a proposal to ensure that the poor as well as middle-income countries have access to the vaccine. The proposal includes a way in which wealthy countries can get access to the same vaccines while supporting equitable global distribution. At the summit, it was repeatedly emphasised that while the race to develop a vaccine was a crucial one, a bigger challenge lay in making sure that the vaccine i distributed globally to stamp out the pandemic as quickly as possible and avoid a humanitarian disaster in which rich countries restart their economies while people in poorer countries continue to die.

At the virtual meet hosted by UK Prime Minister Boris Johnson a new funding mechanism was unveiled whereby rich countries would guarantee purchase of the drugs to allow poor countries to get access to those medicines at an affordable rate. Though this mechanism has been in place for a few years and it led to creation of a market for a pneumococcal vaccine for lower income nations, the challenge of access to healthcare has not really been addressed in any significant manner since and gap in inequality in healthcare had only increased upto the outbreak of the pandemic.

The situation has undoubtedly become far worse since as the global economy itself is set to shrink by nearly 6 pc and while the rich countries have all got their reserves to fall back upon, the poor and middle income countries are bound to be entirely ruined by the economic shock that the virus has delivered to the world. In such a situation, it becomes even more crucial for the rich countries to ensure that the Big Pharma lets go of its penchant for fat profits and that drugs, not just for coronavirus but for many other communicable and lifestyle diseases are provided to the poor and needy in order to avoid tens of millions of deaths.

In such a scenario, it is heartening to note that a few vaccines are under development in India, as well, with the human trials of Bharat Biotech’s Covaxin slated to begin shortly. Last week, the entire effort faced a real risk of losing its credibility due to ridiculous comments by the leading medical research agency in India, Indian Council for Medical Research, which declared that the vaccine would be launched by August 15, Indian independence day, even though human trials had not yet begun. The comments drew sharp rebukes from scientific community in India and globally as well. ICMR’s statements put a dark shadow on the reliability of Indian pharmaceutical regulations, raising doubts whether the regulators would turn a blind eye to companies cutting corners in testing the safety of the vaccine, just so that they could launch by August 15. Incidentally, even the most advanced vaccine research programmes around the world are predicting that a safe launch could be yet a few months away.

Thankfully, most pharma companies in India have themselves clarified that development of vaccines is a much longer process and can not be completed so soon. If indeed, the tests of Indian vaccine prove to be successful, it could help not just millions of people in India, but indeed people around the world. Over the past four decades, with its prowess in the generic drugs business, India has already emerged as the pharmacy to the world by providing essential, often life saving, drugs to people around the world at highly affordable costs. If indeed Indian companies crack the vaccine challenge as well, leaders of various developing countries can breathe a lot easier as they can expect the Indian vaccine to be effective and affordable.