Fighting vaccine inequalities

In order to give us protection in this pandemic, vaccines need to available as well as effective. At the current time there are many inequalities in vaccine access. More precisely, there are two types of discrepancies:

• Firstly, developed countries have obtained the majority of the world’s stock of vaccines, by buying up more than two times the amount they need to vaccinate their populations. For this reason, some developing countries have barely started their vaccination campaigns.
• Secondly, delivery of vaccines is problematic in these latter countries, especially in Africa. It is the same type of problem as that encountered with anti-HIV treatments from the middle of the 1990s to the beginning of the 2000s: the availability of medicine is not in itself enough to control the illness. An effective health system infrastructure is necessary to guarantee medicine distribution, ensure that the local population has health care, identify at-risk sections of the population, and develop protection strategies.

These are the challenges for effective and equitable global distribution of SARS-CoV-2 vaccines to meet. International actors and health care workers have been reflecting about the different solutions that need to be promoted. Here are some examples:

• The first step towards solving problems of vaccine stock and supply is to coordinate international decisions. Very early during this pandemic, each government invested in its own pharmaceutical companies. This inevitably led to numerous, often risky, small investments, and did not result in either sufficient stock being available or in fair distribution of supplies. However, a more promising initiative involved a dozen or so countries who created the CEPI (Coalition for Epidemic Preparedness Innovations) several years ago and have invested, since 2020, more than 5,6 billion dollars in academic and private research and development, illustrating the importance of major joint investment in enhancing innovation, development and production. Numerous private companies have received financial support from the CEPI, including AstraZeneca and Novavax.
• The 2^nd solution, already practised in more than 100 countries, would be to remove patent and intellectual property barriers on anti- COVID-19 vaccines. Current stock is insufficient, and the few producing countries do not ensure an equitable distribution of doses.

Beyond the question of stock, it is also necessary to create an infrastructure providing an efficient system of logistics for receiving and distributing vaccines (fully equipped storage spaces). This is especially the case for mRNA (Moderna and Pfizer-BioNTech) vaccines, which need to be stored at -20°C, and require special equipment, trained staff, and a stable electricity supply.  What is more, just as in developed countries, there is widespread vaccine scepticism in Africa (in 56% of the population of the Democratic Republic of Congo). It is therefore indispensable to put vaccine information campaigns into operation, to counteract the disinformation currently circulating, especially on social media.

The availability of a vaccine is, therefore, not a sufficient condition in itself to control the pandemic. In order to allow equitable, universal distribution, it is necessary to take infrastructure, logistics, local epidemiology, and population compliance into account, not only in Africa, but throughout the world.