More than 600 million people worldwide have been at least partially vaccinated against Covid-19 – meaning that more than seven billion have yet to be vaccinated. It’s an amazing feat with an enormous challenge.
Half of all doses delivered so far have gone into the arms of people in the countries where one-seventh of the world’s population lives, primarily the United States and European countries. Dozens of countries, mainly in Africa, Hardly it started Their vaccination campaigns.
While rich countries envision the epidemic receding within months – while poor countries face the prospect of years of suffering – the frustration Have people all over the world ask why no more vaccines are available.
Nationalism and government action do much to help explain the world’s stark inequality between the haves and have-nots. So, as far as this is concerned, is the government inaction? And the power of pharmaceutical companies that sometimes It appears to be holding all the cards, Cannot be ignored.
But a lot of that is due to pure logistics.
Immunizing most people in a short time is a huge task, which has not been tried before, and one that experts say the world was not prepared to face. They noted that things had already moved at an unprecedented speed: a year and a half ago, the disease was unknown, and the first vaccine clearances came less than six months ago.
But there is a long way to go. Here’s a look at the causes of the vaccine shortage.
Global capacity is limited.
There are just too many factories around the world that manufacture vaccines and so many people trained to make them – and they were busy before the pandemic. Likewise, the production capacity of biological raw materials, cell culture media, specialized filters, pumps, tubes, preservatives, glass flasks and rubber stoppers is also limited.
“We don’t suddenly stop making every other vaccine,” Sarah Scheffling saidAn expert in pharmaceutical supply chains and humanitarian relief at Liverpool John Moores University in Britain. “We’re adding this on top. We’re essentially doubling production. Supply chains of this size usually take years to accomplish.”
The world’s largest vaccine maker, Serum Institute in India, makes the Covid-19 vaccine developed by AstraZeneca and the University of Oxford, and produces one 1 billion doses this year, plus nearly 1.5 billion doses annually for other diseases. But it took months to scale up.
Thanks to huge investment from governments, companies have repaired factories, built new ones from the ground up and trained new employees, an effort that began last year and is still far from complete.
Rich countries can do more for the poor.
The world’s wealthiest countries pledged more than $ 6 billion Kovacs, the global effort to provide vaccines For the developing world, at little or no cost.
However, some of the pledges have not yet been fulfilled. In any case, it represents a small fraction of what the rich countries spent on themselves, and a small fraction of global needs.
The Covax campaign also lost some progress when concerns surfaced that the AstraZeneca shot – which was expected to be the backbone of the effort – may be associated with very rare but serious side effects. This has resulted in some general caution over its use.
Many public health advocates have called on Western governments to force drugmakers to do so Share their patented processes With the rest of the world. No vaccine producer has done so voluntarily, and no government has indicated it will move in this direction.
Given the limited production capacity in the world, and how recently vaccines have been developed, sharing patents may not increase supply significantly at this point. But in the future, as capacity expands, it could become a major factor.
The Biden administration announced financial support for an Indian company, Biological E, to ramp up support Mass production from Johnson & Johnson shot For people in other parts of the world. The administration said this week it would send up to 60 million doses of the AstraZeneca vaccine – which the United States has bought but does not use – to other countries.
But the United States is still behind China and Russia in such “vaccine diplomacy.”
The United States and other countries have imposed restrictions on exports of some vaccine-making materials, which has sparked strong criticism, especially from India, where Covid is devastating this country On a scale never seen anywhere else. The Government of India has banned the export of finished vaccines, which has hindered immunization efforts in Africa.
Last week, the Biden administration said it would Relax India’s export controls.
Governments could put more pressure on pharmaceutical companies.
The United States and other developed countries invested billions of dollars into developing vaccines and expanding manufacturing, and spending billions of dollars on the resulting shots. The United States government too Controls an important patent On a process used to make the vaccine, its National Institutes of Health helped develop the moderna vaccine.
All this gives governments tremendous power to force companies to operate across borders, be they corporations or national, but they have been reluctant to use them. In the US, that has been changing since President Biden took office in January.
“The government has tremendous influence,” he said, “more than our country.” Tinglong Dai, Associate Professor of Business Administration at Johns Hopkins University specializing in health care management.
Patents are one area where governments can be more aggressive about using their influence. But in the short term, Dr. Day said, what would have been the biggest impact would have been if officials had acted earlier and more forcefully to insist that companies developing vaccines make deals with their competitors to increase mass production.
This kind of cooperation has proven necessary.
Several Indian companies have agreed to make Russia’s Sputnik vaccine. Sanofi, which is already involved in producing vaccines for Pfizer-BioNTech and Johnson & Johnson, struck a deal with Moderna to work on the shot as well. Moderna has already concluded deals with three other European companies.
The Biden administration pressured Johnson & Johnson to sign its rival, Merck, in March to produce its vaccine, and the government allocated $ 105 million to refurbish the Merck plant in North Carolina for the purpose.
Former President Donald J. Trump refused to rely on the Defense Production Act to give vaccine makers preferred access to the materials they needed, a move Mr. Biden took.
Vaccine production is difficult. The new ones are harder.
Even with a consistent product and stable demand, vaccine making is a rigorous process. With a fresh take, new product lines, and increased global outlook, it’s getting more difficult.
both of them AstraZeneca And the Johnson & JohnsonTwo of the world’s largest pharmaceutical companies have faced serious production problems with Covid-19 vaccines – objective lessons in the challenges of rapidly expanding from nothing to hundreds of millions of doses.
Adding to the difficulty, the Pfizer-BioNTech and Moderna shots are based on an extract from the coronavirus’s genetic code called messenger RNA or mRNA. Until last year, That process It has never been used in a vaccine produced in large quantities. It requires different equipment, materials, technologies, and expertise than standard vaccines.
Messenger RNA vaccines encapsulate the genetic material in “lipid nanoparticles”, which are microscopic bubbles of fat. Few facilities in the world have any experience producing anything similar on a large scale. Vaccines also require extremely cold temperatures, which experts say limit their use – at least for now – to wealthier countries.
Many pharmaceutical companies insist they can take over this production, but experts say they will likely need significant time and investment to prepare, a point made by Stefan Bansl, CEO of Moderna, in February at a hearing of the European Parliament.
Mr. Bansel said that even in contracting with highly advanced companies to do the work, our modernity had to spend months essentially building the facilities, rebuilding them to new specifications with new equipment, testing and retesting that equipment and teaching people the process.
He said, “You can’t go into a company and have them start immediately making an mRNA product.”