Hilary Thomas, KPMG UK’s Chief Medical Adviser, looks at why collaboration is at the heart of developing a COVID-19 vaccine and distributing it.
The truth is that developing a vaccine is the first stage in a longer race – planning its distribution will require enormous levels of global cooperation.
First, assuming that a safe and effective vaccine(s) for COVID-19 can be developed, it is highly likely that there will be several different manufacturers with different vaccine products – there are perhaps 224 candidates currently in development. Second, one manufacturer alone will not be able to provide the volumes of product required for world immunisation.
As a result, international collaboration will be essential to plan for global distribution and manage equitable distribution and surveillance – health leaders have been calling for global regulatory alignment to help ensure this access. However hard it is to predict how things might play out, given current geopolitical uncertainties, the need for a global consortium to work together to plan vaccine distribution in the developing world could not be greater.
For any candidate vaccine showing promise, the manufacturer will need to navigate intense media interest and challenging geo-political issues as governments look to gain influence and prioritise supply from firms headquartered in their respective countries – with recent high-profile examples already reported in the media. Where a vaccine has been developed with the support from the Gates Foundation, the World Health Organisation or Coalition for Epidemic Preparedness Innovations, this could cause further complexity around the allocation of supply and as, in many cases, vaccine development requires international collaboration across firms and countries, difficult decisions on allocations likely lie ahead.
The vaccine development ecosystem is very complex with more than a dozen companies globally working on hundreds of potential vaccines for COVID-19. Some big pharma companies with established vaccines business are collaborating with others – GSK and Sanofi have announced they are joining forces – while others continue to go it alone. Others are moving into the area and collaborating with established companies, such as BioNTech and Pfizer, while others are collaborating with academia, such as AstraZeneca and the University of Oxford. Furthermore, some biotech companies are looking at how they might scale in the event of a successful vaccines being developed, for example, the partnership announced between Moderna and Lonza.
There are many unknowns about the possible vaccines at this stage: what will they cost, will there be special handling and storage requirements, what unique therapeutic profiles will they have? For example, how many doses, and over what period will these vaccines will be needed? COVID-19 is not particularly immunogenic, so will the elderly struggle to mount an immune response? If so the population most at risk may not be best served.
Even if we are able to supply part of the world population with vaccine, we still cannot let up on care for the rest of the population that is still vulnerable while the vaccine is being rolled out. Continuing to support medical systems, educating on social distancing and other safety measures, access to frequent testing and ensure any “return” to work….to life….is safe, is crucial. Whilst we may have vaccines available for manufacturing at scale as early as September, in reality it will take some months for the required volumes to be available globally especially given the need to provide it to the developing world.
It is perhaps trite to quote WB Yeats – “All changed, changed utterly” – in relation to this pandemic, but this virus does not respect borders. How the world coordinates the supply and distribution of vaccines for COVID-19 will have implications for all of us and how well and how soon the global economy recovers. Like it or not we are in this together and the way we work together for the greater good will have far reaching implications for global comity and the future world order. If ever there was a time for effective global collaboration it is now.
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