GLOBAL HEALING: THE HUMANITARIAN CHALLENGES OF VACCINE ACCESSIBILITY As vaccines are rolled out, governments will face a number of hurdles in prioritising vaccine dissemination and availability. The global community will need to come up with strategies for effective distribution and find ways to guarantee that the vaccine will reach low-income populations and countries. Meanwhile, the biggest challenge may be combating the disinformation surrounding vaccinations.

Ensuring vaccine availability of a catastrophic moral failure, and the price of this failure will be In November 2020, the world was anxiously awaiting a break- paid with lives and livelihoods in the world’s poorest countries.” through: a jab that would bring an end to the COVID-19 pan- Adhanom called on richer countries to stop hoarding doses demic. Less than three months later, not one but several vaccines for younger, healthier citizens while older, disadvantaged citizens are in production and millions of people have already had their in poorer countries had no access, and stressed that any hoard- initial dose. However, by mid-January, 95% of these vaccines ing would only lead to increased prices. “Ultimately, these me-first have been distributed in just 10 countries, according to the World actions will only prolong the pandemic, the restrictions needed Health Organization (WHO), limiting the doses available for the to contain it, and human and economic suffering,” he added. populations of poorer nations which cannot afford to purchase He called for a full commitment to the global vaccine-sharing vaccines. As the WHO recently warned, the global effort is failing scheme COVID-19 Vaccines Global Access (COVAX) to help end to reach low-income households. the pandemic globally as early as possible. At a recent executive board session, WHO Director-General In a session at the Annual Forum on vaccine accessibility, Dr. Tedros Adhanom shared his fear that “the world is on the brink the general counsel and director of business development at the

10 | THE 11TH ANNUAL FORUM FOR MEDICAL RESEARCH GREGORIO BORGIA/AP/SHUTTERSTOCK

procurement and providing incentives for vaccine manufacturing “WITH COVAX, THE GOAL IS TO ENSURE to ensure rapid supply to nations; and the WHO, which provides THE ROLLOUT AND ACCESSIBILITY guidance on vaccine policy, regulation and safety and allocation. OF THOSE VACCINES AT THE SAME The COVAX initiative is part of the wider Access to COVID- 19 Tools (ACT) Accelerator—a partnership between the WHO, MOMENT AROUND THE WORLD.” Gavi, CEPI, Bill & Melinda Gates Foundation, the Wellcome Trust, the Unitaid, the World Bank, the Global Fund and FIND— Coalition for Epidemic Preparedness Innovations (CEPI) Richard working with governments, civil society and industry to ensure Wilder explained that the COVAX initiative brings together three access to vaccines. “The only way for the world to succeed in principal organisations: CEPI, which was launched in 2017 and developing the necessary tools to deal with the pandemic is whose focus is taking vaccines from conception to clinical trials and to join together,” Wilder explained at the start of his presenta- through to production; the Global Alliance for Vaccines and Immu- tion. “The ACT Accelerator has seen a very large number of nizations (Gavi), which is responsible for pooling funding for vaccine organisations come together to work on several areas of focus.

COVID-19 VACCINE: GLOBAL CHALLENGES & PROSPECTS | 11 Who takes priority? is also the challenge of reaching people Wilder mentioned the need to prioritise in war and conflict zones and in remote vaccination campaigns, with frontline areas. There are millions of villages that healthcare workers at the greatest risk are difficult to reach, and approximately being vaccinated first, followed by vulner- one billion people living in urban slums,” able groups then the general population. he said. “These are people who are usu- With doses being secured in batches, one ally not fairly treated, and all this means of the biggest challenges for governments there will be inequality in securing immu- is deciding which groups should be vacci- nisations worldwide.” nated before others. The Bill & Melinda Gates Foundation But before that can happen, nations is attempting to mitigate these challenges must be ready to receive and store vac- by encouraging donations for more vac- cines, and that is something that COVAX, cine development, particularly to identify along with organisations such as UNICEF, ways to combat variants of the virus. Mariwan Baker addressed areas affected by the crisis. are working to ensure. “Vaccines need “Since January 2020, the foundation has cold storage facilities, and we will need had a four-pronged strategy for response, In addition to addressing access and to ensure country readiness and that the namely: to protect the most vulnerable by allocation of vaccines and how they’re infrastructure exists to receive and then rapidly strengthening capacity and coor- going to be made available on a global store the vaccines to properly distribute dination to detect and respond to COVID- basis, [ACT also focuses on] therapeu- them to clinics where they’re going to be 19 in key affected countries; to accelerate tics, health systems and diagnostics.” used,” said Wilder. detection and containment of the virus; to Wilder went on to explain that COVAX Once the infrastructure is in place, develop and deliver treatments and vac- aims to end the acute phase of the pan- the vaccines can be rolled out. However, cines; and finally to minimise societal and demic by 2021. “We aim to support the some nations will not be able to guar- economic impact by promoting responses largest actively managed portfolio of vac- antee that infrastructure or to subsidise that balance health outcomes and eco- cine candidates globally, to deliver two bil- vaccinations. In his talk ‘Challenges in the nomic recovery on societies and individu- lion doses by the end of 2021, to offer a als,” explained Dr. Holger Kanzler, senior compelling return on investment by deliv- programme officer at the foundation. ering COVID-19 vaccines as quickly as “WE WILL NEED TO possible so that we can save and resus- ENSURE COUNTRY Setting the record straight citate economies around the world, and on disinformation to guarantee fair and equitable access to READINESS, THAT As Baker mentioned in his talk, there has vaccines to all participating countries— INFRASTRUCTURE EXISTS never been as much scepticism or miscon- making sure no country is left behind.” TO RECEIVE AND ception over a vaccination as there is over Past experience with vaccine roll- the COVID-19 jab. “My question is imagine outs has shown that the richer a nation, STORE VACCINES THEN that a vaccine that is safe and with a great the more likely its citizens will be offered PROPERLY DISTRIBUTE efficacy is developed, what would it take vaccinations. “In the past, vaccines have for you to agree to take it yourself and to been developed and then low- and mid- THEM TO CLINICS.” give it to your family, to your children?” dle-income countries would find them- With so much speculation surround- selves only getting access three, four, or delivery of COVID-19 vaccines to people ing the COVID-19 vaccines even before five years after the wealthier countries,” in need,’ Dr. Mariwan Baker, founder and they were approved, experts have says Wilder. “With COVAX, the goal is chairman of the Bring Hope Humanitar- warned that it will take a global effort to ensure the rollout and accessibility ian Foundation (BHHF), put forward the to turn the tide against misinformation of those vaccines at the same moment humanitarian perspective, turning the and prevent the anti-vaccine movement around the world and that the doses that spotlight on areas affected by crises such from thwarting the potential benefits of are available are equitably distributed in as war, poverty, and disease. the vaccines. order to have a public health impact on Baker began by acknowledging that Chairing the ‘Challenges facing COVID- the COVID-19 outbreak.” there have been successful and cost-ef- 19 selection and vaccination’ session, Dr. In November, 186 countries had signed fective global healthcare interventions Gene Garrard Olinger, the principal science up with COVAX. Of these, 94 were self- throughout human history, but then advisor at MRI Global, highlighted the issue funded economies that had pledged to warned that geographic challenges will of distrust of the scientific community as a pour funds into the facility by paying for affect availability of COVID-19 vaccines. general hurdle when it comes to disinfor- vaccine doses themselves, while 92 hoped “Today, there are around 80 million peo- mation regarding vaccinations, especially to receive support in procuring doses. ple in the world who are displaced. There in the case of COVID-19.

12 | THE 11TH ANNUAL FORUM FOR MEDICAL RESEARCH In his talk ‘COVID-19 vaccines in a Hotez also explained the rise of “vac- time of anti-science disinformation,’ Pro- “WE’RE STARTING TO cinationalism,” with people attributing fessor Peter Hotez, founding dean of the SEE AN UNRAVELLING vaccines to the countries where they were National School of Tropical Medicine at developed and tying it to nationalism. Baylor College of Medicine, spoke about OF THE GLOBAL “We’ve never seen this happen before. his work fighting the anti-vaccine move- GOVERNANCE OF We’re starting to see an unravelling of the ment, which he says has now evolved into VACCINES, IN PART global governance of vaccines, and it’s a full-fledged anti-science movement. happening in part because of the anti-sci- “In the US, the movement has become BECAUSE OF THE ANTI- ence movement.” a really powerful and very worrying force,” SCIENCE MOVEMENT.” With dialogue and communication noted the vaccinologist, who has just emerging as key to winning over people published his latest book, Preventing the streets in protest of government advice and dispelling misinformation, Olinger Next Pandemic: Vaccine Diplomacy in a on precautionary measures such as asked how the business, industry and Time of Anti-science. “A lot of this has to mask wearing, social distancing and scientific communities should address the do with the messaging or lack of mes- contact tracing. public amid a global anti-science move- saging about Operation Warp Speed, the That anti-vaccine mentality has been ment. In response, Hotez recalled how in programme to speed up the COVID-19 fuelled by the speed at which COVID-19 the past scientists were not encouraged to vaccine in the US, and because of distrust vaccines have been rolled out, with detrac- speak to the press about their work, as that of the government.” tors claiming it has been too rushed, is not would have been construed as self-pro- Blaming the start of the anti-vac- safe, or a host of other conspiracy theo- motion. “Today, our inability or unwilling- cine movement on Wakefield’s infamous ries. With media now able to reach more ness to talk to the public has created a paper published 22 years ago which people around the globe and not enough vacuum that has enabled the anti-science falsely claimed the MMR vaccine was a communication strategies being put forth movement to flourish. What we need to direct cause of autism in children, Hotez to reassure sceptics or drive home sup- do is build public engagement into our stressed the power of the media in both port for the efficacy of the vaccines, the doctoral science training and education. spreading misconceptions and correcting US’s anti-vaccine movement has gone What this COVID-19 pandemic has taught them, though he added that the latter is global. “Anti-vaxx communications are us, at least here in the US, is that people far more of a challenge. flooding the internet, and we’re seeing pro- really don’t want to have everything filtered The outbreak of the SARS-CoV-2 test marches in London, Berlin, and Paris through politicians and elected leaders. pandemic saw thousands taking to the against vaccines and masks,” said Hotez. They want to hear from us.” SOPA IMAGES LIMITED / ALAMY STOCK PHOTO LIMITED / ALAMY STOCK IMAGES SOPA The global COVAX initiative aims to guarantee fair and equitable access to vaccines to all participating countries, making sure no country is left behind.

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