|High-income country confirmed dose total:||4.2 billion|
|Upper-middle-income country total:||1.2 billion|
|Lower-middle-income country total:||524 million|
|Low-income country total:||670 million|
|COVAX total:||1.11 billion|
|Total worldwide confirmed purchases of Covid-19 vaccines:||7.2 billion doses|
Weekly Insights and Interesting Trends
Author: Andrea Taylor
What is at Stake in EU’s Move to Control Vaccine Exports
AstraZeneca recently alerted the EU that it would only be able to deliver 25% of the 80-100 million doses of Covid-19 vaccine expected this quarter, due to production problems in the European plants. The EU responded by suggesting, in the firmest of tones, that AstraZeneca divert doses from the (recently Brexited) UK manufacturing plants to fulfill the EU contract. AstraZeneca replied that would be impossible, as its UK contract stipulates that doses purchased by the UK must be delivered before their manufacturing capacity can be used for other orders. The EU, with a tone closer to furious, respectfully disagreed.
Amid this row, the EU approved the Oxford-AstraZeneca vaccine and then immediately followed this with export controls. Under the new controls, EU member states can block exports of Covid-19 vaccines if they believe that the vaccine producers are in danger of not meeting their supply contracts with the EU. (The EU appears to be targeting certain countries, including the UK, Canada, the US, and Australia, as it has exempted more than 90 other countries and COVAX from these controls.)
In essence, the EU is saying it will use its significant vaccine production capacity to serve itself first, the world second. And if vaccine producers don’t get in line, the EU will prevent them from fulfilling their global contracts.
Despite rhetoric from EU leaders over the past months about the need for “unprecedented global cooperation,” and calls to treat Covid-19 vaccines as “global public goods” rather than “bargaining chips,” we are now seeing what happens when their own supply is threatened.
To be clear, production of Covid-19 vaccines is incredibly complex, with many partners and pieces coming together. We’ve seen many vaccine developers walk back manufacturing projections over the past 4 months and we will see more production delays in the coming year.
The move by the EU reminds us that, amongst this dynamic landscape, the flow of imports and exports are subject to sovereign whims. As leaders in Australia and Japan noted this past week, the best way to secure vaccine supply is with local production. Countries and regions with limited capacity to develop or manufacture vaccines are most at risk, including most of Africa.
A new report commissioned by the International Chamber of Commerce paints the harshest picture yet of the consequences of unequal access to Covid-19 vaccines globally, modeling economic losses of US $1.5-9.2 trillion, at least half of that falling on wealthy countries. To prevent this, we need to take a global view of vaccine manufacturing, not just distribution.
As a global community, we need to invest now in manufacturing capacity on every continent and every region to ensure truly global response to future pandemics. Nationalism may be inevitable in a global crisis but we can soften the blow and prevent the worst.
More to come from us soon on the importance of manufacturing. Our team is working on new analysis of global vaccine manufacturing data, which we hope to release later this month.
Significant updates, changes, and trends we saw last week:
- The EU granted emergency use approval to the Oxford-AstraZeneca vaccine for all adults. Germany, however, recommended that the vaccine only be used in adults under age 65, given the lack of data in older people.
- The EU’s emergency use approval of Oxford-AstraZeneca’s vaccine was immediately followed by export controls on all Covid-19 vaccines, the latest move in their row with the vaccine developer over a manufacturing shortfall (our take on this below).
- Janssen (J&J) released promising early Phase III results for their single-dose vaccine, expected to receive emergency use authorization in many countries later this month.
- Australia issued full approval (not limited to emergency use) to the Pfizer-BioNTech vaccine and expects to begin vaccination in late February.
- Hungary has issued emergency approval to Sputnik V, Oxford-AstraZeneca, and Sinopharm vaccines and ordered 2 million doses of Russia’s Sputnik V vaccine and 5 million doses of China’s Sinopharm. Hungary is the first EU country to order either Sputnik V or Sinopharm.
- The US has exercised 100 million doses in options for both the Pfizer-BioNTech vaccine and the
- Moderna vaccine, increasing its confirmed order to 300 million doses of each.
- Pharmaceutical companies Sanofi and Novartis will use their own capacity to manufacture millions of doses of rival Pfizer and BioNTech’s Covid-19 vaccine to boost global supply in the short term.
- Peru has granted “exceptional approval” to allow 1 million doses of Sinopharm’s vaccine to be administered in the country, as the country’s health system nears collapse.
- Merk announced that it is discontinuing the development of both of its Covid-19 vaccines, after disappointing Phase I results.
- Egypt and Bangladesh launched immunization campaigns this week, with Sinopharm in Egypt and SII’s Oxford-AstraZenca vaccine in Bangladesh.
- South Africa has granted emergency authorization to SII’s Oxford-AstraZeneca’s vaccine as it prepares to launch a national vaccine roll out.
- Israel secured expedited delivery of Pfizer-BioNTech vaccine by paying far above market value and agreeing to share patient data.
- Pfizer-BioNTech have increased their manufacturing projections for 2021 but this is in part because they have decided the vials contain six doses, rather than five. They are urging countries to change the approved labeling to state that each vial is six doses and they are adjusting delivery quantity to reflect this, as the deals are based on number of doses, not number of vials. The catch is that a special type of syringe is needed to extract the six doses. Suddenly a hot commodity, the syringe is now in short supply.
- African Union announced another purchase of 400 million doses of SII’s Oxford-AstraZeneca
For more information on this research and our findings, please go to https://launchandscalefaster.org/COVID–19.