What is the People’s Vaccine Alliance?
The People’s Vaccine Alliance is a coalition of organisations and activists united under a common aim of campaigning for a ‘people’s vaccine’ for COVID-19. This would be based on shared knowledge and freely available to everyone everywhere – a global common good. The alliance’s members include Free the Vaccine, Global Justice Now, Public Citizen, the Yunus Centre, Frontline AIDS, Amnesty International, Oxfam, SumOfUs and UNAIDS. The call for a #PeoplesVaccine is backed by past and present world leaders, health experts, faith leaders and economists. Click on our ‘Supporters’ page to see a full list.
Are intellectual property and patents the only barrier to mass production of any vaccine?
Pharmaceutical corporations use patents and other intellectual property rights to stop other companies from making the vaccines or medicines they have developed. We are saying that in these unprecedented times, companies should share their knowledge and not enforce intellectual property rights in the interests of public health.
But intellectual property is not the only barrier. Vaccines are not as straightforward as many other medicines to copy and many are made of biological material. Therefore, it is important that corporations and research institutions also share the know-how, biological material and technology behind their vaccine with other companies that could manufacture them. We have seen some bilateral examples of this. For example, Astra Zeneca has licensed production to companies in India, Brazil and in Argentina. However, this process should not be left to the goodwill of individual corporations or subject to secretive deals. The WHO COVID-19 Technology Access Pool (C-TAP) provides a global mechanism for such sharing. The C-TAP can promote technology transfer and the licensing of production to more companies and institutions that are able to manufacture safe and effective vaccines in order to maximise supply.
Aren’t there already knowledge-sharing initiatives such as Covax?
Covax is an initiative led by three global organisations: Gavi; Cepi; and the World Health Organisation (WHO). It is currently the only global mechanism for pooling demand for COVID-19 vaccines to try and secure access for poorer countries. While it is encouraging that at least 170 countries have agreed to work together, rich countries continue to cut bilateral supply deals with pharmaceutical companies which undermine this global effort and limit supply to poorer nations. So far Covax has not been transparent about the deals it is making with pharmaceutical companies and remains silent on how it will tackle monopolies. Covax lacks transparency on decision-making and developing countries have not been involved in strategic decisions. Civil society has also been excluded from decision-making processes.
Moreover, Covax does not use its purchasing power to push corporations to share the science, knowledge and technology behind their vaccines, which could lead to scaled up production. We are also deeply concerned that Covax is considering a tiered pricing model that would mean many middle-income countries, already facing economic turmoil and with under-resourced health systems, may not be able to afford the vaccine or would be forced deeper into debt.
For Covax to succeed it must:
How do you expect pharmaceutical companies to develop vaccines and treatments if there is no promise of a profit?
We are not suggesting that pharmaceutical companies shouldn’t cover their costs or make reasonable profit in normal circumstances. However, given that COVID-19 is a pandemic and most of the research and development (R&D) costs are financed by public money, it would be completely unacceptable for companies to charge the kinds of high prices we have seen for other medicines and vaccines. One corporation (Pfizer) is selling its COVID-19 vaccine candidate for around $39 for two doses, at around an 80% profit margin. This puts it beyond the reach of all but the wealthiest countries.
As most vaccines and treatments have been funded by taxpayer money, governments should impose conditions on their funding to demand the removal of patents and other intellectual property barriers, the open sharing of know-how, and the transfer of technology to as many manufacturers as possible. In these unprecedented times, we should be aiming to maximise supply instead of maximising profits for pharma companies.
Who should pay for the vaccines? (including the costs of shipping, training, public health campaigns, etc)
This is a global pandemic with intolerable economic costs for all countries, especially the poorest nations. Vaccines, tests and treatments need to be supplied at transparent affordable prices so that governments and donors can afford enough for everyone and provide them free of charge to people. The story of HIV treatment is a case in point. When the price was high, people in developing countries were denied access to life saving treatment and millions died needlessly as a result. When generic competition pushed the price right down, it was possible for donors to buy millions of treatments and now over 20 million people are receiving treatment.
Donors must contribute to the purchase of the vaccines via the global mechanism Covax. Covax must take into consideration the fact that governments have funded much of the research and development costs when negotiating prices. Developing country governments must increase financing for health services so that they can deliver the vaccine when it is available.
Are you suggesting a rationing system for any future vaccine and how would this work?
What is important is to scale up production across the globe as soon as a vaccine is found to be safe and effective – this shouldn’t be a choice between vaccinating people in the UK or the US and getting the vaccine to people in Pakistan or Nigeria. But there must also be an equitable system for prioritising who gets access first. It would be hard to think of a system more unfair than our current one, where the wealthiest countries are vying with each other to secure exclusive access to prospective vaccines, leaving most of the world’s population out in the cold. No-one is safe from COVID-19 until everyone is safe, and so it is in everyone’s interests to ensure that all countries get access to a vaccine.
A fairer and more effective system would prioritise those at risk across all countries. The WHO Equitable Allocation framework prioritises the groups to be vaccinated first as health and care workers, people over the age of 60, and all those who have chronic conditions. The vaccine should be distributed according to need rather than auctioned off to the highest bidder.
Are all vaccines the same?
The basic aim of all vaccines is the same: to create immunity in the body before people are exposed to the virus. Once a person is exposed to infection, the body is already prepared and can release antibodies and immune cells to attack the virus and kill it. However, different vaccines use different technology to achieve the same results. Some, such as Sinopharm, use the established method of exposing the body to a weakened form of the virus. Others, such as the Oxford/AstraZeneca vaccine, use part of the virus genome to trigger an immune response. Other vaccines, such as the Pfizer and Moderna vaccines, use a new technology called mRNA which stimulates the body to make a protein which triggers the immune response.
Vaccine development has been fast – is there any danger to people’s health?
Potential vaccines and treatments for COVID-19 are subject to the same rigorous trials as other vaccines and medicines, although huge levels of public funding and advanced technology have enabled them to happen much faster than usual. Vaccine development goes through three phases of clinical trials, including testing on thousands of volunteers to prove the efficacy and safety of the vaccine. Thousands of laboratory workers have been working tirelessly to speed up R&D. All data from the trials go to drug regulatory authorities which examine it before authorising a vaccine for public use. Any vaccine that is passed will continue to be monitored for any signs of harm. In response to public concern, vaccine makers have recently made an unprecedented move in signing a joint safety pledge to ‘uphold high ethical standards’.
There have been some calls to cut corners in the testing of certain potential vaccines, or to create deadlines. Politics should not interfere in science and it should be up to scientists to take the time necessary to provide evidence of the efficacy and safety of any vaccine or medicine, and to be held to account by drug regulatory authorities.
Should vaccines be mandatory for everyone?
Vaccination is one of the most successful health victories in human history, and has led to a massive reduction in infant and child mortality around the world. Vaccines have led to the eradication of small pox and the near eradication of polio. They have saved millions of lives from measles, pneumonia and tuberculosis. In more recent years, vaccinating girls and boys against the human papillomavirus virus (HPV) has protected girls from cervical cancer and boys from genital diseases.
The World Health Organisation advises against mandatory vaccination and instead promotes the use of vaccines by raising awareness of their benefits. There is a debate about whether vaccines should be mandatory for certain groups in society, but it is better to persuade people of the benefits of taking the vaccine than imposing vaccination against their will.
Governments and pharmaceutical companies both have a responsibility to increase people’s willingness to take a COVD vaccine. To achieve this governments must put science before politics to build trust. Pharmaceutical companies and research institutions should contribute to the building of trust by ensuring transparency at all times in terms of: clinical trials; data on safety and efficacy; and cost and pricing. The People’s Vaccine Alliance calls on governments and pharmaceutical companies to ensure transparency on all aspects of vaccine development and testing to help build public confidence in COVID vaccines.