COVAX and the many meanings of sharing

Storeng, Katerini Tagmatarchi; Stein, Felix; Puyvallée, Antoine de Bengy

doi:10.1136/bmjgh-2021-007763

Cited by 15 publications

(14 citation statements)

References 4 publications

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“…Two major global efforts, COVAX and ACT-Accelerator, where richer countries should contribute to supplying and distributing vaccines to poorer countries, have been launched to facilitate global vaccination 120 , 121 , 146 . These schemes, however, have not yet translated into action in terms of global solidarity, although equity gaps may be beginning to narrow 147 , 148 .…”

Section: A Global Health Perspectivementioning

confidence: 99%

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

et al. 2022

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The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected patients with kidney disease, causing significant challenges in disease management, kidney research and trainee education. For patients, increased infection risk and disease severity, often complicated by acute kidney injury, have contributed to high mortality. Clinicians were faced with high clinical demands, resource shortages and novel ethical dilemmas in providing patient care. In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.

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Section: A Global Health Perspectivementioning

confidence: 99%

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

et al. 2022

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“…To reduce investment risk for pharmaceutical companies, COVAX, and with it public funding, has committed to purchase large quantities of vaccine upon successful development and incentivized high-risk investments in global vaccine production capacity ( 59 , 66 ). Criticized are lacking mechanism to ensure sharing of knowledge and data with other companies, and impediment of vaccine donation and resale ( 28 , 67 , 68 ).…”

Section: Resultsmentioning

confidence: 99%

Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines

Voit

Timmermann²,

Orzechowski³

et al. 2023

Front. Public Health

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IntroductionThere is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation.MethodsThe main documents discussing the two strategies are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis.ResultsWe observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation.DiscussionA legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel.

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“…There is a substantial literature that seeks to explain why access was so globally unequal. For example, a significant body of scholarship has focused on advanced purchase agreements (APAs) between vaccine developers and high-income countries (HICs) which allowed them to secure a large proportion of global supply early , or the lack of technology transfer to expand production and the contested role of intellectual property (IP) rights in impeding greater supply (7,8,12,13,15,18,22,25,26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Scholars have also highlighted regulatory and quality issues (8,12,17,41,42) and export restrictions (8,17,18,20,22,25,43) as important factors contributing to access inequities, although less frequently.…”

Section: Literature Review and Research Gapsmentioning

confidence: 99%

“…Scholars have also highlighted regulatory and quality issues (8,12,17,41,42) and export restrictions (8,17,18,20,22,25,43) as important factors contributing to access inequities, although less frequently. There is also significant analysis of the limitations and challenges faced by COVAX, the vaccine pillar of the ACT-A Accelerator, pointing to competition with HICs for doses, lack of sufficient financing, and internal transparency and governance issues (8,16,17,24,(26)(27)(28)(29)(30)(31)(32)(33)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54). .…”

Section: Literature Review and Research Gapsmentioning

confidence: 99%

Which roads lead to access? A global landscape of six COVID-19 vaccine business models.

Ruiz,

Bezruki,

Shinabargar

et al. 2023

Preprint

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3.1. Background Unequal and inequitable access to Covid-19 vaccines in low- and middle-income countries (L&MICs) was a major political, ethical and public health failure in the pandemic. However, vaccine developers’ practices were not monolithic, but rather, took diverse approaches to supplying different countries, with important implications for global access. 3.2. Results Using data on R&D investments, regulatory approvals, manufacturing and purchase agreements, and vaccine deliveries, we identified six distinct business models that apply across the 14 COVID-19 vaccines with more international presence from 2020–2022. “Western Early Arrivers” Pfizer/BioNTech and Moderna supplied the largest volumes quickly and prioritized high-income countries (HICs) from registration to vaccine delivery. “Western Latecomers” Janssen and Novavax supplied intermediate volumes later, also prioritizing HICs but with a greater proportion to L&MICs. “Major Chinese Developers” Sinopharm and Sinovac supplied intermediate volumes early, primarily to middle-income countries (MICs). “Russian Developer” Gamaleya completed development early but ultimately supplied small volumes, primarily to middle-income countries (MICs). “Cosmopolitan Developer” Oxford/AstraZeneca supplied large volumes early to HICs and MICs at the lowest prices. Finally, “Small MIC Developers” CanSino, Bharat Biotech, Medigen, Finlay Institute and the Center for Genetic Engineering and Biotechnology (CGEB), exported relatively small volumes to a few MICs. Low-income countries (LICs) were not targeted by any developer, and received far fewer doses, later, than any other income group. Almost all developers received public funding and other forms of support, but we found little evidence that such support was leveraged to expand global access. 3.3. Conclusions Each of the six business models has different implications for which countries get access to which vaccines, how quickly, and at which prices. Each offers different strengths and weaknesses for achieving equitable access. Our findings also suggest that Western firms had the greatest capacity to develop and deliver vaccines quickly during the pandemic, but such capacity is rapidly becoming more globally distributed with MICs playing a significant role, especially in supplying other MICs. Given the critical role of public support in enabling pandemic vaccine development and supply, governments have both the capacity and responsibility to craft international rules that will make responses to future pandemics more equitable and effective.

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COVAX and the many meanings of sharing

Cited by 15 publications

References 4 publications

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines

Which roads lead to access? A global landscape of six COVID-19 vaccine business models.

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