Vaccine procurement during an influenza pandemic and the role of Advance Purchase Agreements: Lessons from 2009-H1N1

Turner, Mark

doi:10.1080/17441692.2015.1043743

Cited by 18 publications

(8 citation statements)

References 38 publications

(26 reference statements)

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“…The equitable allocation of vaccines globally means that all countries, regardless of their developmental or economic status, should have equitable access to vaccines, as assessed by the objective possibility for countries to obtain vaccines. The disadvantageous position of low- and middle-income countries in accessing scarce resources such as vaccines was widely noted during the highly pathogenic avian influenza A (H5N1) epidemic in 2004 and the influenza A (H1N1) pandemic in 2009 [ 4 , 5 ]. To address the issue of vaccine access in low- and middle-income countries, observed in previous pandemics, during the COVID-19 pandemic, the World Health Organization led the launch of COVID-19 Vaccines Global Access (COVAX) as an implementation framework for the equitable allocation of and access to COVID-19 vaccines [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy

et al. 2021

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Inequity in the access to and deployment of the coronavirus disease 2019 (COVID-19) vaccines has brought about great challenges in terms of resolving the pandemic. Aiming to analyze the association between country income level and COVID-19 vaccination coverage and explore the mediating role of vaccination policy, we conducted a cross-sectional ecological study. The dependent variable was COVID-19 vaccination coverage in 138 countries as of May 31, 2021. A single-mediator model based on structural equation modeling was developed to analyze mediation effects in different country income groups. Compared with high-income countries, upper-middle- (β = −1.44, 95% CI: −1.86–−1.02, p < 0.001), lower-middle- (β = −2.24, 95% CI: −2.67–−1.82, p < 0.001), and low- (β = −4.05, 95% CI: −4.59–−3.51, p < 0.001) income countries had lower vaccination coverage. Vaccination policies mediated 14.6% and 15.6% of the effect in upper-middle- (β = −0.21, 95% CI: −0.39–−0.03, p = 0.020) and lower-middle- (β = −0.35, 95% CI: −0.56–−0.13, p = 0.002) income countries, respectively, whereas the mediation effect was not significant in low-income countries (β = −0.21, 95% CI: −0.43–0.01, p = 0.062). The results were similar after adjusting for demographic structure and underlying health conditions. Income disparity remains an important cause of vaccine inequity, and the tendency toward “vaccine nationalism” restricts the functioning of the global vaccine allocation framework. Stronger mechanisms are needed to foster countries’ political will to promote vaccine equity.

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Section: Introductionmentioning

confidence: 99%

Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy

et al. 2021

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“…Through their greater advanced purchasing power and their ability to manufacture vaccines, HICs have a track record of dominating the global supply of pandemic vaccines. In 2021, 51% of the initial supply of COVID-19 vaccines had been purchased for 13% of the world’s population, mostly residing in HICs,28 30 40 indicating that fair vaccine allocation is hindered by the inability of LMICs to procure or negotiate access to pandemic vaccines at the same level as HICs 6 54…”

Section: Resultsmentioning

confidence: 99%

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

et al. 2021

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ObjectiveTo identify the factors contributing to equitable access to COVID-19 vaccines for low and middle-income countries (LMIC).MethodsWe conducted a scoping review following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and a five-stage framework for scoping studies. We performed systematic searches for published peer-reviewed literature in five databases: Medline, Embase, Web of Science, Global Index Medicus and COVID-19 Evidence Epistemonikos (August 2020, updated May 2021).ResultsSystematic selection according to predefined criteria resulted in the final inclusion of 45 peer-reviewed articles, with no limitations on study design or publication type. We derived four key factors that potentially influence equitable access to COVID-19 vaccines in LMICs: (1) collectively agreed global mechanisms or frameworks; (2) bilateral purchasing, contracting, and vaccine prices; (3) vaccine manufacturing that is supported by sharing know-how; and (4) countries’ strength in implementing vaccination programmes.ConclusionsThis scoping review highlights the ongoing challenges for the international community in ensuring equitable access to COVID-19 vaccines for LMICs. The literature suggests that vaccine manufacturing can influence the supply of vaccines, as can the role of patent holders who can influence global governance through their role in the distribution of COVID-19 vaccines. Our findings indicate that including the principles of equitable access throughout vaccine research and development, procurement, scale-up and distribution processes can support equitable access for LMICs. Advances made with mRNA vaccines may have additional benefits in relation to expanding the manufacturing of other vaccine. Finally, the exploration and scale-up of such capacities of LMICs are likely to prove to be a valuable investment, even after the pandemic.

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“…Although similar concerns have previously been identified during other pandemics such as the 2009 H1N1 influenza pandemic, there continues to be a lack of consensus on which are the most pressing challenges, particularity in the context of LMICs [11]. A better understanding of these challenges may also offer robust opportunities and lessons learned to identify potential solutions.…”

Section: Introductionmentioning

confidence: 80%

Identifying priority challenges and solutions for COVID-19 vaccine delivery in low- and middle-income countries: A modified Delphi study

Ariyarajah

Berry

Haldane

et al. 2022

PLOS Glob Public Health

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Background The rapid implementation of global COVID-19 vaccination programs has surfaced many challenges and inequities, particularly in low- and middle-income countries (LMICs). However, there continues to be a lack of consensus on which challenges are global priorities for action, and how to best respond to them. This study uses consensus-based methods to identify and rank the most important challenges and solutions for implementation of COVID-19 vaccination programs in LMICs. Methods We conducted a three-round modified Delphi study with a global panel of vaccine delivery experts. In Round I, panelists identified broad topical challenges and solutions. Responses were collated and coded into distinct items. Through two further rounds of structured, iterative surveys panelists reviewed and ranked the identified items. Responses were analyzed qualitatively and quantitatively to achieve consensus on the most important COVID-19 vaccine delivery challenges and solutions. Results Of the 426 invited panelists, 96 completed Round I, 56 completed Round II, and 39 completed Round III. Across all three rounds there was equal representation by gender, and panelists reported work experience in all World Bank regions and across a variety of content areas and organizations. Of the 64 initially identified items, the panel achieved consensus on three challenges and 10 solutions. Challenges fell under themes of structural factors and infrastructure and human and material resources, while solutions also included items within themes of communication, community engagement, and access and planning, processes, and operations. Conclusion COVID-19 vaccine delivery is challenged by long-standing and structural inequities that disadvantage health service delivery in LMICs. These findings can, and should, be used by global health organizations to efficiently and optimally direct resources to respond to these key challenges and solutions.

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Vaccine procurement during an influenza pandemic and the role of Advance Purchase Agreements: Lessons from 2009-H1N1

Cited by 18 publications

References 38 publications

Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy

Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy

Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries

Identifying priority challenges and solutions for COVID-19 vaccine delivery in low- and middle-income countries: A modified Delphi study

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