Vaccine producers must step up 

The world stands at a critical juncture of the Covid-19 pandemic. Countries that lack the first round of vaccine coverage are extraordinarily vulnerable to the highly infectious Delta variant, and are also seedbeds for new variants that could quickly spread worldwide. 

The Lancet Covid-19 Commission, which I chair, is working urgently with the United Nations system to strengthen the multilateral response. Governments of countries where vaccines are being produced – the United States, European Union members, the United Kingdom, India, Russia, and China – need to cooperate under UN leadership to ensure that a sufficient supply of vaccine doses reaches the poorest countries.

The high-income countries now have more than 50 per cent of their population fully vaccinated. Yet the fully vaccinated population in Africa remains under four per cent. This lack of vaccine coverage in Africa, and in low-income countries elsewhere, poses an imminent danger to these populations. 

US President Joe Biden called for a vaccine summit on September 22. This was a highly significant step forward. But it was important that the US holds this meeting in cooperation with other vaccine-producing countries, and with the UN system. 

In April 2020, the UN created the Covid-19 Vaccine Global Access (Covax) facility to provide vaccines to lower-income countries. These countries expected Covax to provide timely deliveries. Yet Covax has been unable to buy a sufficient volume of vaccine doses mainly because high-income countries have repeatedly cut to the front of the queue. 

Moreover, the vaccine-producing countries’ governments have imposed export quotas so that Covax is often unable to secure even the vaccines for which it has contracts. The company shareholders are, of course, happy with these arrangements, because the rich countries pay more for the doses than Covax would. 

The World Health Organization (WHO) has set minimum targets for vaccine coverage in every country – at least 10 per cent of the population by end-September, 40 per cent by end-2021, and 70 per cent by end-June 2022 – that the current vaccine allocation system will not achieve. 

At this moment of great global peril, the governments of the vaccine-producing countries should take the following steps: 
First, they should chart a path to achieve the WHO targets in all countries, including 40 per cent global coverage by the end of this year. The vaccine producers should cooperate fully by disclosing all existing orders (and prices) on their books, so that the UN and governments can prioritise under-served countries. 

Second, the UN system, with the full support of governments and companies, should set delivery timelines for every low-income country aligned with the WHO targets. The WHO and Covax, and other UN agencies such as Unicef, should work with the recipient countries to scale up the “last-mile” deployment systems for the arrival of the vaccine doses. 

Third, the new $650 billion allocation of special drawing rights just approved by the International Monetary Fund should be used, in conjunction with other emergency financial resources, to ensure that short-term financing constraints pose no obstacles to the supply of vaccines. 

Fourth, the governments of the vaccine-producing countries should agree, in line with long-standing trade agreements on public health, to waive intellectual property rights and to promote technology sharing in order to increase global vaccine production. 

Lastly, governments in all countries should make clear to the public that the vaccines are not sufficiently effective on their own to suppress the community transmission of the coronavirus. 
The bottom line is that we must treat universal vaccine coverage as an urgently needed global public good, not as an eventual outcome of market forces. 

Jeffrey D. Sachsis the director of the Center for Sustainable Development at Columbia University 

- Project Syndicate