Covid and Optimism

Context: With vaccine on the horizon, challenges await: How to get it to every person, while mitigating risks

Measures taken to optimise development and distribution of vaccine:

• Accelerated Vaccine Development:

• For, E.g. Operation Warp Speed that aims to deliver 300 million doses of a safe, effective vaccine in the US by January 2021.

• Ensuring Equitable Distribution: 

• The World Health Organization (WHO) and the European Union are reportedly exploring options of buying medicinal rights and establishing a pool of patents;

• Nations may prefer to invoke ‘compulsory licensing’.

• COVID-19 Vaccines Global Access (COVAX) Facility that seeks to attract rich countries to sign on by reducing their own risk that they are betting on the wrong vaccine candidates

• Managing the demand side: 

• The WHO’s “strategic allocation” approach is targeted at health workers, people over 65 years and those with co-morbidities that put them at a higher mortality risk from COVID- 19.

• US-CDC’s Advisory Committee on Immunisation Practices (ACIP) are debating over a wider set of questions: 

• The disproportionate impact on vulnerable sections -like Hispanics and African-American.

• Crowded conditions and custodial populations such as in prison and homeless shelters.

• Steps Taken by India:

• The Prime Minister of India has declared India’s position during Independence Day speech:

• “To make it available to every person in the shortest possible time.”

• Reports of talks with several global vaccine makers to get priority access to any vaccine produced first

Risks associated with Vaccine Development and Distribution:

• Reality Check on Vaccine Efficacy: Other coronavirus infections such as SARS and MERS have now been studied for a couple of decades, but there are no licenced effective vaccines. 

• The true test of the safety profile (after commercial introduction) is only through continued surveillance, adverse event monitoring and post-marketing surveillance systems.
• Government pushing through vaccine development is forcing the developers to condense a decade long process to mere months, impacting the efficacy and safety of the final product.

• Rising Vaccine Nationalism: 

• For E.g. The WHO Director-General recognises that “supply nationalism exacerbated the pandemic and contributed to the total failure of the global supply chain”.

• Uncertainty in global cooperation: Even if there are broad agreements, they will be riddled with complex institutional arrangements for vaccines to be procured and made available at the point of care.

Way Forward

• India needs to recognise diverse vulnerabilities: India’s National Technical Advisory Group on Immunisation (NTAGI) shall presumably be tasked with the country’s prioritisation strategies.

• Solving the issues: through  

• working on the intersections of incomplete (or contradictory) knowledge, 
• negotiating a number of diverse people and opinions, 
• overcoming a large economic burden, and 
• navigating the interconnected nature of these problems with other problems.

• Maintaining the balance: to address the competing claims of prioritised access.

• Balancing ethics and economics, intellectual property rights and public good, and private production and public distribution.
• A balance of imagination and realism.