COVID-19 vaccines pricing policy options for low-income and middle- income countries

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

“…The global prices of respective vaccines are not uniform across settings, with the price of a COVID-19 vaccine influenced by its patent, indicating the influence patent holders have in the distribution of vaccines. 29 45 48 To counteract the inequality in global distribution, in October 2020, a proposal was made by India and South Africa to the World Trade Organization (WTO) requesting a temporary waiver of certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, based on the need to prevent, contain and treat COVID-19. 44 48 There is no consensus in the literature included in this review on the benefits of the waiving of intellectual property rights (IPR).…”

“… 33 A few MICs (Brazil, India and Peru) have capitalised on their clinical testing or manufacturing capacity efforts by leveraging these for purchase agreements with vaccine manufacturers. 29 Limited capacity affects the global availability of pandemic vaccines for two reasons. First, the world is unable to manufacture the quantity of vaccines demanded, and second, a manufacturing country has the sovereign authority over goods produced within its borders with most countries in the world having legislation in place that require companies to manufacture and prioritise domestic consumption.…”

“…In practice, this means that a country can produce a patented product or process without the consent of the patent owner, as demonstrated by Canada, Chile and Ecuador in their pandemic response. 29 The discussion related to the TRIPS waiver is especially important to LMICs, who recall recent historical experiences from South Africa where patents obstructed access to life-saving medicines for the treatment of HIV/AIDS. 42 Advocates for the COVID-19 products TRIPS waiver argue that significant public monies have contributed to the development of these patents thus waiving IPR will support vaccine development and manufacturing, and that some countries are already undermining existing TRIPS flexibilities through restrictive free trade agreements.…”

“…C-TAP calls for the voluntary sharing of knowledge, intellectual property and data, as well as a guarantee of free access and use by WHO member countries for drugs and vaccines that are developed. 29 35 36 Given the world's limited manufacturing capacity, the use of technology transfer and pooling of vaccines could help alleviate a massive shortage of vaccines given the scale of the need. 38 ► Countries' strength in implementing vaccination programmes may influence their populations' access to vaccines.…”

The future of COVID-19: A vaccine review

“…[ 2 ] Through a combination of private negotiations that involved vaccine development funding and large bundled purchases during clinical trials, HIC have already secured 6 billion doses of the vaccines with the highest published efficacy rates being produced in Western HIC [ 29 ]. The combination of the secrecy of these agreements and the lack of financial assets make world-wide equitable access to the highest efficacy vaccines being developed close impossible for LMIC [ 30 ]. In fact, the lack of vaccine supply in LMIC has even triggered the opening of clinics where wealthier citizens can pay high fees to receive high efficacy vaccines from abroad: opening the door for further socioeconomic status-related disparities in healthcare outcomes across the globe and fraudulent, harmful “vaccines” being used to exploit desperate communities [ 31 , 32 ].…”