How Should the World Pay for a Coronavirus Disease (COVID-19) Vaccine?

Towse, Adrian; Chalkidou, Kalipso; Firth, I.; Kettler, Hannah; Silverman, Rachel

doi:10.1016/j.jval.2020.12.008

Cited by 14 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…39 The AMC was first introduced in 1999 for the development of a late-stage pneumococcal vaccine, with the intention to shorten the time to introduction of a vaccine to LMICs. 39 Under COVID-19, APAs have been widely used to secure priority access to a scarce resource (when one party has committed to buy a specific number or percentage of doses prior to development), the influential factor for equitable access being whether they promote the interests of one country or several, and if they include LMICs. 5 6 30 34 41 50 Bilateral deals contribute to supply inefficiencies and threaten collective approaches to the procurement of vaccines, for example, national APAs initiated by countries that are also members of COVAX (not exclusively, but mainly HICs).…”

Section: Resultsmentioning

confidence: 99%

“…Most articles indicated collective action as being key to contribute to equitable access 1 5 6 13 24–50. Global collective agreements should be driven by multilateral agencies that have the global mandate to convene interest groups, advocate for collective response measures, as well as the investment, procurement and distribution of pandemic vaccines 51.…”

Section: Resultsmentioning

confidence: 99%

“…Pooled procurement is mentioned in the literature of this review as a means to support equity, with Advance Purchase Agreements (APA) and Advance Market Commitments (AMC) being the most common mechanisms identified in our review to facilitate access for LMICs 5 6 25 28 29 33 34 39 45 46 50 55–57. APAs are contracts with a specific product developer, whereas an AMC is a global market commitment 39. The AMC was first introduced in 1999 for the development of a late-stage pneumococcal vaccine, with the intention to shorten the time to introduction of a vaccine to LMICs 39.…”

Section: Resultsmentioning

confidence: 99%

“…APAs are contracts with a specific product developer, whereas an AMC is a global market commitment 39. The AMC was first introduced in 1999 for the development of a late-stage pneumococcal vaccine, with the intention to shorten the time to introduction of a vaccine to LMICs 39. Under COVID-19, APAs have been widely used to secure priority access to a scarce resource (when one party has committed to buy a specific number or percentage of doses prior to development), the influential factor for equitable access being whether they promote the interests of one country or several, and if they include LMICs 5 6 30 34 41 50…”

Section: Resultsmentioning

confidence: 99%

“…COVAX’s pooled procurement through APAs has faced challenges, initially in accessing the necessary financing, which in turn delayed securing supply against other HIC purchasers 1 14 27 29. In addition, it has also faced critique on how price has been determined and whether any costs can be recovered if vaccine candidates fail 34 39 75. While COVAX has attempted to meet foreseen gaps,14 it has been challenged by national interests, highlighted recently with announcements that Australia is purchasing booster shots,76 and that several HICs plan to donate parts of their surplus vaccines to LMICs directly,77 rather than through the COVAX facility, making vaccines a tool of geopolitics.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%