Coronavirus: Who will have access to the vaccine?

The world's leading pharmaceutical companies are on the run. Once developed: will prices be affordable? Will they open their technology package so that each nation can manufacture it locally? The role of multilateral actors.

From the moment the WHO declared the coronavirus a pandemic, competition opened up among the world's strongest corporations to develop a vaccine. The race to end the Sars CoV-2 virus and the disease it produces - covid-19 - seems to be increasingly close. There are already 17 actors who are in evidence in clinical phases. However, once the final solution is developed: who will have access? How much should governments pay the megacorporations that designed it for the millions of doses they will need? Will the price be accessible and for all States equally?“Once the vaccine is developed, a new phase of the battle will break out. I don't see a very collaborative situation unfolding that we say. Imagine the power that the actor who has that technological domain will have. It will surely be tied to a patent, which will open multiple scenarios. Companies want the solution but not because they are altruistic but because the one that reaches the goal will dominate the planet, ”says Darío Codner, Secretary for Innovation and Technology Transfer (National University of Quilmes).

In this framework, the most and least desired scenarios for peripheral nations like Argentina unfold. “ The first and most favorable is that we reach the goal ourselves with our own development. The other option is to have it developed by an outside laboratory. Here, in turn, two paths are presented. On the one hand, there is the option of distributing it and our country becoming the recipient of the doses it needs at a reasonable and solidary price; and, on the other hand, that the corporation that has the vaccine opens its technological package and the knowledge is transferred so that public and private laboratories of our nation, at the behest of the government, can copy the formula and lead their own manufacturing.The opening of technological secrecy should be carried out immediately, ”says Codner, who also serves as the Executive Coordinator of the NETWORK for Technological Linking of National Universities.

This last case, according to the expert, is the projection that best fits a possible reality. However, opening the tech pack doesn't quite fix things. Patents are usually not very descriptive or codify how to execute a technology once it was produced. The solution? Know-how would have to be imported. If China develops the vaccine, Argentina should receive training from Chinese experts; if the US does, the technicians from North America should come.

 

However, there are also less friendly scenarios. “It may happen that the company that carries out the development sets a high price that will scale according to its production. In the capitalist framework in which we operate, private groups impose their rules and hinder the access of states to the good. If the price is pushed up, Argentina will have little chance , "says Codner. In a context of liberalized, deregulated and financialized economies, competition for access will not only be between countries but also - which is much worse - against multinationals.

Some competitors

 

When designing a vaccine, the first thing to think about is what patients need. In this case, they are defenses to react against a specific microorganism such as Sars CoV-2Based on this, the type of vaccine to be manufactured is selected. There are many strategies available: some use the inactivated virus --such as Hepatitis A--, others use the attenuated virus --such as Sabin--, some act on viral RNA, or there are those that only incorporate a protein - -in this case the "S", Spike, gateway to the coronavirus - which a priori are easier to do but have not been tested so far in large populations. Finally, there are those of recombinant proteins - which are used in Hepatitis B and HPV (Human Papillomavirus). In any case, the scientists will have to evaluate safety and toxicity (tests on animals and then on patients), they will check biological effectiveness and, finally, they will begin to explore the possibilities of industrially scaling the product.

Although Tedros Adhanom Ghebreyesus, the WHO director-general, announced that until 2021 there would be no news, the pharmaceutical companies step on the accelerator and overlap, week by week, with the communication of encouraging progress. Over the past few days, the US company Pfizer and the German firm BioNTech announced positive results in their initial human trials. The vaccine was tested in 45 adults (aged 18 to 55) who received different doses from each other (10, 30 and 100 mg) and nine of them received a placebo. The people who underwent the tests developed a number of antibodies that exceeded those presented by the patients recovered from covid-19. Experts noted that "it was well tolerated," although in some cases it generated fevers and other minor collateral damage. The next step will be a bigger challenge and if everything goes as expected it will start this month. Scaling the product is usually one of the main obstacles: they will try to take it from 45 trials to 30,000. Convert a small experiment into one of much more important dimensions. Then, the next step will be to manufacture 100 million doses and, for next year, 1,200 million. The work of the team that dominates the podium will have to be submitted to the magnifying glass of colleagues and, to obtain greater strength, be published in a medical journal of international prestige. The next step will be to manufacture 100 million doses and, for next year, 1,200 million. The work of the team that dominates the podium will have to be submitted to the magnifying glass of colleagues and, to obtain greater strength, be published in a medical journal of international prestige. The next step will be to manufacture 100 million doses and, for next year, 1,200 million. The work of the team that dominates the podium will have to be submitted to the magnifying glass of colleagues and, to obtain greater strength, be published in a medical journal of international prestige.

China approved the use of an experimental vaccine - known as "Ad5-nCoV" - that will be administered to the country's armed forces for a period of one year. It was developed by a public-private initiative involving the Beijing Biotechnology Institute, the Academy of Military Medical Sciences, and the CanSino Biologics company. Another of the corporations that are stomping on the Asian giant is Sinovac. Its vaccine will be tested in 12 research centers belonging to six Brazilian states. The agreement will not only include testing but also technology transfer to manufacture the input on Bolsonaro's land. In Argentina, Juliana Cassataro - Conicet researcher at the Institute of Biotechnological Research at the University of San Martín - leads the team that set out to develop the vaccine locally. It received a grant from the Covid-19 Unit - made up of the MinCyT, the Conicet and the Agency - for its manufacture. It is in the preclinical phase (in mice) and will be based on recombinant proteins.

Lobby

Citizens must be cautious with each of the announcements made by biotech companies because they often disseminate their advances with drums and cymbals to receive more investment during the process. When they communicate good news, their shares skyrocket on the stock market. “ There are well-known scientists around the world who work for pharmaceutical companies and lobby by announcing much shorter times than actual lapses. With this, what they seek is to achieve investments . On the other hand, I get the impression that it will not be one vaccine that comes out but several. It would be positive because the increase in supply would decrease the price ”, explains Mario Lozano, molecular virologist at Conicet and former rector of the National University of Quilmes.

 

Under this premise, how do multilateral organizations act to democratize the conditions of access to the vaccine in the not so distant future? “The WHO, for example, is trying to prepare the ground so that when a private or public laboratory obtains the vaccine, it can be quickly transferred to different latitudes. Mass production will be required to shut down this pandemic. It is impossible to think that the necessary scale can be satisfied by a single player, regardless of its dimensions. For this reason, I think that it will have to be associated with the different governments so that they provide the necessary infrastructure and the initial cost in each case, ”says Lozano. It will not be the same if it is a State that reaches the goal, or a corporation.

 

From this point of view Codner understands it when he warns: “For the region, PAHO and the IDB will also do their part. All players who manage financial resources will play an important role. It will also be necessary to convince the most reactionary organizations, I mean the World Trade Organization, for exampleIn the face of the pandemic, it will be essential to produce billions of doses that are capable of lasting over time, that are safe and accessible to everyone. Although many stages can be skipped, the truth is that developing a technology with this complexity takes a long time. But if there is something that cannot be stopped thinking, it is that if there is a cure, it must be for everyone. Along these lines, “the WHO may make recommendations that will be taken or not by the States, but it does not have much capacity to intervene in the real fight. It is countries that can put limits on corporations. And, within them, of course, the most powerful. We will depend on figures like Trump, Johnson, Macron or Xi Jinping, "concludes Lozano.

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