When a COVID-19 vaccine is ready, will the world be?

June 3, 2020 by PATH

Vaccine feasibility is only one piece of the immunization puzzle. We need to start solving for the rest right now.

In Laos, Orladee Nonnavongsa alights a motorbike and dons her mask to deliver Japanese Encephalitis vaccines. Vaccines need a strong support system to reach the communities that need them most. Photo: PATH/Aaron Joel Santos.

In Laos, nurse Orladee Nonnavongsa dons her mask and prepares to deliver Japanese encephalitis vaccines. All vaccines need strong support systems to reach the communities that need them most. Photo: PATH/Aaron Joel Santos.

As of this article’s publication, there were more than 100 COVID-19 vaccine candidates in development—including several using innovative new approaches not yet tested.

How has the world made so much progress in such a short time? Forward-thinking investments in science that began years before COVID-19. For example, at PATH, we’re helping to assess whether an existing candidate vaccine for SARS could also prevent COVID-19. With so many efforts underway and making progress, public health experts are cautiously optimistic about advancing a safe and effective vaccine against COVID-19.

Unfortunately, the vaccine itself is only one piece of the puzzle. In order to mass produce, distribute, and administer the vaccine to billions of people—a whole host of other challenges must be overcome. Thankfully, researchers, program implementers, and policymakers don’t have to wait for an effective vaccine to be ready.

We need to begin laying the groundwork right now. Here’s how:

  1. Invest in delivery systems (just like vaccines)
    Investments in research and development jumpstarted this work. We now need the same investment in delivery systems, like health workers, cold chain equipment, and more. This is the only way we can ensure that, once ready, an effective COVID-19 vaccine reaches everyone, everywhere—especially those facing barriers to accessing health care. These foundational investments will continue to pay dividends long after the current pandemic.

  2. Commit to cooperation and data-sharing
    Experts are cautiously optimistic about the scientific feasibility of a COVID-19 vaccine, but this says nothing about its accessibility. Speed and efficiency of access hinge upon coordination and data-sharing.

    The Access to COVID-19 Tools (ACT) Accelerator offers a means of coordination. It allows researchers to share real-time data, identifying what’s working and what isn’t, and informing resourcing decisions without the sway of national, political, or economic interests.

    The World Health Organization (WHO)—along with Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), the Bill & Melinda Gates Foundation, the Global Fund, Wellcome Trust, and a host of industry and government partners—are all working together to find global solutions that will meet the needs of all countries, especially those with weaker health systems.

    WHO was created to serve as the global convener during health crises, and PATH strongly supports buy-in from all nations.

  3. Collectively prioritize recipients
    The time to think about vaccine distribution is now. Who receives the vaccine first: elderly populations, health workers, marginalized communities where physical distancing isn’t possible?

    The guiding principle for this decision should be the public good. We must make decisions that maximize the vaccine’s protective power—because this is ultimately the best way to protect everyone.

    For our part, PATH’s is working to ensure all essential vaccines—including new COVID-19 vaccines—are affordable, available, and accessible to the most marginalized and underserved among us.

  4. Share the risk of early investment
    Many of the diseases in PATH’s vaccine portfolio share a common challenge: the public health needs of impacted communities are immense, and the private sector’s financial return-on-investment in these markets is slim to none.

    For the sake of public health, donors and governments can incentivize industry.

    For example, in order to expedite the development of a COVID-19 vaccine, manufacturers are now preparing to mass produce multiple vaccine candidates—even though several or all could ultimately prove untenable—so that they can seamlessly continue in whichever direction the data points them. To help mitigate this risk, the Bill & Melinda Gates Foundation is funding manufacturing platforms for several candidates.

    Public-private partnerships make it possible.

  5. Embrace innovation in financing
    Gavi, the Vaccine Alliance is a cornerstone of vaccine financing for low-income countries, and continued donor commitments to this fund are essential. But Gavi is just one of many mechanisms that will be necessary to achieve global coverage.

    As middle-income countries “graduate” from Gavi funding, they will require other means of support if we are to fully contain COVID-19. PATH’s Hannah Kettler is part of a thoughtful group designing an Advanced Market Commitment that could ultimately expand access to a COVID-19 vaccine for low- and middle-income countries.

    We all have a stake in ensuring that all countries have access to the forthcoming COVID-19 vaccine, because until that happens, no nation is safe.