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Life After Covid For Third World Countries

In May of 2020, 1.2 billion would go to the British drugmaker AstraZeneca to speed up their Covid-19 vaccine research. In exchange, AstraZeneca promised the U.S. 300million doses. Suppose the Vaccine made it through safety and efficacy trials. Earlier that month, the United Kingdom signed a similar deal with the same company to secure 90 million doses.

These Transactions, where a country deals directly with a company, are called bilateral deals. In 2020, rich countries made a lot of them. Those billions of dollars helped fund research that brought us the world's leading covid vaccines in record time. But that money also determined where those vaccines would go by January 2021. 96% of the Pfizer-BioNTech vaccine doses that were scheduled to be produced by the end of the year had already been bought and held over half of the amounts from the most promising vaccine developers. Rich countries got vaccines. Poorer countries did not. In Brazil and India, health systems are being pushed to the limits. At the same time that the U.S. is quickly opening up vaccinations for anyone. It's making the pandemic last longer. It is allowing infections to rage and new variants to arise. More people are dying than they need to be.


The same deals that helped develop vaccines are making it harder to get them around the world. Now what? What's happening now with the Covid-19 vaccine Inequality is not at all unprecedented. In 2009, the WHO declared Swine Flu a Pandemic. After securing their vaccine deals, the nine higher-income countries pledged 120 million doses to the WHO for lower-income countries. But then they only started sending those donations after they realized the outbreak isn't as severe as everyone initially thought, and it takes decades for them to trickle down to poorer countries." The problem starts with the vaccine market itself. Getting a vaccine from development to manufacturing to distribution. It is a Multi-step Process. Rich countries got in line here at manufacturing by making bilateral deals with developers and suppliers early on. However, there was no guarantee that any given vaccine would work or even get past regulators to reach the market. If a vaccine fails shortly after funding, those billion-dollar investments are lost. For years, we've seen how technology is rolled out in rich countries, and it takes decades for them to trickle down to poorer countries.


The problem starts with the vaccine market itself. Getting Vaccines from development to manufacturing to distribution is a multi-step process. They are getting Vaccines from the product to manufacturing, to distribution. Rich countries got in line here by making bilateral deals with developers and suppliers early on: at manufacturing. There was no guarantee that any given vaccine would work or get past regulators to reach the market. If a vaccine fails shortly after funding, those billion-dollar investments are lost. So, to offset that risk, countries invested in multiple options and suppliers, often securing enough doses to cover their populations several times. As of March 2021, Canada had secured over 300 million doses: And the deals the U.S. made were enough to cover its population at least twice. Which worked out of them because even though they secured 300 million doses of AstraZeneca a year ago, as of April, it still hasn't been approved for use in the country. But the Pfizer and Moderna doses that the government pre-purchased are still enough to cover most of the population. Most countries can't afford to make multiple high-risk investments early on. So they wait until the Vaccine is further along in the approval process. Then by then, they're already at the back of a very long line. Peru, for example, made a bilateral deal with AstraZeneca, But won't see those doses until at least September. "Those that Purchased first, or made the most significant orders. "Those that purchased first, or made the biggest orders, or invested into the research and development, are standing at the front of the line. Most of the poorer countries in the world don't have 240 million doses combined. So, is there a way to get a lot of money here without creating a priority line over here? Maybe one program underway is designed to work as a sort of middleman between countries and the drug companies making vaccines, It's called Covax. It's an initiative formed by three global health groups, including the World health organization. Its main objective is to provide vaccines to 92 middle and low-income countries. "Covax is kind of like the Paris climate agreement of the vaccine world.



So it's this multilateral effort, with almost 200 countries that have joined. The idea is that everyone has access to Covid-19 vaccines, regardless of the country's GDP." It does this using a two-part system. The first allows high-income countries to buy into and access multiple vaccines at once. So, instead of one country giving $2 billion directly to AstraZeneca. They provide the money for Covax, which would use it to fund several different vaccines. This way, if one or two of them failed early on, it wouldn't be a total loss; The other vaccines in the portfolio would make up for it. It's a multilateral system that's much lower-risk for those countries than a bilateral one. The idea is that Covax could use that more extensive purchasing power to negotiate deals with manufacturers and developers on a global scale, which would drive the costs down and fund vaccine development. The second part buys vaccines for lower-income countries—donations from whether governments and charities support it. The U.S. alone has pledged $4 Billion to this fund. As vaccines become available, Covax hands them out to everyone once, so Rich countries and poorer countries all get a fair share. At least, that's the idea. The biggest problem with Covax is the bilateral deals we talked about. For Covax to work as intended, it needs most countries to be using its multilateral system. However, Covax was formed a month into the pandemic. The incentive for rich countries to Join Covax was low.



But without them, Covax might be underfunded. So it let them have it both ways: Rich Countries could join Covax and keep their bilateral deals. That would get them more vaccines, faster. And those undermined Covax. However, they put themselves at the front of the line. Ahead of the access that countries will get through this collective agreement. The U.S., for example, has donated the most money to Covax, Is also still at the front of the manufacturing lines, waiting for its own doses. The U.S. and U.K. have both promised to donate extra amounts to Covax. However, neither country has said when. That means rich countries, like the U.S., decide who gets what, when. Instead of some global collaborative process of Vaccine allocation.

Experts are skeptical Covax will meet its original goal of delivering 2 billion vaccine doses by the end of 2021 and produce 45 million quantities. So they've reached a massive number of countries, But nowhere near enough to cover even frontline health workers. Other essential workers, in most of the countries that these vaccines are going to. Meanwhile, as of April, the U.S. has already administered over 200 million doses. What Covax is setting out to do is hugely challenging. They probably won't meet their first targets. That probably wouldn't otherwise have them this quickly. Vaccine inequality is bigger than just bi-lateral deals. It's in every step of the process. From limited manufacturing to cold chain distribution; even debates around the intellectual property of vaccines. Our current system is not a well-oiled machine at all. There's a lot of work to do if we want to be better prepared for the future. The pandemic is unexpected; you can't prepare for something that's going to happen.




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