Instead of a coordinated global effort among governments to prepare the world to produce and distribute a vaccine, the pandemic has set off a wave of “me first” health care nationalism. Early in the pandemic, nations scrambled to bring production “home” and to secure enough doses of a still-hypothetical vaccine for their own citizens first. From export controls on critical health care supplies to closing borders to the movement of people, many measures governments took to protect their own citizens have also made it more difficult to orchestrate a global response, according to a new episode of POLITICO’s Global Translations podcast released Wednesday.
Governments have been looking for national solutions even though there is no “wholly domestic supply chain for any product” in the vaccine race, Jim Robinson, a former executive from the pharmaceutical giant Merck, told the podcast.
Robinson is now working with a handful of international organizations racing to fill in gaps in the global vaccine supply chain — and in global leadership — to ensure the world gets access to the vaccine. “Unfortunately, this is not a global effort to find a global solution,” he said.
Robinson leads the manufacturing strategy for Covid at the Coalition for Epidemic Preparedness Innovations, an international organization that works with the World Health Organization and GAVI, the Vaccine Alliance. Their partnership created COVAX, a voluntary multilateral effort to ensure equitable access to the vaccine around the world; 156 countries are now eligible to buy vaccines from COVAX. COVAX member countries get access to purchase vaccines from a portfolio of potential candidates and access to globally sourced supplies. The idea is to ensure it will be accessible to rich and poor countries alike.
Under the Trump administration, the United States, like Russia, has stayed out of COVAX. It is forging ahead on its own with Operation Warp Speed, a collaboration between the Department of Health and Human Services and the Pentagon to develop, manufacture and distribute a vaccine. It has partnered with several leading pharmaceutical companies, and a half dozen vaccine candidates are already in advanced clinical trials.
Anthony Fauci, the U.S. government’s top infectious disease expert, said the massive logistics and sourcing challenge is why the U.S. government turned to a four-star Army general, Gustave Perna, to serve as chief operating officer of the effort. “The purpose of getting someone of the experience and talent of Gen. Perna was precisely to assure that we can get [that] done,” Fauci said in an interview airing in the podcast.
Many countries around the world either don’t have the infrastructure to manufacture a vaccine in-house or don’t have access to necessary supplies, said Robinson. “Our goal is to really fill in the gaps for the global vaccine ecosystem to help create capacity for the rest of the world.”
The COVAX initiative is helping governments fumble toward cooperation. Initially, China, like the United States, stayed out of the coalition, preferring a nationalist approach to vaccine development. But earlier this month, declaring vaccines to be a “global public good,” Beijing joined COVAX.
Although Robinson now believes there will be enough supply of vaccine — in part because countries like the U.S., Canada, and the U.K. are planning to produce many times more vaccine than will be necessary to cover their populations — CEPI has taken steps to hedge against the possibility of export controls that could require vaccine manufacturers to serve local populations before being allowed to export.
“We have created, intentionally, a regionally diverse network such that we don’t have all of our product being made in one location at risk of being blocked by export restrictions,” he said, citing a supply chain of five continents and 30 countries. “We have addressed the risk of nationalism through diversification.”
With pandemic threats emerging in the world on average every five years, he hopes the severity of Covid-19 will inspire a move to a more unified and collaborative global pandemic response by governments next time. “This outbreak won’t end until the world is vaccinated,” Robinson said. “Until we’re all protected, none of us are protected.”