Zain Rizvi and Lawrence O. Gostin
In 2006, amid fears of a bird flu pandemic, the Bush administration launched a program to teach the world how to make a flu vaccine. “We are helping countries help themselves,” said one U.S official. By the end of the program, participating manufacturers could produce 500 times as many doses.
Today, we need a similar plan to help the world make a coronavirus vaccine. The pandemic is the worst crisis since World War II, but new vaccines offer hope. However, Serum Institute of India, the world’s largest vaccine manufacturer, recently warned that a dose might not reach everyone around the world until 2024.
President Joe Biden has the power to change this and combat vaccine scarcity by helping the world quickly manufacture vaccines.
Learning from the bird flu program
The bird flu program offers a model. How did a tiny team, burrowed within the Department of Health and Human Services, dramatically scale up flu vaccine manufacturing capacity in 13 countries?
The team worked hand in hand with the World Health Organization, supporting the agency’s global flu plan everywhere from Serbia to South Africa and shared the vaccine “recipe,” providing technical assistance and allowing more manufacturers to pump out doses. They helped build factories, and a collaboration with Vietnam’s Ministry of Health resulted in a new facility capable of producing millions of doses.
“Diseases do not respect borders, so increasing the ability to make flu vaccine in any country helps every country reduce the spread of flu,” said one U.S. official leading the program.
Biden can bring this same approach to the global coronavirus crisis. It isn’t just a humanitarian imperative. If developing countries are unable to vaccinate most of their populations by the end of the year, the world economy is projected to lose $1.5–$9.2 trillion,with the United States and other high-income countries losing the lion’s share. It could also take many years for low-income countries to reach herd immunity.
The Biden administration can start by mobilizing the global community to think bigger. The global COVAX effort, which many low- and middle-income countries are relying on, aims to provide enough coronavirus vaccines for only a fifth of their populations, which is wholly insufficient.
There is increasing momentum for a bolder, more collaborative approach at the World Health Organization. Biden can inject American ambition into the response. He can champion a plan to share the vaccine recipe — most of which has been funded by taxpayers — and build manufacturing capacity.
Sharing the recipe can help enlist manufacturers around the world. Biden should convene vaccine developers and urge them to share their vaccine technology with others to quickly ramp up supply. The president should negotiate with the developers for the recipe, fairly compensating them while taking into account the substantial public investment. If pharmaceutical companies were unwilling to share, he can use his legal authority to mandate them. The Defense Production Act can help facilitate information sharing when required by the national defense, and ending the global pandemic is very much in America’s national security interests.
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Using its logistics prowess, the federal government can also supplement existing factories and build new ones. The government can draw on the recent experience of Operation Warp Speed, which augmented 23 manufacturing facilities within six months, and the wealth of experience from the flu program.
Time to mobilize the global community
There are some differences between the coronavirus crisis and the flu plan. For example, many coronavirus vaccines use newer vaccine technology (such as messenger RNA vaccines produced by Pfizer and Moderna) compared with flu vaccines. This could raise the prospect of more complex intellectual property claims that the flu program largely bypassed. Perhaps the biggest difference is that the flu program was launched when a pandemic was a remote possibility.
However, the real challenges are ultimately questions of political will. Biden asked the nation to act like it is a national emergency, but the sense of urgency is worldwide. Today, a new virus batters economies, fuels inequality and has killed nearly 2.5 million people. Letting the virus further spread unchecked and mutate poses additional risks to public health and the economy — around the world and at home. Diseases do not respect borders.
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The debate around vaccine access often focuses on ethically distributing limited doses. But the more fundamental question is why the knowledge required to produce more doses and end the pandemic is kept secret. Biden can show the world a different way. By mobilizing the global community, sharing the vaccine recipe and building manufacturing capacity, the president can help countries help themselves. There is no better way to demonstrate America’s renewed commitment to the world.
Zain Rizvi is a law and policy researcher at Public Citizen. Lawrence O. Gostin is a Georgetown law professor and director of the O’Neill Institute for National and Global Health Law. Follow them on Twitter: @zainrizvi and @LawrenceGostin