A photo illustration of vaccine bottles and a syringe

World faces risk of 'vaccine nationalism' in COVID-19 fight, says CEPI chair

With so many competing interests facing off, it's far from clear that once an effective vaccine is produced, all of the world's citizens will have equitable access to it.

The World

Global competition to find a vaccine to tackle COVID-19 is fierce, with at least 130 groups racing to be first.

One US-based company, Moderna, announced preliminary positive results Monday, saying a human vaccine trial produced protective antibodies in a small group of healthy volunteers.

The Moderna vaccine is one of more than 100 under development intended to protect against the novel coronavirus that has infected more than 4.7 million people globally and killed over 315,000. There are currently no approved treatments or vaccines for COVID-19, and experts predict a safe and effective vaccine could take 12 to 18 months to develop.

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The very early data offers a glimmer of hope for a vaccine among the most advanced in development. And with so many groups around the world working towards an inoculation, the odds of finding a way to put a stop to the pandemic increase.

But the competition it's also somewhat worrisome. With so many competing interests facing off, it's far from clear that once an effective vaccine is produced, all of the world's citizens will have equitable access to it.

It's a problem Jane Halton, a former WHO board member, calls "vaccine nationalism."

"I worry that some countries will see that there is strategic advantage in the use of any developed vaccine, if they are successful. I also think that there is, in some cases, a need to deal with domestic concerns," Halton said. "And I understand that being able to balance a need for domestic distribution, particularly for the vulnerable, but at the same time acknowledging that all countries are in this together — I think there's a middle line to be struck here."

Halton, who is chair of the Coalition for Epidemic Preparedness Innovations and former head of Australia’s health and finance departments, tells The World's host Marco Werman that vaccine production should be globally distributed and initially target the most vulnerable in all nations.

"What I hope is that whomever succeeds in this search, the quest for a vaccine, that when that vaccine is actually developed and is approved for use, that it isn't used exclusively for the needs of one population, when in fact, the people who need this vaccine are the vulnerable healthcare workers around the world, the elderly, the immune-compromised. And I think that is going to be the very big challenge we're about to face," she added. 

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Marco Werman: Scientific teams in countries around the globe are trying to develop a vaccine and there is a fear that a country could hoard the vaccine or keep it to themselves. I mean, so you're saying that fear is real?

Jane Halton: Yes. So "vaccine nationalism" is how I've been describing this, where one country seeks to preference their entire population over the vulnerable in the rest of the world. Now, at the end of the day, I think personally that is short-sighted because if one country still has people with the virus, it affects all of us.

Related: Inside the global network of scientists racing to curb the spread of coronavirus 

So if the goal of a vaccine is to stop the virus globally, what is the smartest way to distribute a hypothetical vaccine at some point?

The smartest way would be to ensure that the global allocation mechanism, which is being talked about and currently developed, will actually ensure that the vulnerable of the world get priority. We need a mechanism globally to decide firstly, who those people are, and then secondly, to make sure that they are the first to receive this vaccine.

As with all things, we can design something. But if people aren't prepared to participate, if they decide that they will go their own way, then of course that mechanism will not be as effective as it might be otherwise. There's still a way to go before we're in this position. But if we don't talk about this now, if we don't get it agreed now, I genuinely fear that we will see what happened in 2009. That the wealthy countries of the world will preference their entire populations before we actually provide vaccines to the truly vulnerable right round the world.

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Remind us, 2009 — what happened then?

Swine flu, as it was known. Basically, the big wealthy countries already had pre-pandemic contracts in place. And even though we had a global discussion about there being a proportion of vaccine provided to the rest of the world, the low- to middle-income countries. Even though some, in some cases, people promised 10% of vaccine production, that wasn't delivered in all cases. So that meant that the wealthy were protected and people without those resources, without manufacturing onshore and the research to develop their own vaccines — they missed out. And that is not right. And it's not it's not an equitable thing to do. And certainly with something like this coronavirus outbreak, it's actually also not smart for the rest of the world.

Related: Research on COVID-19 vaccine shows unique global collaboration

The mantra these days is "we're all in this together." Is there a way to actually get people to be embracing that idea in a very practical sense when it comes to a vaccine?

Well, of course, we can't make people, and I'm reminded of when my children were little and we all used to say to them, you know, "play nice." And that's essentially what we're asking people to do here. We can't make people. We can't force them. But what I think we can do is be clear about what the globe's expectations are. That because we don't know who will succeed in the development of a vaccine, if we all agree, obviously in any one country, there is a need to meet domestic demand, particularly for the vulnerable. But if you're not looking out for everybody else, who's going to look out for you if you don't get there first?

This interview has been edited and condensed for clarity. Reuters contributed reporting. 

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