A call for equitable distribution of covid-19 vaccines – The BMJ

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As the UK approves the Pfizer BioNTech vaccine, these authors call for an inclusive approach to vaccine allocation

For the majority of health threats that humanity has faced these past three decadesbe it Ebola, swine flu, HIV/AIDS or othersreflections on an equitable response have been an afterthought, and this has only happened solely thanks to the fight and advocacy for social justice by global health activists. Provision of life saving medical and public health interventions have often disregarded the most vulnerable in society, despite the fact that they are more likely to be disproportionately affected. A prime example is the HIV/AIDS epidemic, during which the delayed establishment of a life-saving antiretroviral (ARV) programme in South Africaone of the first African countries to get access to ARVsis estimated to have caused the preventable loss of 330,000 lives between 2000 and 2005.

Global health activists have stood up during each new health threat to say that it is time to ensure that history doesn’t repeat itself. However, we have never succeeded in making this inclusive approach a universal principle. The covid-19 pandemic is an opportune time to issue that statement again. Today the UK government announced that the UK’s independent Medicines and Healthcare Products Regulatory Agency (MHRA) has just approved Pfizer and BioNTech’s covid-19 vaccine. Recent developments with the Pfizer and Moderna trials illustrate a 95% and 94.5% effectiveness of their vaccines respectively as well as a potential 90% effectiveness of the Oxford University vaccine. We know that despite the many vaccine development trials taking place, it will take years before the whole world is vaccinated. However, it is time to ensure that, for once, vaccine allocation is made with an equitable agenda at the forefront.  

It is important to be proactive in this discussion because historically various players within the health industry have disregarded equity. Pharmaceutical firms have continuously abused their power by leveraging subsidies and exploiting the sick for profit. For example, while the cost of production of a 12-week Hepatitis C treatment was $68-136, it was sold at the market price of $84,000 in the US. Given the structure of the patent system and intellectual property rights, we are at risk of having a few companies monopolize the production of the covid-19 vaccines and consequently charge high prices. This is despite the development of this lifesaving product being paid for partially by taxes from citizens, including the vulnerable. Unless we come together in solidarity to advocate and fight for equitable distribution, the usual scenario that occurred with the distribution of medicines for HIV/AIDS, hepatitis, and other deadly diseases will be repeated.

The COVAX facility, an initiative co-led by GAVI – the Vaccine Alliance, the World Health Organization, and the Coalition for Epidemic Preparedness Innovations…



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