Race for a COVID-19 vaccine: will emerging economies be left behind?

As several countries face a second wave of outbreaks of COVID-19, many emerging markets are pinning their hopes on a vaccine that will allow them to reopen their economies with confidence without fear of overwhelming health services. With more than 22 million people infected worldwide, it is becoming increasingly clear that a vaccine is needed to bring societies and economies back to normal. Currently, researchers around the world are working on more than 150 different vaccines, 26 of which are already being tested in humans. The problem presents an interesting conundrum for emerging markets, amid concerns that many may lose early access to vaccines to richer countries.

At the end of July, the US government announced that it had signed a $2 billion contract with the US multinational Pfizer and the German company BioNTech to develop 100 million coronavirus vaccines before the end of the year, while in June Germany invested 300 million euros, a 23% stake, in local shares, the biopharmaceutical company CureVac, which is working on a COVID-19 vaccine. Meanwhile, China has also invested heavily in several domestic companies, and international media reported that it had spent around $140 billion on measures to combat the virus, including the development of treatments and vaccines.

Some emerging markets have sought to position themselves favourably for access to vaccines by collaborating with international pharmaceutical companies in testing. In the Middle East, Saudi Arabia, the United Arab Emirates and Bahrain have begun clinical trials of a viral vaccine in cooperation with Chinese companies. Phase three trials for the potential vaccine will see about 5,000 adults in each country participate in the trial.v Meanwhile, in Asia, Indonesian state-owned Bio Farma has partnered with China's Sinovac to conduct phase three vaccine trials in West Java, while local health giant Kalbe Farma has also partnered with South Korea's Genexine for phase two trials of the company's vaccine.

In addition, a national consortium under the Ministry of Research and Technology has begun working on a longer-term, self-sustaining strategy to develop its own vaccine. "Emergency situations tend to stimulate innovation. In Indonesia, we have seen many academic bodies and research institutions come up with innovations to boost the national response," Endang Hoyaranda, commissioner of the Prodia Group, told OBG. "Efforts are under way to find a vaccine, but we have also seen more immediate results in areas such as the development of ventilators and diagnostic test reagents. Indonesia also has the capacity to develop and test treatments using stem cells. Meanwhile, similar efforts toward vaccine self-sufficiency are underway in Peru and Mexico.

The ability of emerging markets to develop working relationships with leading medical research nations is considered key to gaining access to future vaccines. For example, China has indicated that it would give the Philippines priority access to any vaccines it develops. The importance of strong ties with richer countries comes amid concerns that they may outpace emerging markets once approved solutions enter the market, which then leaves low-income nations at the end of the queue.

Indeed, the World Health Organization has warned against so-called "vaccine nationalism," noting that, given the interconnected nature of the global economy, it would be in the general interest to share the benefits of any potential vaccines. To avoid such a situation, an international coalition of organizations has developed the COVAX Facility, a mechanism designed to provide rapid, fair and equitable access to COVID-19 vaccines globally.

The initiative involves high- and middle-income countries that finance vaccines through their own public budgets, and then partner with lower-income nations to provide voluntary donation support to the COVAX Advanced Market Commitment, led by Gavi, the Vaccine Alliance. So far, 75 countries have expressed interest in funding the initiative, which would benefit 90 lower-income countries. The goal is to deliver 2 billion doses of approved vaccines by the end of next year. The plans call for equal delivery to all participating nations, in proportion to their populations, with priority initially given to health workers.