Vaccinations and reproaches

The 73rd World Health Assembly was held in Geneva, Switzerland from 9-14 November. Delegations from several countries participated in the Assembly and reported on their positions on the management of the SARS-CoV-2 health emergency and the imminent challenges facing the World Health Organization (WHO).

Tedros Adhanom, head of the organisation, who incidentally this year sounded his name for the Nobel Peace Prize - and who finally did not receive it - during his intervention at the opening of the event called for "leadership based on mutual trust and responsibility" to put an end to the pandemic.

Adhanom welcomed Democrat Joe Biden's victory in the US elections and expressed confidence that the US will soon return to the WHO.

During this year, the United States stopped contributing between 400 and 500 million dollars; the WHO is trying to reorganise its finances for 2021 under the argument that health needs have multiplied due to the immediacy of the coronavirus, which has also distracted medical attention from other pathologies.

The hope is that Biden will return the sanity of respect for multilateralism as well as international organisations and with this return to the WHO and once again contribute 15% of its budget.
 

In a part of his speech, Adhanom reproached that the equivalent of the "annual finances of the organism" means the world-wide expenditure of tobacco "in a single day" as a sign of the precariousness of its budgets.

This is not easy, nor will it be, because his claim comes at a time when people, governments, companies and institutions are facing severe liquidity problems due to the economic crisis caused by the health emergency.

Finances have been disrupted, but plans and programmes have also been neglected as quickly as usual and vaccination campaigns are being interrupted in several countries, to the detriment of public health.

Gaps in health are at risk of widening in Africa, Oceania, Latin America and the Caribbean. The WHO itself and UNICEF recently issued a global alert asking governments of the most vulnerable countries not to interrupt measles and polio vaccination campaigns. 

The two agencies estimate that $655 million ($400 million for polio and $255 million for measles) is needed to support countries with precarious budgets that, because of the health emergency caused by the pandemic, are using the resources available to them to stop using them for their original purposes.

Adhanom has also been critical in pointing out that the pandemic will not end at the very moment when one or more effective coronarivus vaccines are available, warning also of all the devastating effects and aftermath that the unprecedented situation is leaving on all economic and productive sectors, on people and on life itself.

As of mid-November, preliminary figures show that the virus has claimed the lives of more than 1.3 million people globally and has infected more than 52 million.

To deal with this health emergency that has overtaxed the capacity of public and private hospitals around the world, decisions are being taken not only to set up emerging field hospitals in their own spaces for fairs and congresses as is the case in Europe, but also to employ doctors, including foreigners, in emergency situations, making recruitment rules more flexible. 

But scientists are also under unprecedented pressure to target serum for immunisation against VID 19 and to do so safely, efficiently and effectively for as long as possible, while pharmaceutical companies are organising how to produce billions of doses in record time for distribution around the world. 

Potential vaccines are being developed from all techniques known so far: 1) inactivated or attenuated virus vaccines; 2) nucleic acid vaccines with genetic material of the pathogen both RNA and DNA; 3) protein subunit-based vaccines; and 4) vaccines made from virus vectors.

Among the ten most advanced in the last phases of exploration are the University of Oxford and the Jenner Institute with the pharmaceutical company AstraZeneca; the Modern Laboratory of the United States; the Chinese company Sinovac; there is another Chinese company, Sinopharm, together with the Wuhan Institute; the American pharmaceutical company Pfizer with the German company BioNTech; From Russia, the Gamaleya Institute with its Sputnik V vaccine; there is another Chinese one, Cansino; there is also the American Janssen who has already started testing its vaccine outside the United States with a group of Spanish volunteers; then there is the Novavax vaccine and, finally, another Chinese one with Sinopharm and the Beijing Institute.

The coronavirus vaccine is not exempt from the geopolitical context, nor did it escape the US election campaign on 3 November.

President Donald Trump, the Republican Party candidate for re-election, who did not succeed, promised that the vaccine would be available to Moderna, AstraZeneca and Pfizer by the end of October at the latest.

The Federal and Drug Administration (FDA) itself acknowledged pressure from the White House to approve a coronavirus vaccine before the elections.

Finally, on November 9, Pfizer said that its vaccine developed together with the German BioNTech generated 90% of immunity, and that it was ready to conclude the last phase and thus begin with its commercialization. This is the first vaccine for the West that is based on messenger RNA (nucleic acid vaccines).

More recently, Moderna announced that its anti-VID serum was 95% effective, although it is not yet known how long it will be able to immunise people.

Since last March, the American dignitary has ordered contributions from his country's treasury, through the Department of Health, for a group of privileged pharmaceutical companies with subsidies and some financing totalling $10.761 billion.

The pharmaceutical companies that have benefited have been: Moderna with $2,455 million; the same as Pfizer and Biontech with $1,950 million; AstraZeneca and Oxford with $1,200 million; Novavax with $1,600 million; Johson & Johnson with $1,456 million and GSK with Sanofi with $2,100 million.

What was the only condition in return for this financial boost to accelerate your SARS-CoV-2 vaccine research? The responsibility to supply the United States first, rather than another country, with an initial 300 million doses.

Trump intended to use the vaccine in the election, and neither Pfizer nor Moderna allowed this, so it is now up to the FDA to give express consent for it to be marketed in the US.