No time to lose: strengthen global vaccine co-operation and leave no country behind

By Zhang Laiming, Vice President and Research Fellow of the Development Research Center of the State Council of the People’s Republic of China

In the fight against COVID-19, the most pressing priority is to bridge the global vaccine divide. While 71.56% of the population in high-income countries have been fully vaccinated, the same can be said for only 4.89% of people in low-income countries. As long as the vaccine divide exists, the coronavirus will not stop spreading and mutating, and no country will be safe. To this end, countries must work together. So, what needs to be done in the near future?

Over the past two years, China has worked hard to contain the pandemic at home and support the rest of the world’s efforts including through vaccine supply as a global public good. Through COVAX, and bilaterally with other developing countries, China carried out vaccine co-operation in the form of donations, distribution, research and development (R&D), and local manufacturing. Chinese vaccines were the first available to many developing countries, and for quite a long time, the only vaccines they could access. In Laos, when a new wave of cases struck in June 2021, only 5.5% of vaccine commitments from other countries had been fulfilled, and nearly 90% of doses administered in Laos were donated by China.

By the end of 2021, China had provided over two billion vaccine doses to more than 120 countries and international organisations, accounting for one third of vaccination outside China. To help the African Union meet the goal of vaccinating 60% of the population by the end of 2022, China pledged another one billion doses to Africa in November 2021, including 400 million doses to be jointly produced by China and African countries.

Indonesia, the UAE, Egypt and Brazil became the first countries in their respective regions to be equipped with vaccine production capacity, supported by Chinese enterprises. In Egypt, a vaccine production line with annual production capacity of 200 million doses is up and running.

Promoting vaccine equity is the common responsibility of all global stakeholders. Looking forward, the international community should join forces to address the unequal distribution of vaccines and leave no one behind.

Strengthening the international vaccine co-operation mechanism

It is imperative to strengthen multilateral and bilateral coordination and put in place a global mechanism for fair vaccine distribution, building on existing mechanisms such as COVAX. The World Health Organisation’s (WHO) leadership role in coordinating such efforts should be strengthened. Vaccines must be produced and distributed in an equitable and holistic manner, and should be allocated to high-risk groups as a priority. This also means building on existing regional co-operation mechanisms and developing an information system for intra-regional vaccine distribution. For instance, the international community can work more closely with the African Union, ASEAN, and CELAC (Community of Latin American and Caribbean States) to help them improve vaccine data integration, sharing, and monitoring systems, so as to increase the efficiency and precision of vaccine distribution.

Supporting local vaccine production

In October 2021, China launched an action plan for global vaccination, which supports an early decision by the WTO on the TRIPS waiver for COVID-19 vaccines, encouraging vaccine producers to transfer technology to developing countries. More efforts are needed to support developing countries to establish regional vaccine production centres so as to improve their vaccine self-sufficiency. For instance, the vaccine manufacturing site in Egypt is the result of successful co-operation between Chinese Sinovac and the Egyptian enterprise VACSERA. Sinovac not only provides the vaccine raw material but also sent technical experts dedicated to helping VACSERA solve problems every step of the production process and meet COVID-19 vaccine quality standards. VACSERA has been working to build another vaccine factory, which will be the region’s largest factory of locally produced COVID-19 vaccines, with the capacity to produce over one billion doses, making Egypt a hub for vaccine export to the African continent.

Strengthening cross-border vaccine trade

It is important to ensure the smooth flow of vaccines and raw and auxiliary materials for their production and distribution, and to establish a more efficient and resilient vaccine supply chain. The WTO, WHO and other international institutions could jointly build a comprehensive platform of vaccine trade, providing timely and accurate data on the supply and demand of vaccines, promoting liberalisation and facilitation of vaccine trade and investment, and further improving existing international rules that address the needs and concerns of developing countries.

Building health system capacity for vaccine logistics, distribution and roll-out

Broad co-operation in capacity building is urgently needed. International organisations, development partners and national governments should be encouraged to help developing countries improve their capacity in logistics, vaccine storage and rollout. Health systems need to be strengthened to provide universal health services including vaccination, which calls for continuous investment in the health sector, in particular at the primary healthcare level. Leading pharmaceutical companies could fulfil their corporate social responsibility to disseminate the latest technical guidance, facilitate training for vaccinators and assist in implementing smarter vaccine logistics and storage systems.

Optimising vaccine financing

Another key solution is to enhance vaccine financing co-operation among low-income countries, development assistance providers, development financial institutions and the private sector, in order to enhance vaccine affordability in developing countries. In 2021, developed countries made many commitments for financing vaccination in developing countries. Now is the time to fulfil them. While respecting the central role of the WHO in global health governance, major international economic organisations like the G20 could unite as one to build up complementary financing mechanisms that address the urgent needs of developing countries.

Promoting mutual vaccine recognition

Now is the time to encourage cross-national studies on vaccine effectiveness, data-sharing, mutual vaccine recognition and regulatory policy coordination. The Global Vaccine Co-operation Action Initiative, put forward by Chinese President Xi Jinping at the 16th G20 Leaders Summit, reflects a firm resolution to fight COVID-19 together with the world. We, seven billion people on the planet, live in an interconnected community with a shared future. We should join hands immediately in securing equitable access to affordable vaccines and constructing the most solid line of defence against COVID-19.