JERUSALEM – A three-way collaboration between Israel, Austria and Denmark to expand COVID vaccine manufacturing capacity may be taking shape – just as Moderna gears up for a major global manufacturing expansion and the Israeli-based firm, Teva Pharmaceuticals, negotiates with vaccine manufacturers about ways to support more vaccine production and distribution.  

Austria’s Chancellor Sebastian Kurz and Denmark’s Prime Minister Mette Frederiksen were reported to be planning a visit to Israel at the invitation of Prime Minister Benjamin Netanyahu – to talk about setting up “an international corporation for manufacturing vaccines” – in the words of the Israeli prime minister on Monday.  

The high-profile visits, if they come off, coincide with a quest by Moderna Therapeutics to set up some 20 new manufacturing plants around the world where “fill and finish” vaccine manufacture could start immediately, Israeli sources told Health Policy Watch. 

But rather than siting their plants in Israel, Moderna may also be eyeing Teva facilities in Europe or elsewhere, some sources suggest. Teva, while based in Israel, has a worldwide network of over 61 manufacturing plants, including Austria and Denmark as well as elsewhere in Europe. 

Riding on the jet-stream of fast-moving vaccine geopolitics, Pfizer’s CEO Albert Bourla was also reportedly set to make a visit to Israel on Sunday, 8 March. The visit could coincide with an announcement by Pfizer that it will locate a vaccine R&D facility in Israel – to come up with next-generation jabs against the ever-mutating coronavirus.

Bourla last week described Israel as “the world’s lab” for the Pfizer vaccine “ because they are using only our vaccine at this state and they have vaccinated a very big part of their population, so we can study both economy and health indices.”  

Moves Come Against Backdrop of Israeli Election Campaign 

However, some leading Israeli scientists and diplomats have urged the Pfizer CEO to postpone his high profile visit –  which would come just two weeks ahead of a hotly-contested Israeli national election campaign. 

Netanyahu is trying to retain his 12-year-long grip as prime minister – despite corruption cases in the courts and political challenges from former allies on the political right. Showcasing Israel’s success in its vaccination campaign, which has seen over half of Israelis get first jabs and led to a dramatic decline in COVID cases among people over the age of 60, has been a key part of Netanyahu’s re-election strategy. 

While Netanyahu has been widely acknowledged by Israelis for his aggressive moves to acquire and roll out vaccines rapidly and efficiently – he has also been criticized for politicizing an already charged vaccine landscape at home and abroad  – including recent offers of vaccines to alliles in far-flung capitals even before Palestinians next door get access to significant COVID vaccine supplies.

“It is understandable why the chairman and CEO of Pfizer, Dr. Albert Bourla wants to visit Israel. The country – both the government and the scientific and medical communities – will enthusiastically welcome him. Many are looking forward to exploring the possibility of R&D projects and a Pfizer production line in Israel,” wrote Alon Pinkas, former Israeli Consul General in New York, in an op-ed in the Ha’aretz national daily. 

But, Pinkas added, “It defies logic why Bourla, the CEO of a world-leading biopharmaceutical company worth nearly $190 billion, would visit Israel on March 8, 15 days before the Knesset [parliamentary] election. To put it bluntly, Pfizer will become a political prop, and the visit will be politicized with high-octane intensity. Prime Minister Benjamin Netanyahu no longer has Donald Trump as some brother-in-arms campaign asset, so why not use Pfizer?”

Netanyahu Says Israel May Host Moderna Plant –  Others Say Country Lacks Immediate Manufacturing Capacity

In a February 15 interview with Israel’s Channel 12 news channel, Netanyahu said that he was negotiating with both Moderna and Pfizer  “to build two factories in Israel – making us a global center in the fight against COVID-19.” 

“The Moderna complex will be a center for filling vaccine vials, while Pfizer’s will work as a research and development site for the fight against future viruses,” Netanyahu said.

However, Tal Ohana, the mayor of the Israeli Negev desert town of Yeruham, which had been considered one of the leading sites in the country for a vaccine manufacturing plant, said in an interview with Health Policy Watch that she doubts that Israel can host a plant of the capacity and dimensions that Moderna is seeking at this stage. 

“We are in touch with Moderna,” said Ohana, who had been trying to attract a vaccine manufacturer to the town of 10,000 people even before the pandemic began. “They have decided to create 20 new manufacturing sites around  the world.  But they need something immediate for ‘fill and finish’, with sterile rooms.  To produce at export scale, the company is also looking for large-scale facilities – e.g. of 5,000 square meters in size and employing about 200 workers to produce 100 million vaccines a year, she said. 

While Yeruham is “the most advanced in the process among all of the options in the country… we aren’t at that stage…. we don’t have that capacity here. It takes time,” Ohana said of the facilities already available. “So Moderna is looking at establishing sites elsewhere in the region and to come back to us later.”  

Ohana said it was her understanding that Pfizer would, however, be setting up an R&D facility somewhere else in the country soon. She noted that the company has been eyeing an R&D facility in Israel for some time – “but there were disputes over the IP… then with the interventions of the prime minister, I’m pretty optimistic it will happen,” she added.    

The 36 year-old Ohana, who holds a master’s degree in government and diplomacy and has won recognition for driving COVID cases in the town down to single digits, said that she is focused on attracting a vaccine manufacturer – which would provide a larger employment base. To that end, the municipality is still in negotiations with a third pharma company – which she preferred not to name.

Teva Keen to Fill Manufacturing Niche in International Vaccine Market 

Meanwhile, as another piece in the jigsaw, Teva appears likely to step in soon as a manufacturing solution for capacity-strapped vaccine producers – which are struggling to fill orders now that vaccines have been approved. A spokesperson for Teva, the world’s largest generic drug manufacturing company, confirmed to Health Policy Watch on Wednesday that “there are discussions between Teva and vaccine originators about production – but we have no information to add about their identity.”

In a series of mid-February media interviews Teva CEO Kare Schultz said Teva was one of the companies best positioned to fill the current holes in the COVID-19 vaccine manufacture market: 

“We have a large, worldwide network of manufacturing capabilities,” from creating underlying drug substances to putting solutions into sterile vials, known as the fill-finish process, Schultz told Fortune Magazine. “There are a limited number of facilities that can do this kind of manufacturing, and it takes time to build them.”

While declining to comment on which vaccines Teva might produce, the company is equipped to make the messenger RNA active ingredients used in the Moderna and Pfizer-BioNTech vaccines.

Teva has already played a huge roll in Israel’s massive vaccine rollout, – the largest in the world, handling the distribution process from airport delivery to ultra cold-chain storage and transportation to hundreds of vaccination sites around the country.

“We also have distribution capability in the U.S. and would be more than happy to help there,” Schultz also said.

But significant to any upcoming talks between Israel, Austria and Denmark, Teva also has plants in Europe, including in Seborg, Denmark and  Teva Ratiopharm Austria, an Austrian firm acquired by Teva in 2010, 

Flurry of Activities Come Against Persistent European & Global Vaccine Shortages 

The flurry of activities by both countries and pharma manufacturers to rev up vaccine manufacturing production come against the stark reports of vaccine supply shortages in Europe – not to mention globally. 

Speaking at her first session of the World Trade Organization’s General Council on Monday, incoming WTO Director General Ngozi Onkonjo-Iweala noted that the world’s vaccine manufacturing capacity currently stands at only about 3.5 billion doses annually – while the needs in the COVID era are for the manufacture of some 10 billion doses a year. 

Iweala has also said she would advocate for a “third way” approach with pharma companies to expand global manufacturing, particularly in low- and middle-income settings where production could also expand access to vaccines among less developed countries.  

It remains to be seen if the vaccine scale-up envisioned by Moderna, and the moves being made by Teva, as well as Israel and its European allies will support that wider objective – or merely expand supplies to high-income countries in Europe and elsewhere.    

Image Credits: Youtube – Israeli PM, wikipedia , Kobi Gideon, GPO.