Days after government officials took a break from frenetic pandemic accord negotiations, news broke that European countries had destroyed at least 215 million unwanted COVID-19 vaccine doses valued at over €4 billion.

The 19 countries surveyed dumped 0.7 doses per resident – with Estonia and Germany being the most wasteful, according to Politico, which broke the story this week.

In 2021, the European Union (EU) bought the equivalent of three doses per resident in secret deals with drug companies – hoarding these when African countries did not have access to any vaccines, not even for health workers.

Ending this cycle of waste and want is at the heart of the current pandemic agreement negotiations hosted by the World Health Organization (WHO). The talks are due to conclude in May 2024 with an agreement to govern countries’ conduct during pandemics – but parties seem to have entrenched disagreement about how best to ensure equitable access to vaccines and other medical products in future pandemics.

The People’s Vaccine Alliance’s Piotr Kolczyński said that the EU appears not to have learnt from its COVID mistakes, based on the positions it has taken during the pandemic agreement negotiations.

“The EU pumped unprecedented public funding into COVID-19 vaccines with no strings attached to ensure universal access. Yet, instead of learning from its mistakes, public funding conditionalities have been deleted from the draft Pandemic Agreement, and the EU is now trying to remove the remaining transparency and equity measures too,” said Kolczyński, who is the EU Health Policy Advisor at Alliance and Oxfam.

Several countries and non-state actors involved in the pandemic agreement negotiations advocate for governments that have invested public money in the development of pandemic products to retain a stake in these – via measures such as shares or joint intellectual property (IP) – so that private companies do not call the shots during pandemics.

However, the EU and the US have been lukewarm about this proposal.

COVAX lessons: Mitigating vaccine nationalism

Meanwhile, the four global co-convenors of the COVID-19 vaccine access platform, COVAX, urged in a joint statement on Tuesday that “future global pandemic preparedness and response architecture” be informed by COVAX learnings.

Noting that COVAX would close at the end of December, the Coalition for Epidemic Preparedness Innovations (CEPI), vaccine alliance Gavi, UNICEF and the WHO, highlighted three key learnings.

The first is the need to design, invest in and implement “an end-to-end solution to equitable access ahead of time” that “centres on the needs of the most vulnerable”.

While “vaccine nationalism will persist in future pandemics”, they urge “mechanisms to mitigate it – including by diversifying vaccine manufacturing so all regions have access to supply”.

The third lesson is “the need to take financial risks to avoid potentially deadly delays to the development, procurement and delivery of medical countermeasures”. 

Money left over from COVAX will be redirected to implement some of these lessons, including investing $1 billion in the establishment of an African Vaccine Manufacturing Accelerator (AVMA) to support African vaccine manufacturing, a measure announced recently by the Gavi board.

“In addition, a First Response Fund will be established to ensure financing for a vaccine response is immediately available in the event of a future pandemic,” they note.

New Africa-Caribbean solidarity

Meanwhile, Tuesday also saw the launch of a new South-South partnership, the Health Development Partnership for Africa and the Caribbean (HeDPAC) to strengthen health cooperation between Africa and the Caribbean.

“Promoting technology transfer for pharmaceutical manufacturing, building regulatory capacity, and enhancing universal health coverage will be core HeDPAC strategies,” according to a statement released via the WHO.

“COVID-19 left an indelible scar on our global solidarity and the right of all people to good health”, said Prime Minister Mia Mottley of Barbados. “It is our shared responsibility to ensure that the inequity of the global response to COVID-19 is not repeated. This is the kind of action that will allow us to help people where they need it most.”

HeDPAC will also focus on strengthening the health workforce in the two regions, and sharing innovative solutions in primary health care, with a special emphasis on climate resilience, and maternal and child health.

Pandemic negotiations 2024 deadline

The seventh meeting of the Intergovernmental Negotiating Body (INB) negotiating the pandemic agreement ended late on 7 December with a rapid and vapid report back – likely indicating that the negotiations remain difficult.

While informal inter-sessional meetings are set to continue in early January, the INB meets for the eighth time from 19 February to 1 March 2024. 

A ninth meeting is also planned before the World Health Assembly at the end of May at which the pandemic agreement is due to be presented.

Image Credits: Photo by Mat Napo on Unsplash, @CEPI .