Health experts and access advocates warn that rich countries may leave poorer countries in the lurch as states scramble to preorder doses while COVID-19 vaccine candidates enter late stage clinical trials.

The United Kingdom on Friday secured 90 million doses of two promising COVID-19 vaccine candidates, joining a growing group of rich countries buying up doses of promising vaccine candidates before they hit the market. 

It’s “urgent” for the UK government to clarify how it will ensure equitable global access to these vaccines in light of the deals, said Alex Harris, head of Global Policy at the research foundation The Wellcome Trust in a press release. 

“Without this clarity, the risk increases that other rich countries will seek to strike similar bilateral deals, potentially securing significant oversupply, leaving insufficient volumes of vaccine for the rest of the world,” added Harris. 

Access advocates decried the move, accusing the UK of fueling ‘vaccine nationalism’ and joining other rich countries to ‘hoard’ the vaccine before it even hits the market.

“This latest vaccine deal shows the government shows a complete disregard for its own claims about supporting equitable global access to Covid-19 vaccines,” said Heidi Chow, senior campaigns and policy manager at Global Justice Now. “This UK-first approach is fueling vaccine nationalism as rich countries scramble to hoard vaccine supplies, leaving poorer countries without access. The fastest way to end this pandemic is through global collaboration.”

Health experts have generally agreed that a successful COVID-19 vaccine should first be given to healthcare workers, and then to high-risk groups in areas with high transmission of the virus. But many are concerned that the deals being struck between vaccine producers and high-income countries will leave poorer countries with potentially higher numbers of COVID-19 cases without access.

“Instead of accelerating an arms race for access to COVID19 tools by competing with other countries to get preferential access to potential vaccines, the UK should be taking a collaborative approach,” said Diarmaid McDonald, lead organiser for Just Treatment, a patients advocacy group in the UK. 

“If we want to manage this pandemic successfully the UK Government need to be championing global collaboration and coordination,” added Saoirse Fitzpatrick, advocacy manager for STOPAIDS. “This means supporting international efforts to facilitate the sharing of research data to speed the vaccine discovery process, and ensuring that patent monopolies do not drive up the prices of these vaccines and cause supply shortages.”

Countries Scramble to Secure Vaccine Stocks Through Bilateral Deals

The UK signed its latest deals with Novavax and Janssen Pharmaceuticals, a branch of Johnson & Johnson, promising to support clinical trials for both companies’ vaccine candidates. Neither vaccine candidates has entered the last phase of clinical testing before being eligible for regulatory approval. 

Earlier this year, the UK had signed a contract with Sanofi/GSK for 60 million doses of their investigational COVID-19 vaccine, and has also secured deals with the University of Oxford/AstraZeneca and the BioNTech/Pfizer alliance for stocks of their trial vaccines.

The UK deals follow the United States’ announcement of the largest pre-order contract to date of an investigational COVID-19 vaccine. The Trump administration announced Wednesday that it had ordered 300 million doses of Moderna’s investigational COVID-19 vaccine to be manufactured, ready to be deployed if the vaccine shows success in Phase III clinical trials. 

Oxford/AstraZeneca, Moderna, and BioNTech/Pfizer’s vaccine candidates have begun Phase III trials, aiming to enroll around 30,000 volunteers for each trial.

The European Union is also pursuing bilateral deals with pharmaceutical companies to secure doses of the vaccine for Europe. So far, it is in talks with Sanofi/GSK to buy up 300 million doses of their investigational vaccine.

One global initiative, the COVAX facility, aims to secure at least 950 million doses of any successful vaccine for low-income or lower-middle income countries. However, some low and middle income countries are in talks with banks to finance their own bilateral deals with vaccine producers, in an effort to avoid being left behind.

Even the World Health Organization is concerned about the implications of these deals.

“Excess demand and competition for supply is already creating vaccine nationalism and risk of price gouging,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus on Thursday. “This is the kind of market failure that only global solidarity, public sector investment and engagement can solve.”

Image Credits: Flickr: Nenad Stojkovic.