Multilateral action can turn blueprints for equity during future pandemics into reality – the industry’s proposal

Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), explains how the biopharmaceutical industry’s Berlin Declaration will help the world’s most vulnerable populations.

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Photo by Towfiqu barbhuiya on Unsplash
 

 

Building on the lessons learned from COVID-19, the biopharmaceutical industry has tabled a proposal to reserve part of the real-time production of vaccines, diagnostics, and treatments (VDTs) against future pandemics for high-risk populations in low-resource settings. With political endorsement by the G7 and the G20, the “Berlin Declaration” can be the foundation for a new social contract that guarantees the world’s most vulnerable populations are protected.

More impressive is the achievement of 1.61 billion doses delivered to 146 countries through COVAX.

Close to 20 million lives worldwide were saved thanks to COVID-19 vaccines in the first year of the pandemic alone. Science, innovation, and collaboration worked in step to arrive at the approval of a vaccine just 326 days after the sequence of the virus was shared, kicking off the largest vaccination programme in history. The super-charged R&D and manufacturing effort meant we went from no vaccines against this new threat to billions of doses of multiple vaccines in record time. By the end of December 2021, global manufacturing output totalled more than 11 billion COVID-19 vaccine doses, supported by over 370 voluntary licensing, technology transfer, and know-how partnerships between innovative vaccine manufacturers and developing countries vaccine manufacturers.

But more lives could have been saved, especially in low-income countries. Deliveries of first vaccine doses in Accra and Abidjan at the same time as vaccines arrived in Tokyo gave hope that global solidarity would prevail. Yet vaccine hoarding, trade barriers and export bans, as well as a lack of adequate financing were among the factors that cast a shadow on the extraordinary feat of scientific ingenuity.

For example, a ban on vaccine exports in India significantly impacted much of the supplies that were committed for COVAX to distribute, particularly to sub-Saharan African countries. COVAX found itself having to revise its vaccine delivery targets significantly downward while it sought to secure vaccines from other manufacturers. More impressive is the achievement of 1.61 billion doses delivered to 146 countries through COVAX.

Building on a deep analysis of the biopharmaceutical industry’s lessons learned from the COVID-19 pandemic, we must define how we achieve greater equity from the outset of future pandemics, through global collaboration and action from all relevant stakeholders.

Berlin Declaration – the foundation of a social contract

We are tabling the “Berlin Declaration” for discussion with world leaders. The core of the proposal is an offer by industry to prioritise and reserve a meaningful allocation of real-time production of VDTs for distribution to priority populations in lower-income countries.

Such a move could be a game-changer for future pandemics and would build equity into future pandemic preparedness. It has the potential, if key countries and international governmental organisations work with us, to form a new social contract by which solidarity acts in synergy with innovation for the benefit of global health security. The Berlin Declaration would create the framework for the supply of vaccines but also treatments and diagnostics that would be developed to tackle whatever the next pandemic may be. Products developed and manufactured by innovative biopharmaceutical companies could be delivered to those who need them most as early as possible in future pandemics.

However, for this joint proposal to be successful, there are several elements that need to be in place. This includes having a thriving innovation ecosystem, without which it will not be possible to respond quickly in developing safe and effective tools when the next pandemic-level threat emerges. Another important factor that would need to be addressed is ensuring that trade and regulatory barriers don’t hinder VDTs from reaching those in need.

To remove any delays due to insufficient or unclear lines of financing, it would also be important to have an Advance Commitment Facility with access to a credit line on day zero of the next pandemic. This would fund a pre-allocated share of VDTs, allowing lower-income countries to secure orders earlier for a much faster and equitable global response and avoiding more episodes of vaccine hoarding.

Lastly, the proposal requires governments to invest in strengthening and building pandemic preparedness into national health systems, absorption capacity, and global infrastructure.

Embedding the proposal into wider pandemic equity blueprints

Since the launch of the declaration in July 2022, several key players have already voiced encouraging and positive reactions and the willingness to work with us on how to operationalise this framework. We have received statements of support from Indonesian Minister of Health, His Excellency Budi Gunadi Sadikin, who said the industry plays a critical role in close collaboration to improve real-time access to priority populations in lower-income countries, as well as from CEPI. We are also heartened by the positive reaction we got from the Gavi Chair and COVAX co-Chair, José Manuel Barroso, who welcomed the proposal as a strategic opportunity to forge a new social contract for future equitable access in pandemics and called on political leaders to do their part and engage with industry on how to make this work.

There are many other things that need to be done to prepare adequately for future pandemics, but this proposal is something tangible and concrete that could firmly place equity at the centre of any pandemic response. Over the coming weeks and months, we will be working with Gavi and other relevant stakeholders to bring it to life. We are excited about how the process has started and look forward to discussing with key players how they can join in making our vision a reality – forging a unique, game-changing social contract for equitable access in pandemics, without which any attempts to improve fair responses to future pandemics will falter.

Through the Berlin Declaration, a practical solution is proposed. With support of G7 and G20, the framework could be up and running by early 2023.