The World Health Organization (WHO) has done the math and announced that in order to achieve an effective response that will end the covid-19 pandemic, it will take 31.3 billion dollars, about 28 billion euros, for the next 12 months. This is an amount equivalent to the GDP of countries such as Nepal or El Salvador, and is necessary to develop treatments and vaccines against the disease. Despite what has been raised to date, almost € 25 billion is still missing, an “urgently needed” amount, according to Soumya Swaminathan, WHO chief scientist.
These data are derived from the virtual meeting held last Friday with representatives of the WHO, the Global Vaccination Alliance (GAVI), and CEPI, a global organization to improve the study and launch of vaccines created as a result of the epidemic Ebola disease in Africa. The heads of the three organizations have announced the progress made in the past three months in the fight against the disease caused by SARS-CoV-2 through the so-called ACT-Accelerator or therapeutic accelerator covid-19. Led by WHO, it is a coordinating mechanism for all the working groups that are looking for a solution for the new coronavirus. It was born in April and is powered by the world‘s two largest philanthropic health organizations, the Bill & Melinda Gates Foundation and Wellcome Trust, and by the MasterCard company.
As soon as the covid-19 crossed the Chinese borders and reached the category of world pandemic, humanity was confined as a whole, but it also set to work to end this new enemy as soon as possible. One of the first steps that were taken, back in April 2019, was the creation of this international consortium. The ACT-Accelerator began operating with an investment of $ 125 million that would serve to support efforts in the search for a vaccine against covid-19, but also to strengthen the availability of diagnoses, treatments and medicines to cure patients because, until an effective immunization is achieved, there are many patients to save their lives: specifically, more than five million, of the ten million infected.
After several months of work and after receiving the budgets of the organizations included in this consortium, on Friday the WHO announced this gap of almost 25,000 million euros. “The required investment is significant, but it pales in comparison to the price of the covid-19: the total cost of labor for the ACT-Accelerator is less than a tenth of what the World Economic Fund estimates that the world economy is losing every month due to the pandemic. 468,000 thousand people have already lost their lives, “recalled Richard Hatchett, CEO of Cepi. “Losing a month could mean having 200 million fewer doses by 2021,” urged Seth Berkley, GAVI CEO.
This million dollar figure will allow the delivery of 500 million diagnostic tests and 245 million treatments to low and middle income countries, as well as the delivery of two billion doses of vaccines (when one exists). Of these, slightly more than half will go to the most impoverished countries.
The WHO chief has also drawn attention to how some high-income countries are seeking bilateral deals to try to buy treatments and future vaccines in advance while poorer others cannot. “But it is also not good for those who are making these initial investments, because it is very risky, since one does not know scientifically which of the [inmunizaciones] Candidates will be successful, “he warned.” It is also not a correct ethical approach because it leaves the rest of the world without doses of vaccine. “
Losing a month of work could mean having 200 million fewer doses of the vaccine by 2021
The race for the vaccine
“The most important thing is to agree on an allocation framework so that we can have equitable access so that there are no vaccines available for some countries and not for others,” said Swaminathan. But there are more fronts. The ACT-Accelerator representatives have detailed how work has been organized in recent months to precisely accelerate that response to the pandemic. The working groups have been divided into four pillars: one for diagnosis and one for treatment, whose respective missions are to accelerate the arrival of diagnostic tests and drugs at all stages of the disease and ensure that they are accessible to all regardless of what geographical point is the patient and his financial resources. A third party that works as a connector to healthcare systems: their job is to ensure that healthcare systems and local community networks can fully utilize these and other essential tools in their battle against covid-19.
The fourth is that of vaccines, and it is the most media: the race for immunization is in the news every day, and to coordinate those efforts CEPI and GAVI are in charge, whose work to bring affordable vaccines to the whole world has been made worthy of the Princess of Asturias Award for Cooperation of 2020, awarded last Thursday, June 25.
The mission of this pillar is to ensure that vaccines are developed and manufactured as quickly as possible, and that two billion doses can be delivered between now and 2021 without forgetting middle and low-income countries, both in terms of distribution and price. for sale (see on this map the trials around the world). In this sense, they have been questioned about the complaints of some humanitarian organizations, among them Médecins Sans Frontières, who maintain that GAVI does not demand sufficient transparency regarding prices from pharmaceutical companies. In an open letter published last Friday, 45 organizations accuse GAVI that the system it has devised to qualify for vaccines, called the Covax Mechanism, requires more explanations to be given and requirements to be met by poor countries that receive international aid funds and However, the self-financing wealthy leave more freedom to use their assigned doses of vaccines as they see fit.
One of the four pillars of Act-Accelerator is that of diagnosis, and is led, among others, by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Its purpose is to save nine million lives and prevent further infections, especially in poor countries where some, if not all, of these diseases are endemic. It is a real threat that the WHO has warned on several occasions since the start of the pandemic: with the diversion of resources and means to fight covid-19, and especially in countries with fragile health systems, other pathologies will no longer be addressed. and the progress made in the last 20 years will be reversed. In the worst case scenario, the Global Fund estimates that the death toll will double. “The impact of covid-19 on these three diseases in terms of incremental deaths may be greater than the direct impact of the virus,” warns the Fund.
“We have been able to offer new vaccines to the world population with a 98% reduction in their price and we have been able to do it by working with companies that have staggered prices, so we believe it is the right way. Of course, we need to negotiate and debate with the companies, “Berkley has defended. For his part, the CEO of CEPI has clarified that it is impossible to have discussions on final prices because they lack accurate information on the cost of each dose of vaccine. “We do not know what the final performance of the manufacturing process will be on an industrial scale, we hope to know more at the end of this summer,” he said. “The other thing that is critical for determining the cost is knowing how much vaccine antigen should be in each dose and that, together with the information that we will obtain about the performance will help us to know the real cost of producing the vaccine,” Hatchett added.
As for progress, WHO chief scientist Soumya Swaminathan has opined that the experimental vaccine being developed by AstraZeneca with researchers from Oxford University is the most developed right now. The pharmacist has already started conducting large-scale human clinical trials. “It is possible that it will have results quite soon,” said the expert, who added that the Modern American laboratories are also very advanced. And that of the 200 immunization research projects, 15 are already in the clinical trial phase.
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