How to ensure access for all to a coronavirus vaccine should be the priority for world leaders. Dr Bernard Pécoul offers five ideas leaders should consider this week as they aim to raise €7.5 billion to fund vaccine research.
Dr Bernard Pécoul is Executive Director of the Drugs for Neglected Diseases Initiative
A “worldwide pledging marathon” hosted by the European Commission and partners has kicked off this week to raise funds for the development of COVID-19 tests, treatments, and vaccines. But euros alone won’t be enough to put life-saving health technologies into the hands of clinicians and patients.
Through my years as an infectious diseases doctor with Médecins Sans Frontières, I know the desperation faced by health workers on the COVID front-lines — when you have no effective drugs or vaccines to offer a patient. The populations I worked with are far from the spotlight, and highly neglected. With COVID, the crisis is magnified on a global scale, impacting all communities and disrupting everyone’s lives.
I’m now head of a non-profit that tries to bring an answer to the lack of medicines for neglected diseases. We drive research, run clinical trials, partner with ministries of health and pharmaceutical companies, and develop and deliver new drugs for the most vulnerable. Many of the challenges we have faced, and that on our modest scale we have overcome, are the very same obstacles governments must tackle now on a global scale.
Angela Merkel has spoken of making any future COVID vaccine a “global public good”. This is a very noble objective but will remain empty talk unless bold action is taken.
As the multilateral response for COVID research takes shape, here are five concrete steps that governments need to take to ensure their good intentions turn into tangible health tools in the hands of clinicians and patients:
One – don’t make funding decisions a closed-door exclusive club. It can’t be up to a small group of countries to find and decide on the tests, drugs and vaccines that work. We need to identify the tools and interventions that are the most appropriate and effective in widely different settings and different countries. Including all countries recognizes the reality that we need to harness the multiplicity of solutions and contributions. Researchers and public health leaders from low- and middle-income countries are both the most legitimate and the most likely to identify what works best for their populations.
Secondly, commit to open sharing of research knowledge and data. R&D is often done behind closed doors, whether due to commercial confidentiality or because companies don’t want to disclose negative results. But we know from experience that open science – publishing results and data in the open, in real-time – improves efficiency and accelerates scientific progress by sharing research knowledge. Funding should be made conditional to results and data, including genetic data on the virus, promising compounds, clinical trial protocols and results, being put in the public domain.
Three – make health tools free of intellectual property restrictions. Legal rights to control knowledge can act as a barrier, both to research itself and to large-scale production of affordable health technologies. Funding should require that no new legal rights should be sought, and technology owners should commit to either not enforce their existing intellectual property, or to share this knowledge, by licensing it on a non-exclusive basis globally.
Four – take steps now to ensure sufficient production, equitable allocation, and affordable pricing. Ensuring enough quality-assured tests, treatments, vaccines, and other essential equipment are manufactured may be the greatest challenge of all. Increasing existing production capacity will not be enough. Additional sources will need to be created, including through transfer of technology. Once new health tools are developed, they will need to be equitably allocated both between wealthier and poorer countries, and within countries. This means the most vulnerable and those at highest risk must be prioritized. The pricing of these tools must be as close as possible to what it costs to make them, so that they are affordable for health systems, and free to those most in need.
And five – require full transparency on R&D funding. The investments of public money in the discovery and development of health technologies to address COVID-19 are colossal. Any taxpayer has a right to see a public return on these public investments in R&D. Transparency will be key to securing public trust and support and to demonstrate that both governments and funding recipients are accountable for these investments and how they are used.
The pledging conference is a promising sign of cooperation and solidarity. This gives much needed solace, both in the face of the horror of the COVID crisis, and in light of the threat of profiteering or hoarding.
Just as the COVID crisis is unprecedented in its magnitude, the response must be unequalled in its ambition. With bold action, the COVID-19 funding effort launched by the EU could well become a turning point: most urgently, by developing new health tools for the pandemic; but also in a longer perspective, to put us on the path toward a more sustainable, effective and equitable innovation system for all.