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Vaccines in The Developing World

The world stood back in amazement.

Vaccines that normally take years to develop were ‘discovered’ within months of the outbreak of SARS-COV-2. Everyone breathed an enormous sigh of relief. And now on to the next problem. How do we make sure vaccines are distributed safely and fairly across the globe as quickly as possible. The EU is leading this process.

Last week, I was on a call organised by John Lahart TD with Professor Luke O’Neill. Luke has become well known over the last few months for his accessible commentary on Covid 19. He is an immunologist with 50,000 followers on twitter so what he says and how he says it matters.

On the call, he gave every reason to believe that there would be a swift distribution of a vaccine in Ireland. He pointed out that Ireland would get 1% of the vaccine portfolio purchased by the EU. As the EU has purchased 600 million doses of the vaccines produced by Pfizer/BioNTech and by Moderna, we will have enough in Ireland to get everyone a first dose. He predicted that 20% of the Irish population would be covered by the end of March including health care workers, the elderly and those with underlying conditions.

Later in the week I attended (virtually) a meeting of the International Development committee of the European Parliament. The main presentation was by Dr. Seth Berkley who is CEO of GAVI, the vaccine alliance. Dr Berkley’s presentation outlined a number of things about the possible distribution of a vaccine.

Firstly, GAVI initiated a global agreement earlier this year called COVAX, which should ensure that poorer countries will get access to vaccines at the same time as wealthier ones. Secondly, he outlined that 80 million children in developing countries are missing their normal vaccines because of the impact of Covid on routine medical services.

Finally, he pointed out that the next big problem we will have is anti-vaxxers. In trying to explain this phenomenon, he pointed out that in bygone days, most families knew someone who had had polio or measles and that this was enough to ensure widespread uptake of the vaccines.

Nowadays, the absence of the illnesses has allowed anti-vaccine theories to proliferate. Also, conspiracy theories (eg that Bill Gates started Covid to boost his Microsoft shares) and political divisiveness amplified by social media are connected to anti-vaccine sentiment. This is much more prevalent in the developed world.

Vaccine hesitancy is a consequence of hard-line anti-vaxxers’ social media output, putting everyone at risk.

But overall, while the news for the Covid vaccine was good, the secondary effects will be felt for a long time. According to the Gates Foundation, 25 years of work on immunisations has been set back in about 25 weeks.

About five years ago, when I was CEO of GOAL, we started discussions with Johnson and Johnson about vaccine trialling in Sierra Leone following the Ebola outbreak. In the event, J&J were not successful as the Ebola outbreak came under control.

GOAL also discussed the roll out of a trial of the eventual successful vaccine with the US Centre for Disease Control. As it happened, with Ebola under control as mentioned, not enough patients were enrolled. However, a similar and successful trial in neighbouring Guinea not involving GOAL, cleared the way for the breakthrough last year.

Exactly a A year ago, 11th November 2019, Merck’s vaccine was approved by the European Medicines Agency. In December 2019, it was approved in the US.

Not only that, but it was delivered in the Democratic Republic of Congo this year using an ultra cold chain (-80 degrees) in what is a very difficult environment. All of this is incredibly heartening in terms of what could be achieved with the newly discovered Covid vaccines.

The story of the Ebola vaccine is a really good news story and one that should be told more widely. It is a triumph for science and for the many people dedicated to ensuring that great scientific advances are distributed evenly across the world.

The only slightly dispiriting part of the story is that the Ebola vaccine took more than 40 years to be approved whereas the Covid 19 vaccine will probably take less than 40 weeks. You can’t help wondering if this because of where the respective disease outbreaks occurred.

Last week, the EU pledged an additional €100 million to COVAX with the aim of supporting access to vaccines in lower income countries. This is in addition to €400 million already approved.

As Dr Berkley commented, none of us are safe from Covid until all of us are safe.

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