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    The United States, Europe and other wealthy countries are causing that the Coalition for Epidemic Preparedness Innovations (Cepi) falter, Cepi has the purpose of ensuring future COVID-19 vaccines are fairly distributed, and this is becoming ever more challenging. And it is that these rich nations have already monopolized the first doses.

    Seven months after the onset of the Pandemic, and even before clinical trials of the experimental vaccines have concluded, the United States, the European Union, the United Kingdom, Canada and Japan have ordered a total of at least 3.1 billion doses, according to a count by the AFP agency.

    Donald Trump was the first: his government signed contracts that guarantee at least 800 million doses from six manufacturers, for 330 million inhabitants, which will begin to be delivered at the end of the year.

    “The United States is potentially in a position to have too many vaccines if all the projects it has invested in are successful,” Cepi general manager Richard Hatchett said in an interview. He says, that national leaders serve their citizens as a priority, but he asks Washington to behave like a world “leader” and share its doses with other countries, something that for the moment is not in Trump’s plans.

    “We have to persuade world leaders that as long as the vaccine is available in these initially limited quantities it should be shared globally, that it should not be the case that only a handful of countries receive all available vaccines in the first half of 2021”, says Hatchett.

    Cepi’s general manager fears that the scenario of 2009 will be repeated, when rich countries had reserved the first vaccines against the H1N1 flu. Hatchett’s concern, shared by several organizations, led to the creation of a device, the Covax, to buy and distribute equitably 2 billion doses in 2021 at the initiative of the World Health Organization (WHO), Cepi and the Alliance for the Vaccine, Gavi.

    To date, 92 developing countries and 80 developed countries have joined. The European Union announced on Monday a contribution of 400 million euros. At this point it has only acquired 300 million doses from AstraZeneca, a pharmaceutical group that has separately signed partnerships with the United States, Europe, Russia, South Korea, China, Latin America, and Brazil. The American biotech Novavax, on its part, has signed a partnership with an Indian group to produce up to 1 billion doses of its possible vaccine in India.

    Collaborative project

    Cepi’s negotiations, funded mainly by public and private donations, including the Gates Foundation, are “ongoing” with the other laboratories, but no agreement has been announced. Not even with the American biotech company Moderna, despite the fact that Cepi invested in it very early on.

    The ideal goal of WHO is to vaccinate the entire planet in an order of priority independent of nationalities, starting with the 20% of the most vulnerable people in each country, including medical personnel, before moving on to the rest.

    “We understand why they (rich countries) do it, but it is unfortunate that governments buy more vaccines than necessary for these priority vaccinations,” says the head of Cepi. The coalition believes that with 172 Covax members, however, it can negotiate good prices. “This is one of the reasons why we are asking countries to confirm their commitment to the mechanism,” he urges. “The greater the number of countries that negotiate together, the greater our purchasing power and the more attractive the price.” But the European Union has sealed its own agreements with major laboratories and has not said whether the bloc will use the WHO device.

    Longer term, Hatchett says Cepi has yet to raise between $ 700 million and $ 800 million of the $ 2.1 billion needed to continue vaccine research. Because nothing guarantees that current developments will be successful.

    More challenges ahead

    Temperature, is another challenge In addition to the problems of getting the vaccine at an affordable price, several countries in Latin America, Asia and Africa will have to fight another enemy when distributing the vaccine. Getting this drug from manufacturing sites to some parts of the world with rural populations and unstable electricity supplies will be a huge challenge, given the need to store some vials at temperatures as low as -80 degrees Celsius, Deutsche Post warned Tuesday.

    The German logistics firm said the distribution of an eventual vaccine to large parts of Africa, South America and Asia will require extraordinary measures to keep deliveries of so-called mRNA vaccines refrigerated at temperatures similar to Antarctica.

    Companies that develop vaccines that require exceptionally cold storage, such as Moderna and CureVac, are working hard to make their injections last longer in transit. The new class of mRNA vaccines is among the most advanced in a field of 33 injection options that are being tested in humans globally, but may need to be cooled to -80 degrees Celsius.

    Improving cold storage infrastructure in some regions outside of the 25 most advanced countries, which are home to one-third of the global population, will represent a huge challenge, Deutsche Post said in its study, conducted with consulting firm McKinsey.

    Vaccine developers Translate Bio and Moderna said in June that they are working to show evidence that their respective products can be transported and stored at less extreme temperatures.

    A CureVac spokesperson said their vaccine candidate is based on an experimental rabies vaccine that has already been shown to maintain its molecular structure when stored in a common refrigerator for months. Tests are underway to show that the COVID-19 product has the same durability and the company is confident that the data will be “competitive,” they added.

    Deutsche Post noted that even if the vaccine’s cold chain requires temperatures as low as -8 degrees Celsius, the number of the world’s population with reliable access to it would increase to only about 70% and substantial parts of Africa would be at risk of being left out.

    “We anticipate that 10 billion doses of the vaccine will have to be distributed around the world and that includes regions that do not have road access every 5 miles (8 kilometers),” the commercial director of Deutsche’s DHL global forwarding unit told Reuters.

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