The only realistic way to accelerate vaccination elsewhere in the world is to expand vaccine production, and it appears that the US has a unique ability to make this happen.
The two vaccines best suited for accelerated production are the mRNA vaccines marketed by Pfizer and Moderna. This is because manufacturing processes for mRNA vaccines require smaller manufacturing facilities than conventional vaccine production, and these facilities can be built in less than half the time and with much lower capital costs. In addition, it is likely that mRNA facilities could be reused at new variants and even new threats.
While it is possible that other vaccine platforms could be expanded, including the promising protein-based approach such as that of Novavax and the vector-based platforms of the vaccines Johnson & Johnson, AstraZeneca / Oxford and Russian / Sputnik V, their vaccination processes are more difficult to replicate and their products are less adaptable to variants of this coronavirus and other threats. No other vaccination platform offers the flexibility and a relatively low barrier to access to mRNA technology.
In an effort to develop vaccines at unprecedented speeds, U.S. taxpayers have made significant public investments in research and development for Covid-19 vaccines. The results exceeded the most optimistic forecasts, but with public investment comes both responsibility and unique opportunities.
The US has a vital interest in sharing the results of this research to protect both global health and our own health safety.
Vaccine manufacturers have not been able to meet the urgent health needs of the global pandemic. Therefore, the United States must take steps to enable facilities in low- and middle-income countries to produce mRNA vaccines. The U.S. government must strongly encourage companies to securely share their intellectual property and provide detailed technology transfer to new global manufacturers, and must compensate the originator with a reasonable royalty and payment for sharing their intellectual property and expertise.
Moderna is in a unique position as their technology was developed by the National Institutes of Health and they accepted advanced development funding from Operation Warp Speed. As a smaller and newer company, Moderna may be more willing to explore new models of collaboration. If they and other manufacturers follow this approach, it will benefit the world and their reputation.
(If roots do not work, the US government has a stick for the Bayh-Dole Act. Under the law, the government has the right to issue additional licenses for technologies whose development is supported with taxpayers’ money. But it will slowly be cumbersome and politically charged process; a voluntary arrangement would be faster.)
A sensible approach would be to bring about a competitive process to select producers in four regions of the world to make mRNA vaccines. Websites that accept funding and expertise will do so in exchange for agreeing to produce reasonably priced products that meet strict quality standards and to ensure that these products are distributed in regions served below. This effort can focus on countries with pre-demonstrated ability to meet the needs for speed, strict quality control and regional impact. These include India, Brazil, Indonesia, Senegal and others that have produced pre-qualified WHO vaccines, or South Africa and Vietnam, which have shown leadership in health technology. Countries like South Korea can also play a big role.
Congress and the Biden administration need to draw up an initial budget of about $ 500 million, possibly through USAID, to upgrade at least four facilities in different regions of the world to manufacture Covid-19 vaccines. This seed investment will not only support the fight against Covid and encourage other countries and development banks to invest, but also better prepare for the next pandemic. Between pandemics, these facilities can maintain capacity and sustainability if they produce products from public goods, such as cheap routine vaccines, and potentially commercially competitive products for use in their regions.
Improving access to vaccines is just one of a series of measures that need to be taken to implement the lessons of the Covid pandemic. Stronger systems to find, stop and prevent health threats are needed. It will require continued funding and technical assistance, including strengthening systems that can detect a new threat – whether it is a variant of the virus that causes Covid-19 or a new pathogen – as well as treatment systems. and deliver vaccines.
The transfer of technological know-how and the establishment of production lines around the world is one of the most important steps the Biden administration can take to bring the Covid-19 pandemic under control. Such an investment would save lives, revive economies, protect Americans from the risk of variants and new threats, and restore the U.S. position as a trusted and reliable partner while promoting global health security and diplomacy.