Coronavirus vaccines: Will any countries get left out?

By Alice Cuddy
BBC News

Publishedduration38 minutes agoimage copyrightReuters

Health experts say the only solution to the coronavirus pandemic is a global one.

There have been more than 55 million cases of the virus confirmed around the world and more than 1.3 million deaths. Many hopes are pinned on a vaccine as a solution. But there are concerns that poorer nations could get left behind.

We have spoken to the experts about the main concerns that lie ahead and whether efforts to come up with a fair system will actually work.

The rush to buy in advance

Early results indicate that at least two vaccines are highly effective, several others have reached late-stage trials, and many more are at some stage of development.

None of these vaccines have been approved yet, but that hasn't stopped countries purchasing doses in advance.

A key research centre in the US – Duke University in North Carolina – is trying to keep tabs on all the deals being done. It estimates that 6.4 billion doses of potential vaccines have already been bought, and another 3.2 billion are either under negotiation or reserved as "optional expansions of existing deals".

The process of advance purchasing is well established in the pharmaceutical industry, as it can help to incentivise the development of products and fund trials, according to Clare Wenham, assistant professor of global health policy at the London School of Economics.

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But it also means that whoever can pay the most at the earliest stage of production gets to the front of the queue, she says. And Duke's research found that the "vast majority" of vaccine doses that have been bought so far are going to high-income countries.

Some middle-income countries with manufacturing capacity have also been able to negotiate large purchase agreements as part of manufacturing deals. While other countries with the infrastructure to host clinical trials – such as Brazil and Mexico – have been able to use that as leverage in procuring future vaccines.

India's Serum Institute, for example, has committed to keeping half of all doses it produces domestically for in-country distribution. Meanwhile, Indonesia is partnering with Chinese vaccine developers and Brazil is partnering with the trials run by the University of Oxford and pharmaceutical company AstraZeneca.