COVID-19 is a novel virus that emerged from Wuhan City of China in December 2019 and subsequently devastated the global population by posing unprecedented challenges for primary care workers whose responses have been inspiring and varied but nevertheless concerning. Today the public at large has become aware of different health systems in other parts of the world, including those in low and middle income countries. Now they also recognise the strengths and weaknesses of their own systems and realise that decisions about public health are part of a political process, which they can influence through their vote. The role of different stakeholders, such as religious leaders, in health is also being recognised.
Moreover there is a renewed conversation about the importance of vaccines, which may help tackle the worrying trend in vaccine hesitancy and the need to earn the public's trust in the advice of healthcare workers. In January, WHO had identified this as one of the biggest challenges that we shall face in the next decade. Meanwhile the scientists have been breathlessly conducting research by sharing their knowledge to invent drugs and the 'veritable' covid vaccine. If their efforts succeed vaccines would be developed faster than ever instead of entailing many years.
The International Primary Care Respiratory Group (IPCRG), a clinically led charitable organisation, was born with the scope for research and education to improve prevention, diagnosis and care of respiratory diseases in the global community and primary care settings. Incidentally, ten COVID 19 vaccines could be available by the middle of next year if they win regulatory approval, but their inventors need patent protection, director general of International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), Thomas Cueni has stated.
Though there are approximately 48 vaccine candidates including the ones by Bharat Biotech, Zydus Cadila and Johnson & Johnson (all India based), there is a fear about hoarding of vaccines by rich nations as many rich countries have already reserved billions of doses that is equal to more than a year's supply of vaccines for their citizens, leaving little for the world's poor.
The US alone has bought nearly a sixth of the world's supply and Canada has secured enough doses to inoculate each citizen nine timesThe US alone has bought nearly a sixth of the world's supply and Canada has secured enough doses to inoculate each citizen nine times. With 1.6 billion doses, India is the number one advance buyer, but it averages out to just over 1 dose per person. The rush to hoard vaccines has left many low and middle-income countries unable to immunise their entire populations until 2024.
Countries are purchasing billions of doses of the vaccines undergoing advanced trials. Of the 9.6 billion doses that have been reserved, 6.4 billion are confirmed purchases and 3.2 billion are under negotiation or parts of an option to expand an existing deal. However with the limitations of manufacturing capacity, some countries mainly lower and middle income ones may not have enough doses to immunise their entire populations by 2024.
Some wealthy countries have advance purchased enough doses to immunise their citizens several times over, according to a Duke University database, while many countries will struggle to vaccinate anyone beyond frontline healthcare workers and some of their most vulnerable citizens for years.
Some middle income countries like India and Brazil are developing their own vaccines. To ensure availability of vaccines in low and middle-income countries immunise at least 20% of their population, a coalition of international agencies and nonprofits, called Covid-19 Vaccines Global Access Facility (COVAX), has been raising funds to secure 2 billion doses by the end of 2021.
Many governments will be entirely dependent on COVAX to immunise their people. More than 150 countries have agreed to contribute to it. However, Serum Institute of India, set up at Pune in 1966 as manufacturer of immunological drugs, including vaccines, is now the world's largest vaccine producer making around 1.5 billion doses each year. Once it succeeds, the global supply will get a boost and prices shall remain relatively low. This will also put a check on rich nations (in terms of their tendency to hoard vaccines). But as of now everything is uncertain, and who knows managing COVID 19 could be a challenge for much longer than expected.