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The Implications of Pre-Ordering Vaccines

Image from Dogukan Keskinkilic/Anadolu Agency/Getty

The COVID-19 vaccine may almost be here, but the race is far from over. Countries have scrambled to secure doses for their populations, while often neglecting the needs of low- and middle-income countries (LMICs). As a result, LMICs have been placed last on the waiting list, with the Duke Global Health Innovation Center predicting they may have to wait until 2023 or 2024 for vaccination.

Nature reports that over 10 billion doses for the vaccine have been pre-ordered, which includes most of the 2021 manufacturing capacity for all three leading candidates (AstraZeneca, Pfizer, and Moderna).

Although they account for only around 13% of the world’s population, 27 member states of the EU along with five rich countries have pre-ordered about 1/2 of this global supply. Canada alone has pre-ordered almost 9 doses of the vaccine per person, followed by the United States, the United Kingdom, Australia, and the European Union in terms of the number of pre-ordered doses. Vaccine hoarding by rich countries leaves the world’s most vulnerable without access, raising questions on equitable vaccine allocation. Read more on Nature News here.

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The History of mRNA Vaccines

Image from STAT News

With progress on the vaccine front making the news over the past few weeks, we can look to the history of mRNA vaccines to highlight the importance of a free vaccine. While no public statements on ensuring global access to the COVID-19 vaccine have been made, Pfizer has made sure to note that their vaccine was developed with no public funding.

Nevertheless, the Pfizer vaccine is a joint effort with the German company BioNTech, who did accept public funding for the research and development of the vaccine candidate. In addition, the technology behind Pfizer/BioNTech’s vaccine was first developed by researchers at the University of Wisconsin, an institution that receives public funding, in 1990.

While the idea was dismissed upon its discovery, it has become the leading technology in the COVID-19 vaccine race, used as the backbone for both the Moderna and Pfizer vaccines. Read more from STAT News here.

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To Stockpile or To Share?

Washington Post reports that the new frontier of vaccine diplomacy can be characterized by two paths: stockpile or share. While entities like the United States and the European Union have been focusing on stockpiling vaccines for their respective populations, other countries, such as China and Russia, have been focusing on sharing their vaccine(s) with other entities around the world. The issue of vaccine distribution and allocation has quickly become a leverage point in diplomacy, which will have significant impacts on distribution equity.

“There are critical questions about safety and efficacy — or even how much each country can produce. But, for the moment, those questions are overshadowed in a seller’s market.”

Read more about the implications of vaccine diplomacy on global public health here.

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Register Now: Vaccine Allocation and Social Justice

On December 4th and 9th, 2020, several organizations are collaborating to host the event: Vaccine Allocation and Social Justice. Open to all, the purpose of the event is to share concrete steps on how to improve the chances of equitable vaccine allocation. The event will include multiple sessions which different focuses, including challenges in distribution, legal ways of allocating vaccines equitably, and implementing equity.

“A particular focus is on ensuring that the needs of vulnerable groups whose communities often experienced—and experience—structural racism and other forms of systemic injustice are central, rather than, as too often in the past, peripheral.”

The participating hosts include Ariadne Labs, Boston College, the Harvard T.H. Chan School of Public Health, the International Society for Priorities in Health, MIT Economics, the O’Neill Institute, and the University of Pennsylvania.

More information and registration for this virtual event can be found here.

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ANTICOV: A Continental Collaboration

Image from the Drugs for Neglected Diseases Initiative

Today, the Drugs for Neglected Diseases Initiative (DNDi) announced in a press release that thirteen countries in Africa, along with an international network of research institutions, are launching the largest clinical trial in Africa for mild-to-moderate patients. DNDi is a global non-profit drug research and development (R&D) group that has extensive partnerships in Africa.

“We welcome the ANTICOV trial led by African doctors because it will help answer one of our most pressing questions: With limited intensive care facilities in Africa, can we treat people for COVID-19 earlier and stop our hospitals from being overwhelmed?’ – Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention.

The purpose of the ANTICOV trial is to identify early treatments that can prevent the progression of COVID-19 to a severe form of the disease, potentially limiting its transmission. Read more about the trial and institutions participating in the novel effort here.

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Access Champions News

“Vilomah:” An Essay by Kisha Patterson

Kisha Patterson is a historic preservation architect, artist, and activist practicing in Pittsburgh, PA. She is grateful for the health and safety of her children and urges everyone to demand a People’s Vaccine and sign the Open Covid Pledge. She has been volunteering with Free the Vaccine for COVID-19 since March of 2020.

“Vilomah” is the only word I’ve ever found to mean a mother who has lost her child. On September 22, 2020, Jamain Stephens was buried under a tree on a high spot overlooking the rolling hills of Allegheny Cemetery in Pittsburgh, Pennsylvania. 220,000 deaths are so incomprehensible it is easy to become numb to its all, at the same time losing this one young life has been acutely painful to me. Jamain was nearly 21, a football player, healthy, and died from a blood clot he suffered as a complication of Covid-19 in the late summer of 2020. A New York Times article calls into question the safety of contact sports, and the college football team with which he had played and practiced. I don’t care for football, and this may be an argument against the institution entirely – but that isn’t what moved me. He grew up near where I grew up, and his mother is about my age. 

Since the spring lockdowns, I had started running and biking through this old cemetery nearly every day. The first lock-downs of the Covid-19 Pandemic brought a period of fear and isolation, I found solace among the graves.  Green leaves overtook bare trees like they do every spring. Manicured lawns lined with mausoleums and markers in stately rows seemed to imply a natural order to the world, even in death. I slowly realized that I have been crying over the death of this one stranger because I recognized the spot where he was buried.

On the occasions I strolled the winding paths with my children, we would read the headstones. We would say a special prayer for the interred mothers, especially the ones whose graves were dated after her children. It is an old cemetery, some remembered there passed away 175 years ago. I wondered if some of those mothers had any living descendants because they were buried next to two or more of their infant and toddler children. These were the graves of the wealthy, in the late 1800’s clean water and medicine were hardly commonplace, lots of children died quite young.

My 13-year-old son speculated about the headstones dated between 1918 and 1920, wondering how many were victims of the “Spanish Flu”. Like in 2020, an invisible contagion transformed life. I wonder if anyone gathered at homes or graves to try to console mothers having to bury their young adult children? In those times, some cities restricted funerals, and Pittsburgh was one of them. What was it like to grieve alone? In either case, no one could have sequenced the disease’s DNA or peered into the lungs of those infected. Science would not deliver any flu vaccine for another 20 years.

No one has set the grave maker for young Jamain yet, but it will say 2020. One hundred years from now, someone will see all the graves there, from 1840 and on. They will damn, as I do, the lack of sewers and science in the 19th and 20th centuries that resulted in so much suffering, death, and so many inconsolable mothers.

Jamain Stephens went to Central Catholic High School, not even half a mile from the University of Pittsburgh. In 1955, from this University’s Virus Research Laboratory,  Jonas Salk declared his vaccine for polio safe, and effective. More importantly, he wouldn’t patent this find.  He made this compassionate gift to be sure his vaccine would be widely available.

“Could You Patent the Sun?” -Jonas Salk

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News

The Future: An Uneven Burden of COVID-19

Image from Suzanne Kreiter via The Boston Globe

First, last week brought news that Pfizer and BioNTech’s vaccine had reported 90% efficacy. Then, we heard news from another top contender for the vaccine, Moderna, who reported 94.5% efficacy for their vaccine. Finally, Pfizer announced that their COVID-19 vaccine is 95% effective with no safety concerns. These headlines may suggest promising news for individuals in high-income countries like the United States, but what about the rest of the world?

Mike Ludwig from Truthout reports of a “global vaccine apartheid.” Rich countries can distribute the vaccine (after its approval) amongst their populations after engaging in billion-dollar manufacturing deals with pharmaceutical companies, leaving billions of people around the world unable to access the global vaccine supply. This can lead to “economic devastation for vulnerable communities.”

According to Peter Maybarduk, the director of the Access to Medicines program at Public Citizen, these funders have responsibility to the public. They are not responsible for a pharmaceutical company’s profit margins. This is a People’s Vaccine, and we must continue to fight for it.

Read the full article on Truthout here.

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Access Champions News

Aly Bancroft: Pharma’s Billions Sprang from the Taxpayer Dime

Image Credit: Dado Ruvic/Reuters/Washington Post

Megan McArdle was correct that the coronavirus pandemic has revealed the drug development system is working. What she didn’t mention is that the system is working as it was designed: to maximize monopoly profits for the pharmaceutical industry.”

Universities Allied for Essential Medicines (UAEM) board member and Free the Vaccine for COVID-19 participant Aly Bancroft submitted a Letter to the Editor that was featured in the Washington Post! Aly is also the campaign coordinator at Public Citizen’s Access to Medicines program. Read the full letter here.

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Access Champions News

Meet our Participant: Dannie Synder!

Recently, I was given the opportunity to be able to learn more about one of our participants: Dannie Synder. Dannie has been living all over the place since the start of the pandemic, from Austin to Washington D.C. to Mexico City, but has been a dedicated participant of the Free the Vaccine for COVID-19 campaign since Season 1. Read more about her work throughout and beyond the campaign below!

What does the Free the Vaccine for COVID-19 movement mean to you?

I am an artivist: an artistic activist. I consider myself an activist, and I started out in mostly prison abolition. I began as a teacher in juvenile detention centers and through that became interested in the prison abolition movement, particularly because it touches so many different elements from homelessness to mental health to the Black Lives Matter movement — and I’m learning more how it touches access to medicine. This is an area that I have never had much experience and I’m still learning a lot. I’m still gaining confidence in speaking about this movement, and everyday it is shocking to me that access to medicines is an issue. That was one of the reasons I wanted to join this campaign — this is an area that I have been really hesitant to get into as it seems very technical and embedded in the legal system. This campaign is allowing me the opportunity to continue developing my abilities as an artistic activist. 

Given that you mentioned your experience working in prison abolition, have you made any connections with the access to medicines movement?

Well, I’m learning more about mental health issues and with the BLM movement and with everything else that is going on right now, we have to ask these questions like “who do we call when there’s an emergency?” We cannot call the police because it leads to violence, so who can we call and what kind of organizations are available in different cities?

This is really addressing the issues of communities with lack of access to not just physical medicine, but also mental health resources. I’m someone who doesn’t have health insurance, and I’m learning how difficult it is  to get health insurance in America. I did not realize until during this campaign that one in five people can’t afford their medicine and can’t get access to medicine — I am curious to learn more about prisoners in particular those with mental health issues how many of them actually had access to the essential services that they need.

What are you most looking forward to for this season? 

Right now in Season 2, one one of the leaders of our team of our lab is helping come up with really great tactics. One of the things I continue to learn about everyday is we can come up with all these really creative tactics, but what’s actually going to be effective? I really like working with the artistic activism side of this campaign, because we are really good at pushing each other and pushing everyone. I think working also with people from an access to medicines background helps us decide how we are going to get results, since they have experience dealing with the more legal aspects of medicine. 

One thing in particular: I have been super excited about the Jolene vaccine challenge. We made the video the trailer to our music video trailer season 1 and probably by the end of November early December we’re going to make the full-length music video. This is all super exciting for me; I felt very important and I felt very happy that we made something which got so much traction on social media. It was a really nice moment we felt like even though we didn’t get Vanderbilt University on the phone yet (who is our target) you know we still can get a response from them from the video. We felt like we did accomplish something by all the people who were exposed to our video, and learned something important and new about the access to medicines movement. 

What do you think would be a good outcome for this campaign? 

It would be great if we could garner an impressive number of universities to sign onto the Open COVID Pledge. If we could get an institution like [Major State University] to sign the Open COVID Pledge, we know that people like politicians for example are going to pay attention to that. We need to always push universities to do better, and if we can do that, then we have done our part as a campaign!

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News

COVID-19, Generics, and the Medicines Patent Pool

On November 12th, 18 producers of generic medicines joined an effort by the Medicines Patent Pool (MPP) in order to expedite access to COVID-19 intellectual property. The MPP is a UN-backed public health organization that accelerates access to essential medicines in low- and middle-income countries (LMICs). In addition, a generic drug is a drug that works the same way and provides the same clinical benefits as a brand-name drug, but for a lower cost.

In this rare move, a group of pharmaceutical manufacturing companies recently signed onto the MPP’s COVID-19 Open Pledge, promising to “work together via the Medicines Patent Pool (MPP) to accelerate access to hundreds of millions of doses of new interventions for low- and middle-income countries (LMICs).” Under this pledge, the manufacturing companies are offering their production capacities to helping create billions of doses of COVID-19 vaccines or therapies for LMICs, given that the producers of the therapies allow them to be licensed to these generic manufacturers.

Read more on STAT News here.