Vaccines

On 24 February 2021, Ghana became the first recipient of a shipment of 600 000 COVID-19 vaccines under the COVAX initiative, a global effort to provide access to vaccination and curtail transmission of the virus in developing countries.

Joshua Appiah, who is living with HIV, was apprehensive about getting the Covid vaccine because he had been influenced by misinformation: “Some of what was circulating on social media frightened me. I was scared the jab would compromise my immune system and kill me!”. 

After coming to learn that it is a lack of vaccination which poses a threat to health, particularly for people living with HIV, Joshua is angry at those who have promoted “misleading stories about the vaccine, its effects, the motivations behind its creation”. That is why Joshua decided to play his part. In June this year, he became one of 40 Vaccine Champions to undergo COVID-19 vaccination advocacy training, aimed at reinforcing their capacity to spread positive messaging and debunk “fake news”, myths and lies in their discussions with local community members. In turn, the programme hopes to increase vaccine uptake in local communities and among people living with HIV at ART sites, as Ghana continues to battle vaccine hesitancy.

The two-day training for Vaccine Champions was organised by Hope for Future Generations (HFFG), in partnership with the National Association of Persons Living with HIV (NAP+) Ghana, Young Health Advocates Ghana (YHAG), and the Ghana Red Cross Society (GRCS), with technical support from the Ghana Health Service. This activity falls under the Partnership for Accelerated COVID-19 Testing (PACT) 2.0 project, supported by UNAIDS and funded by the Government of Germany.

For Joshua, the topics covered, such as public sensitization on COVID-19, debunking myths and misconceptions, developing effective communication strategies, investigating the role of Vaccine Champions and working with data collection tools, have been enlightening and have empowered him to spread the word on vaccine uptake. “I took particular interest in the sessions on COVID-19 vaccine myths and misconceptions. I am now convinced that vaccines do not contain microchips, nor render people infertile, and I also feel comfortable spreading scientifically sound facts among the communities I am in contact with.” 

In her opening remarks for the training in Accra, Executive Director of HFFG, Cecilia Senoo, described the current state of vaccine hesitancy as worrying, reinforcing the urgency of the project. She commended the Vaccine Champions for embarking on a “worthy cause” and encouraged the Vaccine Champions to remain devoted to their mandate. UNAIDS Ghana Youth Programs Officer, Eric Sinayobye, stated that, “vaccine hesitancy is a stumbling block to achieving mass immunity in Ghana, hence the need for Vaccine Champions to help educating members of the community”.

After the training, the 40 Vaccine Champions were deployed at ART sites and inside communities to provide education on the importance of getting vaccinated, as well as to help debunk myths surrounding the vaccines in the next three months. With funding from the Government of Germany, UNAIDS continues to work with the Africa Centers for Disease Control (Africa CDC) to strengthen community-led response against COVID-19 and HIV in Africa.

GENEVA, 28 October 2021—UNAIDS welcomes the agreement between the Medicines Patent Pool (MPP) and the pharmaceutical company Merck Sharp & Dohme through which the intellectual property rights over an antiviral medicine to treat mild to moderate forms of COVID-19 in adult patients are shared with interested sub-licensees on a non-exclusive and transparent basis. The new medicine, molnupiravir, is still pending regulatory approval but has obtained optimal results in clinical trials.

“This agreement is a good first step, where public health has been prioritized over profits,” said the Executive Director of UNAIDS, Winnie Byanyima. “This new treatment promises to be a valuable addition in the response to COVID-19 and access to it will be considerably widened by allowing companies from around the world to produce more affordable versions of the medicine.”

This is the first licensing agreement on a COVID-19 tool to be established within a public health perspective. It is a significant development considering the lack of medicines to treat COVID-19. The initiative will allow the entry into market of more affordable generic versions of this medicine as soon as it is granted authorization from national and/or regional health regulatory bodies or included in the World Health Organization (WHO) list for emergency use.

According to the agreement, pharmaceutical companies based anywhere in the world that are interested and qualified to manufacture generic versions of the product will be allowed to commercialize the medicine in the 105 countries included in the geographic scope of the licensing agreement. Nevertheless, recognizing that COVID-19 knows no geographic boundaries, UNAIDS expects that all countries suffering the disease burden will have access to the generic market for this product. All health technologies should be considered global public goods.

This agreement includes all sub-Saharan countries, all low-income countries, the majority of lower-middle-income countries and 20 upper-middle-income countries.

Originally established to negotiate public health-oriented licensing agreements for HIV, tuberculosis and malaria products, the MPP has been an important player in the HIV response by promoting competition within the pharmaceutical market and helping to push down the prices of essential medicines. UNAIDS and MPP are both members of the steering committee of the WHO COVID-19 Technology Access Pool (C-TAP), an initiative that calls for the voluntary sharing of technologies, knowledge, data and intellectual property rights of health products to prevent, diagnose and treat COVID-19.

“It is high time that similar arrangements are also made for making COVID-19 vaccines. What works for medicines should also work for vaccines and diagnostics and other life-saving technologies,” said Ms Byanyima. “I call on the Group of Twenty and other governments to ensure that patent holders are obliged to share life-saving tools and technologies equitably.”

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Developing countries have been hit with an endless tide of inadequate gestures and broken promises from rich countries and pharmaceutical companies, who are failing to deliver billions of doses they promised while blocking the real solutions to vaccine inequality, according to a new report published today by the People’s Vaccine Alliance.

The report, “A Dose of Reality,” found that of the 1.8 billion COVID vaccine donations promised by rich nations only 261 million doses – 14 per cent – have been delivered to date, while western pharmaceutical companies have delivered only 12 per cent of the doses they allocated to COVAX, the initiative designed to help low- and middle-income countries get fair access to COVID vaccines.

At the same time, the EU and other rich nations have refused to support the proposal of over 100 nations to waive patents on vaccines and COVID related technologies while leading pharmaceutical companies have failed to openly share their technology with the World Health Organisation to enable developing countries to make their own vaccines and save lives.

Winnie Byanyima, Executive Director of UNAIDS, said: “Rich nations and corporations are shamefully failing to deliver on their promises whilst blocking the actual solution; ensuring developing nations have the ability to make their own vaccines.

“It is painfully clear that the developing world cannot rely on the largesse and charity of rich nations and pharmaceutical companies, and hundreds of thousands of people are dying from COVID-19 as a result. This is beyond appalling.”

The UK Government, which has been actively blocking calls from countries like South Africa and India to be allowed to make their own vaccines, has only delivered 9.6 million – less than 10 per cent - of the 100 million doses it promised to poorer nations. Meanwhile it has itself taken half a million doses from COVAX, despite extreme vaccine shortages in developing countries and having already secured more than enough doses for British people from direct deals with the pharmaceutical companies. Canada has taken over 970,000 doses from COVAX, while delivering only 3.2 million – or 8 per cent – of the 40 million doses it promised. Germany, another country blocking the waiver, has delivered 12 per cent of the 100 million doses it promised and France has delivered just 9 per cent of the 120 million it promised. The US has delivered the most doses - nearly 177 million doses – however this is just 16 per cent of the 1.1 billion promised.

The Alliance said that while COVAX failed to acknowledge that relying on pharmaceutical companies may not deliver doses, the companies have undermined the initiative, first by not allocating it enough doses and second by delivering far less than they agreed. Of the 994 million doses allocated to COVAX by Johnson & Johnson, Moderna, Oxford/AstraZeneca, and Pfizer/BioNTech, only 120 million -12 per cent- have actually been delivered, which is fifteen times less than the 1.8 billion doses delivered to rich countries from these companies. Both Johnson & Johnson and Moderna are yet to deliver a single dose they promised to the initiative.

Oxfam’s Robbie Silverman said: “The failure of rich country donations and the failure of COVAX have the same root cause – we have given over control of vaccine supply to a small number of pharmaceutical companies, who are prioritising their own profits.

“These companies can’t produce enough to vaccinate the world, they are artificially constraining the supply, and they will always put their rich customers at the front of the line.

“The only way to end the pandemic is to share the technology, and know-how with other qualified manufacturers so that everyone, everywhere can have access to these lifesaving vaccines.”

During the UN General Assembly in September, President Biden rallied support for the goal to vaccinate 70 per cent of people in every country by September of 2022. While this target is rightly ambitious, the People’s Vaccine Alliance says it should be achieved much more quickly, and there is still no plan to achieve it.

The WHO stated that it must be a global priority to get doses to developing countries by the end of this year, but the Alliance says rich countries are not listening and working to a timetable of delivering an inadequate supply of doses by some time in 2022, which is likely to lead to countless unnecessary deaths.

Maaza Seyoum, of the African Alliance and People’s Vaccine Alliance Africa, said: “Across the world health workers are dying and children are losing parents and grandparents. With ninety-nine per cent of people in low-income countries still not vaccinated, we have had enough of these too little too late gestures.

“Governments must stop allowing pharmaceutical companies to play god while raking in astronomical profits and start delivering actual action that will save lives.”

To deflect growing pressure to share their vaccine technology free of intellectual property restrictions leading western pharmaceutical corporations have consistently over-exaggerated their projected production volumes, claiming there will soon be enough for everyone while delivering the overwhelming majority of their stock to rich nations. Collectively, the four companies claimed they would manufacture an estimated 7.5 billion vaccines in 2021, yet with less than three months until the end of the year, they have only delivered half of these. Forecasts suggest the companies will produce 6.2 billion vaccines by the end of the year, a shortfall on their projections of more than 1.3 billion doses.

With a week to go before leaders meet for the G20 summit in Rome, The People’s Vaccine Alliance - which has 77 members including ActionAid, the African Alliance, Global Justice Now, Oxfam and UNAIDS – is calling on them to stop breaking their promises to vaccinate the world and to:

• Suspend intellectual property rights for COVID vaccines, tests, treatments, and other medical tools by agreeing to the proposed waiver of the TRIPS Agreement at the World Trade Organisation.
• Demand, and use all their legal and policy tools to require pharmaceutical companies to share COVID-19 data, know-how, and technology with the WHO’s COVID-19 Technology Access Pool and South Africa mRNA Technology Transfer Hub.
• Invest in decentralised manufacturing hubs in developing countries to move from a world of vaccine monopolies and scarcity to one of vaccine sufficiency and fairness in which developing countries have direct control over production capacity to meet their needs.
• Immediately redistribute existing vaccines equitably across all nations to achieve the WHO target of vaccinating 40 per cent of people in all countries by the end of 2021 and 70 per cent of people in all countries by mid-2022.

More than 140 former heads of state and government and Nobel laureates today called on the candidates to be the next German chancellor Annalena Baerbock, Olaf Scholz, and Armin Laschet to declare themselves in favour of waiving intellectual property rules for COVID 19 vaccines and transferring vaccine technologies, and “to make these the policies of any future coalition government”.

The signatories underlined that ending German opposition to waiving patents is vital to overcoming vaccine monopolies, transferring vaccine technology and scaling up vaccine manufacturing around the world to prevent millions more deaths from Covid-19.

Former world leaders including former President of France François Hollande, former Prime Minister of the United Kingdom Gordon Brown, former President of Colombia Juan Manuel Santos, former President of Malawi Joyce Banda and Nobel prize winners including Professor Joseph Stiglitz, Professor Francoise Barre-Sinoussi and Elfriede Jelinek express that they are “deeply concerned with Germany’s continued opposition to a temporary waiver of the World Trade Organization’s (WTO) intellectual property rules”, at a time in which “the artificial restriction on manufacturing and supply is leading to thousands of unnecessary deaths from COVID-19 each day”. Less than two per cent of adults are fully vaccinated in low-income countries compared to almost 50 per cent in high income countries.

Signatories urge the three candidates to support a wide and comprehensive waiver of the TRIPS intellectual property agreement on all COVID-19-related technologies at the WTO, and join over 100 countries including the United States and France in doing so. Despite that, Germany continues to oppose a waiver of the trade-related aspects of intellectual property (TRIPS) agreement for Covid-19 vaccines and treatments at the WTO. First proposed by India and South Africa in October 2020, a waiver is now supported by more than 100 nations, with France and the United States announcing their support earlier this year. 

The letter emphasizes that “Having helped create the most successful vaccine technology against COVID-19, by overcoming pharmaceutical monopolies and insisting that the technology be shared, Germany has the ability to help end this pandemic”. In addition to supporting the waiver they call on the next Chancellor to ensure that German pharmaceutical companies openly and rapidly share life-saving mRNA vaccine technology with qualified producers around the world.

Helen Clark, former Prime Minister of New Zealand, said: “Germany’s support for a TRIPS waiver in the exceptional circumstances presented by COVID-19 would send a clear signal that all peoples should be able to benefit speedily from available vaccines and therapeutics. Widespread vaccination now and further scaling up of vaccine production will play a significant role in curbing the pandemic.” 

Joseph Stiglitz, Nobel Economics Prize Laureate, said: “The new Chancellor of Germany will hold extraordinary power to turn the tide on this horrific pandemic and can be the world leader remembered for helping save millions of lives. Intellectual property rules are today locking out people across the world from the benefits of life-saving science - it is time for Germany to ensure the transfer of vaccine technologies and join the rest of the world in backing a temporary waiver at the World Trade Organization”.

As the Heads of State and Government and Nobel Laureates write to the candidates for Chancellors, activists around the world have organized protests to demand the German government to stop blocking efforts to vaccinate the world. Protests will take place from the city of Nairobi to the Sydney Opera House in Australia, from the Union Buildings in Pretoria to Brazil's famous Cristo Rei and the famous Golden Gate Bridge in San Francisco. 

The letter, which was coordinated by the People’s Vaccine Alliance, a coalition of more than 70 organizations including Club de Madrid, Oxfam and UNAIDS, warned that extreme vaccine inequity is bound to last as long as there will be no remarkable increase in vaccine production. While high-income countries are now starting to offer their citizens booster shots, the global supply falls far short of the levels needed to provide global vaccination coverage. 

Notes to editors

Read the full letter and list of signers.

The letter was coordinated by the People’s Vaccine Alliance, a coalition of more than 70 organizations including Club de Madrid, Physicians for Human Rights, Oxfam, UNAIDS, the Nizami Ganjavi International Center, Global Justice Now, the Yunus Centre and Avaaz, as well as Progressive International.

The participants of the International AIDS Society (IAS) Conference on HIV Science session on an HIV vaccine were welcomed by Lucy Stackpool-Moore, Director, HIV Programmes and Advocacy at the International AIDS Society, after which Susan Buchbinder, from the University of California, San Francisco, and the San Francisco Department of Public Health, made introductory remarks. Two recorded presentations were then shown, by Kevin De Cock and Gabriela Gomez, speaking, respectively, on the need for and role of an HIV vaccine and on modelling science around the requirements and impact of a putative vaccine.

UNAIDS’ Science Adviser, Peter Godfrey-Faussett, then moderated a lively panel discussion that included Yazdan Yazdanpanah, Kundai Chinyenze, Rachel Baggaley, Daisy Ouya, Jerome Singh and Paul Stoffels.

The first question was on whether a vaccine for HIV, if it arrived, would be too late in view of the other HIV prevention modalities available. The consensus was that a vaccine is still needed, especially in low- and middle-income countries and for key populations. The participants then discussed how good a vaccine would need to be. Relevant issues include efficacy and durability, but a priority is proof of concept of activity. The participants acknowledged that initial inconvenient dosing schedules are justified if it can be shown that a product is protective. Minimum efficacy probably needs to be in the region of 50–60% for products to be taken forward. 

The discussion also covered engagement by big pharma—Johnson & Johnson is currently the major company pursuing HIV vaccine research, in conjunction with diverse governmental, nongovernmental and clinical partners. It was emphasized that people and individual motivations drive the science, both for HIV prevention and treatment. 

Inevitably, the comparison of vaccine development for COVID-19 and HIV came up. The panellists emphasized, however, that the reasons for a lack of success so far in HIV was largely related to the complex nature of HIV itself.

The discussion ended on a note of realistic optimism, with acknowledgment of the benefits of scientific investment in HIV vaccine research to date, including for COVID-19, but with recognition that long-term commitment is still required. The results of the two ongoing phase three trials (Imbokodo and Mosaico) are eagerly awaited.

More than 170 former heads of state and government and Nobel laureates, including former Prime Minister of the United Kingdom Gordon Brown, former President of Colombia Juan Manuel Santos, former President of Liberia Ellen Johnson Sirleaf, former President of France François Hollande and Nobel Laureates Professor Joseph Stiglitz and Professor Francoise Barre-Sinoussi, today called on President Biden to support a waiver of intellectual property rules for COVID-19 vaccines and pursue a people’s vaccine to end the pandemic in an open letter today.

The letter was sent to the White House as U.S. health authorities advised a pause in the use of the Johnson & Johnson Covid-19 vaccine. A waiver of intellectual property rules would allow for a scale up in manufacturing in the U.S. and around the world, overcoming artificial supply constraints.

The former world leaders and Nobel Laureates encourage President Biden to take the urgent action only he can and “let this moment be remembered in history as the time we chose to put the collective right to safety for all ahead of the commercial monopolies of the few.”

The letter specifically asks President Biden to support a proposal from the South African and Indian governments at the World Trade Organization (WTO) to temporarily waive intellectual property rules related to COVID-19 vaccines and treatments. At the current pace of vaccine production, most poor nations will be left waiting until at least 2024 to achieve mass COVID-19 immunization.

Gordon Brown, former Prime Minister of the United Kingdom said:

"President Biden has said that no one is safe until everyone is safe, and now with the G7 ahead there is an unparalleled opportunity to provide the leadership that only the U.S. can provide and that hastens an end to the pandemic for the world.”

“An urgent temporary waiver of intellectual property rules at the World Trade Organization would help us ramp up global supply of vaccines together with a global multi-year burden sharing plan to finance vaccines for the poorest countries”.

“This would be in the strategic interests of the U.S., and of every country on the planet".

Joseph Stiglitz, Nobel Economics Prize Laureate, said:

“While the U.S. has made enormous progress in vaccinating its own population, thanks to the efforts of the Biden administration, that alone is unfortunately not enough”.

“New mutations of the virus will continue to cost lives and upend our interconnected global economy until everyone, everywhere has access to a safe and effective vaccine. Intellectual property is the utmost artificial barrier to global vaccine supply. We as a nation must lead with our allies to back the South Africa and India waiver at the WTO, insist on technology transfer, and strategically invest in production”.

François Hollande, former President of France, said:

“The extreme inequality in access to vaccines around the world creates an unbearable political and moral situation. It is above all sanitary and economic nonsense as we are all concerned. That the Biden administration is considering waiving barriers related to intellectual property rules offers hope for the international community. If the United States supports the lifting of patents, Europe will have to take its responsibilities. In the face of this devastating pandemic, world leaders must prioritize the public interest and international solidarity”.

Other signatories include Mary Robinson, the former President of Ireland, Fernando Henrique Cardoso, the former President of Brazil, and Helen Clark, the former Prime Minister of New Zealand, together with over 60 other former heads of state and heads of government that span every continent.

The leaders also called for the intellectual property waiver to be accompanied by the open sharing of vaccine know-how and technology, and by coordinated and strategic global investment in research, development, and manufacturing capacity, especially in developing countries, underscoring that threats to public health are global and require global solidarity-based solutions.            
 

These actions would expand global manufacturing capacity, unhindered by industry monopolies that are driving the dire supply shortages blocking vaccine access. The resulting vaccine inequality, the leaders warned, means that the U.S. economy already risks losing $1.3 trillion in GDP this year, and if the virus is left to roam the world, the increased risk of new viral variants means even vaccinated people in the U.S. could be unprotected once more.

The letter, which was coordinated by the People’s Vaccine Alliance, a coalition of more than 50 organizations including Club de Madrid, Health GAP and UNAIDS, warned that at the current global immunization rate, it was likely that only 10 percent of people in the majority of poor countries will be vaccinated in the next year.

Françoise Barré-Sinoussi, Nobel Prize in Physiology or Medicine Laureate said:

“We will not end today’s global pandemic until rich countries – most especially the United States – stop blocking the ability of countries around the world to mass produce safe and effective vaccines”.

“Global health is on the line. History is watching. I, with my fellow laureates and scientists across the globe, urge President Biden to do the right thing and to support the TRIPS waiver, insist on pharmaceutical corporations to share vaccine technologies with the world, and strategically invest in distributed production”.

Muhammad Yunus, Nobel Peace Prize Laureate said:

“Big pharmaceutical companies are setting the terms of the end of today's pandemic – and the cost of allowing senseless monopolies is only more death and more people being pushed into poverty”.

“We need strong government action to lead - not only philanthropy and the private sector – to solve today’s unprecedented crisis. We together urge President Biden to stand on the right side of history – and ensure a vaccine is a global common good, free of intellectual property protections".

--

Notes to editors:

The full letter and list of signatories can be found at here

The letter was coordinated by the People’s Vaccine Alliance, a coalition of more than 50 organizations including Club de Madrid, the Yunus Centre, Oxfam, Health GAP, UNAIDS, Physicians for Human Rights, the Nizami Ganjavi International Center, Global Justice Now and Avaaz.

US, UK and EU blocking proposals at WTO to help poorer countries get vaccines more quickly

One year on from the declaration of the COVID-19 pandemic, the People’s Vaccine Alliance is warning that developing countries are facing critical shortages of oxygen and medical supplies to cope with COVID-19 cases yet the majority have been unable to administer a single dose of a COVID-19 vaccine. In contrast rich nations have vaccinated their citizens at a rate of one person per second over the last month.

Many of these rich nations, including the US, UK and EU, are blocking a proposal by over 100 developing countries to be discussed at the World Trade Organisation (WTO) today, which would override the monopolies held by pharmaceutical companies and allow an urgently needed scale up in the production of safe and effective COVID-19 vaccines to ensure poorer countries get access to the doses they desperately need.

While more poor countries will see the arrival of doses in the coming days from the World Health Organisation’s COVAX facility, the amounts available mean only three per cent of people in those countries can hope to be vaccinated by mid-year, and only one fifth at best by the end of 2021.

Almost one million people worldwide have signed a call by the People’s Vaccine Alliance – a group of campaigning organisations including Oxfam, Frontline AIDS, UNAIDS, Global Justice Now and the Yunus Centre – for rich nations to stop protecting big pharma monopolies and profits over people’s lives. On 11 March protests will take place outside pharmaceutical headquarters as part of a global day of action by activists across the world.

Recent public opinion polls carried out by YouGov for the Alliance in the US, France, Germany and the UK found that on average, across these countries, more than two-thirds (69 per cent) of people thought that governments should ensure vaccine science and know-how is shared with qualified manufacturers around the world rather than remaining the exclusive property of a handful of pharmaceutical giants and that vaccine developers should be adequately compensated for this.

Oxfam International’s Executive Director, Gabriela Bucher, said: “Around the world, two and a half million lives have already been lost due to this brutal disease and many countries are battling without adequate medical care and no vaccines. By allowing a small group of pharmaceutical companies to decide who lives and who dies, rich nations are prolonging this unprecedented global health emergency and putting countless more lives on the line. At this crucial time, developing countries need support – not opposition.”

The Alliance warned that in South Africa, Malawi and other African nations history is in danger of repeating itself. Millions of people died in the early 2000’s because pharmaceutical monopolies had priced successful treatments for HIV/AIDS out of reach at up to $10,000 a year.   

Lois Chingandu, activist and Director of Evidence and Influence at Frontline AIDS, said: “Here in Zimbabwe, I have lost many dear friends, struggling to breathe in their last moments. It is a cruel irony that activists who fought tirelessly for free medicines for HIV/AIDS are now being killed by COVID-19 because, yet again, pharma profits are being put ahead of people’s lives.”

Pharma monopolies were eventually overruled allowing the mass production of cheap effective treatment for those living with HIV/AIDS, meaning millions of people are alive today who would otherwise have perished.

On 10-11 March, more than 100 developing countries, led by South Africa and India will again make the case at the WTO for a waiver of Trade-Related Aspects of Intellectual Property (TRIPS), which would remove legal barriers for more countries and manufacturers to produce the vaccines, protect their people and join the economic recovery ahead.

Nobel Laureate Professor Muhammad Yunus, one of the leaders of the People’s Vaccine Alliance said: “For the rich world, this proposed act of human solidarity to ensure that medicines and vaccines get to the whole human family simultaneously is in their own self-interest, not just an act of charity.

“We should act now. There is no going back. It is totally unfair that rich countries, who have enough vaccines to protect their citizens, are blocking the TRIPS waiver, which could help poorer countries get the vaccines they need.”

All the leading vaccine developers have benefited from billions of dollars in public subsidies, yet pharmaceutical corporations have been handed the monopoly rights to produce and profit from them.

At the same time qualified vaccine producers all over the world stand ready to produce more vaccines if they were allowed access to the technology and know-how now being held under lock and key by these companies. New capacity could be brought on stream within months. Suhaib Siddiqi, former director of chemistry at Moderna, producer of one of the first approved vaccines, said that with the blueprint and technical advice, a modern factory should be able to produce vaccines in at most three to four months.

France has called for the expansion of production in developing countries, and the US has moved to achieve the same domestically. But so far both countries continue to defend the monopolies of pharma corporations. 

To control the virus, enough doses of vaccines need to be produced in different geographies, priced affordably, allocated globally and widely deployed for free in local communities. Thus far, the world is failing on all four fronts.

Winnie Byanyima, Executive Director UNAIDS, said: “Amid so much personal selflessness, sacrifice and heroism, the People’s Vaccine Alliance denounces the hypocrisy, emptiness of human solidarity and myopic self-interest that defeats efforts to control the virus in countries. Only a truly global mobilization of vaccine production to rapidly scale-up the total number of low-cost doses available will get the job done.”

Nick Dearden, Director of Global Justice Now, said: “One year into the global pandemic, it’s an outrage that vaccine factories are lying idle, unable to produce COVID-19 vaccines because rich countries are prioritising the patents of pharmaceutical companies ahead of the lives of people across the world. A global suspension of patents is needed to speed up the production of these vaccines everywhere.”

Notes to editors:

• Drawing on data from OurWorldInData, Bloomberg, John Hopkins University and additional searches, of the 79 low and lower-middle income countries, as classified by the World Bank, the majority (at least 47 countries) are yet to vaccinate anyone. This figure is accurate as of 4 March and factors in reported planned deliveries of COVAX vaccines in the coming days even if vaccines are yet to be administered. We recognise that more unreported COVAX shipments may arrive in the interim.
• Since the start of 2021 high income countries have on average vaccinated citizens at a rate of one dose per second. This is based on the average daily COVID-19 vaccination doses administered between 1 January and 2 March 2021 and was drawn from OurWorldInData for countries classified as ‘High Income’ by the World Bank. An hourly rate was calculated by assuming countries are vaccinating 8 hours per day which was then divided into minutes and seconds. The average of these per second rates for these 68 high income countries was then calculated at 1.1 doses per second or 66 per minute. The average figure includes six High Income countries that have not yet begun vaccinating citizens.
• The YouGov poll results for the individual countries were: US – 69 per cent, France - 63 per cent, Germany 70 per cent and the UK 74 per cent, which gives a combined average across the countries of 69 per cent. All figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 1,351 adults in the US, 1788 adults in the UK, 1010 adults in France and 2039 adults in Germany. Fieldwork was undertaken between 23 – 26 February 2021.  The survey was carried out online. The figures have been weighted and are representative of all adults (aged 18+) in each individual country of the US, UK, France and Germany.
• Last week, The Associated Press found factories on three continents whose owners said they could begin producing hundreds of millions of doses of COVID-19 vaccines on short notice, if only they had the blueprints and technical know how to do so.
• Countries like South Sudan, Yemen and Malawi have seen dramatic surges in cases in recent months. Malawi saw a 9500 per cent increase in cases as the South African mutation spread through the country and two of their cabinet ministers died in one day.

As COVID-19 vaccination begins around the world, UNAIDS spoke to Peter Godfrey-Faussett, UNAIDS Senior Science Adviser and Professor of International Health and Infectious Diseases at the London School of Hygiene and Tropical Medicine, about what is holding up an HIV vaccine.

Many people are asking, “How was a COVID-19 vaccine found so quickly?”

The SARS-CoV-2 virus, which is the virus that causes COVID-19, jumped from animals into humans in 2019. Whereas for HIV, that jump occurred 100 years ago in around the 1920s, and it became a problem in the 1980s when it started spreading among humans to a much greater extent.

The reason we’ve seen such a push on the COVID-19 vaccine is because of the urgency. In 2020, COVID-19 has infected almost 100 million people on the planet. COVID-19 has already killed 2 million people in 2020.

So, this urgency comes about, despite the fact that we’ve seen dramatic changes in everybody’s life, with changes to travel and social distancing and masks and hand washing and sanitizer, and yet we've still seen a rapid rise in infections. This produces a huge urgency to make a vaccine. And, of course, it has a massive economic impact.

HIV and SARS-CoV-2 are quite different, right?

There are fundamental differences between SARS-CoV-2 and HIV. Although they are both viruses, SARS-CoV-2 is a very simple infection. The disease can be complicated, and sometimes mysterious, but almost everyone infected with SARS-CoV-2 develops antibodies to the spike protein and this neutralizes the virus and leads to recovery with a clearance of the virus.

In contrast, almost everybody infected by HIV develops antibodies and we use those antibodies in regular HIV tests. But, unfortunately, very few clear the infection and those antibodies are not sufficient to neutralize the HIV. The HIV envelope, which is more or less like a spike, is a complex structure on the surface of the virus. It’s coated with sugars and the active site is deep inside, so it’s hard to engage with it.

Over time, as people are infected with HIV some people do develop antibodies able to neutralize HIV, but that can take many years, and furthermore HIV is a retrovirus—that’s why we talk about antiretrovirals. A retrovirus is a virus that copies its genetic code and integrates it into the human genetic code. And as it copies, it copies its genetic code, but it doesn’t do it accurately, it makes many mistakes. What that means is that the envelope protein and the HIV itself is constantly changing, shifting its shape, making it difficult for antibodies to protect against it, so even the neutralizing antibodies from one individual often fail to neutralize the virus from a different individual.

We have now found some so-called broadly neutralizing antibodies, as in antibodies that neutralize many different strains of HIV. And those are the antibodies that people are studying at the moment and trying to see whether or not they protect people from catching different strains of HIV. They could be an important part of the process for developing a vaccine against HIV if we could get broader neutralizing antibodies to be generated before the HIV infection occurred.

Finally, we have to remember that, unlike COVID-19, or maybe partly unlike COVID-19, HIV depends a lot on T-cells—the other half of the human defence system. The human immune system has antibodies, but it also has so-called cellular immunity, which is led by T-cells, and that’s much harder to study and much more varied and it also makes HIV difficult and different from COVID-19 when it comes to developing a vaccine.

How much money is being invested in HIV vaccines?

Each year for the past decade we’ve invested around US$ 1 billion in research and development to try to produce an HIV vaccine. Is that a lot or is it not enough? It’s about 5% of the global HIV response budget. There has been some limited success.  Back in 2009 there was great excitement when a vaccine candidate in Thailand did produce some protection against HIV infection, but not enough for it to be taken into widescale production.

And then over the next decade, subsequent trials have taught us a lot about the immunology, about the way human bodies and immune systems interact with HIV, but they haven’t led to a reduction in new HIV infections. Hope is currently resting on two large studies that are in the field at the moment, and there are many other candidates in the pipeline. So, I think there is hope, but we clearly won’t have a vaccine in the short term in the way that we have with COVID-19.

COVID-19 has taken the headlines—what about other infectious diseases?

In Africa, tuberculosis, malaria and HIV each kill more than five times as many people per year as COVID-19 has killed in Africa this year. These are huge problems and they've been going on for a long time. We have a vaccine against tuberculosis, the BCG vaccine, first used 100 years ago, starting in 1920, but unfortunately it doesn't really protect against the common adult forms of tuberculosis. Just recently, new vaccines have been discovered against both tuberculosis and malaria, but they don’t work particularly well. There are discussions about whether to scale them up because they only have a protective efficacy of 30% or less.

The good news is that a new malaria vaccine has just gone into big phase three trials in Africa, and in fact it’s produced by the same setup that has produced the AstraZeneca Oxford COVID-19 vaccine, so the hope is that the research that’s being done on COVID-19 vaccines may act as a shot in the arm for all the other important infectious disease killers that actually kill many, many more people in Africa and other resource-constrained parts of the world.

Watch: UNAIDS Science Adviser explains some differences between HIV and COVID-19