There is every indication that the coronavirus that is shaking the world could establish itself as an endemic virus, present for a long time, with seasonal peaks in virulence. In this hypothesis, medical experts fear that there may not be enough vaccine for everyone. According to scientists, 70 % of the human population, or 5.6 billion people, would need to be vaccinated to achieve herd immunity and extinguish the pandemic forever. But even if we were able to combine unprecedented efforts to make billions of doses of vaccine, national priorities, selfishness and the law of the strongest - the richest - would make this task impossible and leave whole swathes of humanity without vaccine protection. The scenario most feared by public health experts is that of a global struggle in which manufacturers sell only to the highest bidder. This is what is beginning to happen.
Public health experts are shaking. They see a ruthless struggle unfolding before their very eyes to get the SARS-CoV-2 coronavirus vaccine. Rich countries, led by the United States, are pre-purchasing stockpiles of the vaccine before it is even discovered and manufactured. The same scenario is found in the few countries with vaccine manufacturers: stockpiling, pre-production orders, funding research to gain priority over others. The fight for the vaccine is already in full swing and is bringing selfishness and every man for himself into the open.
The scientists who follow these cases are devastated. For by playing every man for himself, the leaders who play these games do not understand that the virus is spreading in defiance of all man-made geographical lines and borders. A country that would like to keep its vaccines for itself alone would have to barricade its borders and prohibit all trade with the outside world. In other words, an impossible scenario.
" The model of countries thinking only of themselves is not going to work. Even if you live in a place that is completely free of infection, your efforts to fight the virus will be in vain if you don't close all your borders and all your trade.« and apologizes to the Washington Post Seth Berkley, head of Gavi, a public-private partnership that helps provide vaccines to developing countries. « It's a global problem that needs a global solution..."
A common sense remark not shared by everyone. In the United States, the federal government agency responsible for emergency vaccine development has indicated that it is putting national concerns first - an "America First" mentality that has shaped much of the Trump administration's response to the pandemic. « For now, we are focusing on the U.S. approach needed to accelerate vaccine availability.« says Gary Disbrow, Acting Director of the Biomedical Advanced Research and Development Authority (BARDA). This federal agency is responsible for protecting Americans against biological threats.
Its action results in the distribution of millions of dollars. It has granted half a billion dollars in emergency funds to the American laboratory Johnson & Johnson to develop a vaccine.
Why not enjoy unlimited reading of UP'? Subscribe from €1.90 per week.
The head of the American agency BARDA says that the Johnson & Johnson laboratory " indicated that approximately 300 million doses of vaccine would be available in the United States each year. "This would be enough to vaccinate 90 % of the US population, or 330 million people. This number of doses corresponds to the projected annual capacity of the Baltimore plant, which is operated by a publicly traded company called Emergent BioSolutions, and which receives funding as one of four federal sites designated as a Center for Innovation in Advanced Development and Manufacturing.
The laboratory refrains from confirming these statements and figures because it wants to reassure its other world markets. The company wants to produce one billion doses by the end of 2021, with the first doses available this winter. « It is unclear where the vaccine will be most needed, although health care workers are a top priority. We need to assess global priorities to stop the pandemic," said Paul Stoffels, executive vice president and chief scientific officer of Johnson & Johnson, citing in an interview the need to assess global priorities to stop the pandemic. He said, "We need to assess global priorities to stop the pandemic. we work a lot with the United States« ...but hastily adds "..." but on the other hand, we also do our best to ensure that we can serve the world"
Following the adage "you don't put all your eggs in one basket", BARDA has also provided hundreds of millions of dollars in financial support for the vaccine research efforts of Sanofi, the large French pharmaceutical company, and Moderna, a Massachusetts-based biotechnology company that is partnering with a Swiss company to manufacture vaccines.
" By working with several companies, we are more likely to have one or more vaccines available as quickly as possible.« ...justifies Gary Disbrow the boss of the BARDA agency.
Frenchman Sanofi will serve the Americans first
The fact that the Americans want, as a matter of priority, to recover a vaccine produced by an American company is shocking in view of the global stakes of the pandemic risk, but can, with a little effort, be understood. But that a foreign laboratory should give priority to serving the Americans at the expense of its own citizens raises questions. This is the case with the French pharmaceutical company Sanofi.
Its leader, Paul Hudson, has just announced to the agency... Bloomberg ...to make it a priority to serve the American people as soon as his lab finds the vaccine. « The U.S. government has the right to the largest pre-order because it is invested in risk-taking.« said Mr. Hudson. The United States, which expanded its partnership with the company in February, is driven by a simple logic. if we helped you make the at-risk doses, we expect to receive the vaccine first."
Sanofi is one of the main players among dozens of companies looking for a vaccine, which is needed to revive economies after a drop in production caused by containment. It has partnered with its British rival GlaxoSmithKline in the U.S.-backed project and says it could produce 600 million doses a year - a capacity that Mr. Hudson has said it wants to double.
The leader says " the United States will get vaccinated first. It will do so because they have invested to try to protect their people, to try to get their economy going again.« . Hudson refers to the $226 million BARDA awarded in December to his company to expand pandemic vaccine production capacity and the $30 million BARDA awarded to the vaccine research program.
So Sanofi decided that the Europeans would come next. At the end of April this year, Paul Hudson deplored the lack of European cooperation, in particular the Commission's lack of commitment to the coronavirus vaccine strategy. The Commission woke up a little late: on 4 May, the President of the European Commission, Ursula von der Leyen, announced that she had raised 7.4 billion euros to finance research and development of a vaccine against Covid-19. But this will not change anything for Sanofi. The Americans will be served first.
However, the French laboratory confirms that it has begun discussions with European governments on the possibility of providing them with coronavirus vaccines. « We regularly receive phone calls« Paul Hudson says, with some countries offering to share the financial risk of producing a candidate vaccine before its safety and efficacy is proven.
To fight against disinformation and to favour analyses that decipher the news, join the circle of UP' subscribers.
Sanofi has two Covid-19 vaccine projects underway. The BARDA-funded project builds on previous development work related to the SARS outbreak and the technology it is already using in one of its influenza vaccines. The French company and GSK plan to begin human trials in the second half of this year and aim to have a vaccine available by the second half of 2021. Sanofi also has a separate coronavirus candidate vaccine in development with Translate Bio Inc., which uses messenger RNA technology to induce the body to make a key protein from the virus, triggering an immune response.
Sanofi's strength in the race for the vaccine is its enormous production capacity: 11 plants (three in France, three in Asia, and the rest in the Americas) and 10,000 dedicated employees worldwide, via Sanofi Pasteur. « There are few companies that can produce vaccines on this scale... " states its CEO at Usine Nouvelle.
A vaccine race full of risks
The race for a vaccine is full of risks, because no one knows which projects will succeed. It forces companies to go to scale to produce millions of doses of vaccine that may end up being worthless.
Pfizer, another competitor in the vaccine race, which is testing several candidate vaccines, has identified plants in the U.S. and Belgium and is securing its supply chain, with the goal of having 10 to 20 million doses available by the fall and hundreds of millions of doses next year.
" We're thinking completely outside the box." said Kathrin Jansen, head of vaccine research and development at Pfizer. « We are proposing unique approaches, entering into contract negotiations with suppliers, and we have not seen a single point of clinical data. It's unheard of"
Pfizer's vaccine, being developed with the German company BioNTech, contains genetic material encapsulated in a fat droplet composed of four lipids. Before Pfizer knew which vaccine was going to be developed, it had to obtain a sufficient amount of each of these lipids. Pfizer needed enzymes to make the genetic material, so they had to find suppliers to ensure a sufficient supply to meet the expected demand.
Forecasting the worst
At the top of the logistics supply chain is scientific uncertainty. Pfizer's planning scenario is based on a "worst-case prediction" that the vaccine it will eventually manufacture will be the one that requires the highest dose. If the company succeeds with a different version - one that makes copies of itself once inside the cells and is therefore effective at about one-tenth of the dose - Pfizer could be thinking of billions of doses instead of hundreds of millions.
" They're all wild cards, and all the current planning requires a certain amount of flexibility« explains Kathrin Jansen. « We don't want to have too low a capacity. We do not want to have too much capacity. We do not know how much we need. It's a very interesting dance that's going on right now to get it right, and none of us have ever done this before."
Kathrin Jansen believes that the global community will have to find a way to distribute the vaccine equitably around the world, through organizations such as the WHO. She did not say where Pfizer's vaccines would go. « I think that when we are faced with this problem, I am very confident that there will be plans in place to ensure that there is an equitable deployment"..
A hope that resembles wishful thinking, so much selfishness is revealed with this vaccine race, which promises to be a tragic clash of vaccine nationalisms.