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Vaccines, Diagnostics and Therapeutics as global public goods

Photo credit: UN photo_Kibae Park

Countries in the Asia-Pacific region are trying their best to deal with the COVID-19 pandemic by rapidly rolling out vaccination programmes and putting in place public health interventions to reduce its impact. At the end of November, there were 262 million confirmed COVID-19 cases and 5.2 million deaths globally. About 60 per cent of all COVID-19 cases and half of all COVID-19 related deaths were in Asia and the Pacific. About 7.8 billion vaccines have been administered globally, and vaccine supply is generally improving.

However, the pandemic has exacerbated inequities between and within countries and communities in the region with regard to access to vaccines, diagnostics and therapeutics. Many countries, particularly lower income countries, are lagging in vaccinating their populations, with less than 1-in-5 of the total population fully vaccinated. This vaccine inequity is prolonging the pandemic in both developed and developing countries. The recent emergence of a new strain of the virus capable of spreading faster, threatens to derail recent efforts to open economies and borders.

We recently brought together leaders and experts from across the region to examine the reasons for the large inequities in access to vaccines, diagnostics and therapeutics, and the ways to close the gap. The Regional Conversation on Equitable Access to Vaccines, Diagnostics and Therapeutics also highlighted some important factors and pre-requisites for ending the pandemic and preventing future ones.

Firstly, while noting the many initiatives supporting countries’ efforts to contain the spread of the virus, inequities had arisen due to procurement and stockpiling of vaccines by higher income countries across the world well in excess of their requirements. Vaccine production was concentrated in selected countries (mainly developed), and “vaccine nationalism” was spreading, coupled with a lack of effective mechanisms to transfer knowledge, technology and other resources. Multilateral mechanisms like COVAX, which had emerged as a lifeline for many lower- and lower middle-income countries, had not been provided adequate vaccines or resources. For the inequity to be narrowed, it is imperative that multilateral mechanisms like COVAX be transformed from a market and charity model to a global public investment and global public goods model.

Second, vaccines and health technologies for fighting pandemics should be recognized as global public goods. Discussions and promotion of this idea at subregional and regional levels could help advance it before elevating it to the global level. At the regional level, procurement of vaccines could be pooled, and regional hubs built for the development and manufacture of vaccines; where these centres already exist they should be strengthened. Public-private partnerships in vaccine development, manufacturing and distribution must be increased. Exchanges and transfer of knowledge, know-how, technology and resources between countries, using North-South and South-South principles, must be stepped up to achieve vaccine self-sufficiency. Promoting policy coherence through regulatory and normative systems to achieve quality and set standards should be part of regional cooperation. WTO member States are discussing the possibility of intellectual property rights to certain health technologies during health emergencies like pandemics, and this needs to be expedited and supported.

Third, having efficient and well-structured vaccination programmes at the national level, with a clear and transparent strategy for reaching population groups in vulnerable situations, was critical to achieving vaccine equity within and between countries. In many high-income countries with abundant supply of vaccines, vaccination rates were lagging due to “vaccine hesitancy” because of misinformation and a lack of trust. In this context, vaccination programmes need to be rooted in strengthened health systems and universal health coverage, with equal access to high quality, comprehensive and affordable health care. More agile, anticipatory and adaptive health systems also must be developed. There should be multisectoral action for health that puts primary health care at its center. Synergies with other sectors should be harnessed to advance public health objectives and to increase public health care funding.

Building on these concrete suggestions that focus on the Asia-Pacific region, we will revisit this subject at our annual session of the Commission in May 2022, when countries will have an opportunity to consider these ideas. Until then, I remind member States and stakeholders in Asia and the Pacific that no single country will succeed in defeating the pandemic on its own. Our only chance is to work together. We require trust and solidarity within and between nations. Without these essential elements, no regional or global arrangements will hold water or succeed.

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Armida Salsiah Alisjahbana
United Nations Under-Secretary-General and Executive Secretary of the Economic and Social Commission for Asia and the Pacific (ESCAP)
Social Development +66 2 288-1234 [email protected]