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More Trials and More Errors?

Entering into the fifth month of the COVID-19 pandemic, the global economy has been impacted massively. According to the International Monetary Fund (IMF), this impact is expected to shrink the global economy by about 4.9 per cent in 2020: the sharpest slowdown since the Great Depression. Amidst the health concerns of the crisis and cascading economic consequences due to lockdown measures, economies are in a constant attempt to “flatten the curve”, which has seen a mixed response for the emerging economies. Countries such as China, Uruguay and Vietnam have managed to contain the virus, however, the pandemic is still unfolding for Brazil, India and South Africa, where the infections are still on a rise. With the world hoping for a return to normalcy, the speculation around vaccine development and trial trumps as the most significant policy response and potential solution to fix the crisis. However, it comes with its own set of problems. 

It is undoubtedly true that the global capacity for vaccine trial and development today is far greater than the 1950s, when the world was trying to sustain the polio epidemic. Vaccines go through a multi-stage clinical process and thereby, it has taken on average, a minimum of 10-15 years for a successful vaccine to be fully developed and be commercially available for use. The trial process begins with checking the vaccine’s safety and ability to create an immune response in a small group of healthy people. The second phase tests the effectiveness of the vaccine by increasing the sample size and the third phase further expands the sample size to the thousands to gauge effectiveness and immunity among a wider group of people varying by age, ethnicity or preexisting health conditions. It is only after these crucial steps that the vaccine is overseen by regulatory bodies for approval, which might be a long process in itself. Considering these are not normal times, some companies such as the Chinese developer CanSino and Russian institute Gamaleya have started mass producing vaccines that are still in clinical trials. Similarly, the USA launched its own collaborative vaccine project known as Operation Warp Speed, and manufacturing investments have already been made in the phase of clinical trials. 

Pharmaceutical companies and researchers are wildly optimistic about the COVID-19 vaccine, envisioning a 12-18-month vaccine commitment. The process is being accelerated by conducting development stages along with working on newer vaccine technologies which raises questions regarding fast-tracking efforts and compromising on quality. Moreover, the exploration of new technology, which clearly is a must for the ongoing pandemic, raises the margin of error in testing, and more so on the basis of the current stretched commitments by pharmaceutical companies. Thomas Bollyky, Director of the global health program at the Council of Foreign Relations, voices a similar concern: “It is not hard to develop a vaccine. It is hard to prove that a vaccine is safe and effective. And if countries are only interested in the former, they can take shortcuts.”

As of August 2020, more than 150 vaccines are in current development worldwide with six being in large-scale clinical trials. It is estimated that more than $10 billion has been invested globally and forward purchases of approximately 4 billion doses have been made. In the context of the crisis, the efforts to speed up the vaccine development process will provide valuable lessons that will likely change the entire systems of vaccines. This being said, a total of $7 trillion has been injected into the global economy so far for the purpose of economic stimulus, and set against this backdrop, the amount spent on vaccine efforts are extremely low. 

Vaccine development and trials are an increasingly multicountry exercise, wherein multiple nations working across multiple types of organization (governments, research groups, pharmaceutical companies, regulatory authorities) invest in multiple vaccines increasing the chance of success rates and then gaining licensure to be made available for widespread use. But, in the current context, there are valid concerns over ‘vaccine nationalism’ taking precedence as countries seem to be in a race for developing the first vaccine rather than ensuring its effectiveness. Due to this competitive aspect, the pandemic has prompted intelligence agencies and pitted them against one another to be able to derive valuable vaccine data and information from other countries. There have been announcements by the British, American and Canadian intelligence agencies of attempts at hacking premier research institutes by the Chinese and Russian intelligence hackers. Reminiscent of the space race, the goal towards the first vaccine seems the right blend of international rivalries and scientific innovation. The extent of cooperation expected amidst a pandemic is being foreshadowed by pre-pandemic geopolitical hurdles. These hurdles are largely responsible for the absence of necessary knowledge-sharing and transparency. 

It is true that nothing before of the sort has occurred wherein the entire international community has engrossed itself towards a common aim. The crisis does demand for urgency as the world suffers. However, nations have been in a vaccine war and working together has almost been absent. Separate circles of experts reckon that the world needs to invest around $100 billion in order to make several vaccines speedily and in sufficient quantities, which is ten times more than the current global investments. In this regard, multicountry investments are the only way forward for the world. It is important to note that clinical trial of vaccines is an important yet only one step in the success of creating a vaccine. The distribution, affordability and economics of a vaccine are much more complex and worthy of exploration to provide a holistic picture of vaccines. In fact, it is believed that ‘vaccine nationalism’ will play a much larger role on a global level when vaccines would be nearing the distribution phase. Moreover, to whom the distribution would be reaching first would also become an important issue. The upcoming months of 2020 are extremely instrumental in knowing the fate of global efforts towards a COVID-19 vaccine. Currently, it does seem like the only underlying hope for the world, but the path is a long one lined with several challenges. 

Swayam Kumar is a Young India Fellow from Ashoka University, who completed his bachelor’s degree from Christ University, Bangalore and is currently exploring opportunities in the sustainability sector.

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