A vaccine is critical to end the coronavirus disease (Covid-19) pandemic, and India’s pharmaceutical industry and will play a major role because of its ability to manufacture high-quality vaccines at affordable prices, said Bill Gates, Microsoft co-founder and co-chair of The Bill & Melinda Gates Foundation (BMGF) in an email interview to HT.
The BMGF’s fourth annual Goalkeepers Report released Tuesday said social and economic impacts of the pandemic have reinforced inequities and derailed 20 years of progress toward the UN’s Sustainable Development Goals that aim to end poverty, fight inequality and injustice, and fix climate change by 2030.
Economic damage from Covid-19 is reinforcing inequalities, and extreme poverty has increased by 7%. The International Monetary Fund projections say that despite the US$18 trillion economic stimulus spent around the world, the global economy will lose US$12 trillion or more by the end of 2021, which is the biggest global GDP loss since the end of World War II.
Are vaccines against coronavirus disease (Covid-19) likely to provide long-lasting protection?
It’s too soon to make predictions about how long protection might last. At this point, we don’t have enough data on the duration of antibody and T-cell response to the disease itself, let alone to the various vaccine candidates. Many of the vaccine trials underway should start to report efficacy data in the next few months, which will start to provide answers to these critical questions. The good news is that there is a large portfolio of vaccines in testing, each with a different approach. This gives the greatest possible chance to develop effective vaccines.
What role can India’s pharmaceutical and vaccine producers play in stopping Covid-19?
They can and will play a major role, because they have the ability to manufacture high-quality vaccines at scale for affordable prices. One great example is the Serum Institute of India, which manufactures more vaccines than any other company in the world. Our foundation and Gavi, the Vaccine Alliance, recently announced funding to the Serum Institute to help it ramp up manufacturing capacity so it can produce up to 100 million doses of Covid-19 vaccine for low- and middle-income countries in 2021. Serum has agreed to price its vaccines at no more than $3 per dose. Serum is just one company in a very dynamic sector that can support the Covid-19 response. Prior to Covid-19, our foundation has worked extensively with other innovative Indian companies, including Bharat Biotech and BioE, to support them as they develop and deliver safe and effective vaccines for India and for the world.
Can Covid-19 end without a vaccine? Is herd immunity possible without a vaccine?
When people refer to a herd immunity strategy to manage the pandemic, there are two issues they’re not addressing. The first is that letting people get sick until most are immune and the disease no longer spreads easily will lead to many millions of deaths. The second is that herd immunity is always temporary, because children are born without immunity, and eventually there will be enough susceptible people that the disease can start spreading easily again. For both reasons, a vaccine is critical. It will save lives now and protect future generations from re-living this experience.
Several rich countries have pre-ordered millions of doses of vaccines. Does that mean poor and marginalised people will get vaccinated last? How are BMGF and partners ensuring equitable access to vaccines?
We are working with many partners on several different fronts to prevent that from happening. One of the key partners is Gavi, the Vaccine Alliance, which has 20 years of experience helping low-income countries immunise their people. Gavi is helping support Serum Institute in the deal I just mentioned, and it’s one of the main partners in an initiative called COVAX, which brings countries together to pool investments in developing, manufacturing, and delivering vaccines equitably around the world. So far, about 80 countries have made commitments to the COVAX Facility, so momentum is building. In the next month, one of our priorities is to help raise the money that’s needed to ensure that vaccines don’t just go to the highest bidder.
Have we had partnerships for a health response at this scale ever before? Is this the future?
That’s one of the big tests of this historical moment. Will we see new models of collaboration emerge to meet this new kind of crisis—or will countries turn inward and try to fight a global problem with national interventions? The root cause of everything that’s happening is a virus that doesn’t recognise borders. Borders matter less and less to the global economy, too. While policies that stop at borders may help citizens of a given country cope with the symptoms of the crisis, they won’t stop it. Every country will benefit when all countries work together on solutions. Hopefully, this crisis helps the world understand that and act accordingly.
What is the role of technology and data in the Covid-19 response?
It would be hard to overstate the importance of data. Right now, while we’re waiting for treatments and vaccines and have to rely on non-pharmaceutical interventions like contract-tracing, quarantine, and social distancing to contain the disease, we need to know with precision how it is spreading. The more countries know about who is at risk, the more likely they are to be able to devise strategies to keep case numbers low. When new treatments and vaccines become available, data will be critical in helping the world determine how those new tools are changing the patterns of disease. As we learn more about Covid-19, we will get better at fighting it—but only if we have access to the data we need to put those lessons to use.
You have been saying the world is not prepared for the next pandemic since the H1N1 in 2009. Are we better prepared now?
We know a lot more now about what it will take to be fully prepared. We’ve seen examples of partners working in new ways that will help keep the next pandemic from doing as much damage as this one. For example, scientific researchers are collaborating to invent more new solutions, faster. Global health organisations are building innovative partnerships to coordinate their responses. But we will need to watch carefully over the next several years to see whether the world follows through to institutionalise all this new knowledge and these new capabilities. That will mean investing enough in a permanent infrastructure of pandemic preparedness and response that we’re never caught flat-footed again.