Reviews | We have seriously derailed in the global fight against Covid
The potential benefits of what experts call distributed manufacturing are clear: It would be much easier to eliminate variants like Delta if every region of the world had its own modern vaccine manufacturing center capable of responding quickly to local needs. It would also leave the world much better prepared for the next pandemic and the one after. The Coalition for Epidemic Preparedness Innovations said regional facilities would create injections within 100 days of dangerous diseases appearing and stop epidemics before they turn into pandemics. Public Citizen estimated that it would take $ 25 billion, and about six months, to establish a network of such hubs around the world and that if officials started today, the world could have billions more doses by now. the same period next year.
The United States’ International Development Finance Corporation, a federal agency that funds and oversees private development projects in low-income countries, has offered at least $ 2 billion in incentives to businesses in low-income countries to help to stimulate vaccine development. But so far, the agency appears to have gotten only fill and finish contracts, in which small businesses finish and pack the shots made by the bigger brand operations. The problem with these contracts, critics say, is that the larger company retains control of the end product, including how much is produced, where and when doses are shipped, and at what price.
The obstacles to increasing manufacturing capacity are legion. Factories need to be modernized or built from scratch, and when it comes to new mRNA vaccines, expertise is scarce outside of the richest countries in the world. But the biggest obstacle, by far, appears to be the stubbornness of the world’s leading vaccine makers, who have largely refused to share their technology, even when it was developed with public money. For example, a technology transfer center established in South Africa by the WHO recently announced its intention to copy Moderna’s mRNA vaccine. But so far, the company has not agreed to share its technology or expertise with the hub, according to Reuters. WHO created a similar global technology transfer platform this year, but so far no company or country has agreed to join.
Industry executives say it will take years for outside companies or low-income countries to develop the infrastructure and expertise to do the shots themselves. Quality and safety would suffer, they claim. And innovation too if they are forced to share their trade secrets with the world. But it’s hard not to see other patterns. “What most established players really want is to stay in control of their profits,” said Andrey Zarur, CEO of GreenLight Biosciences, a biotechnology company that develops mRNA technology. “They say, ‘We’ll keep the technology, but we promise we’ll be good citizens and make sure you get what you need. Africa has heard this a million times before, and they are fed up with it, because they know it will never work that way.
It is also true that vaccines are not easy to manufacture. MRNA injections, for example, require highly specialized equipment and hundreds of ingredients, most of which are not made in underfunded environments. For example, a chemical styling agent that prevents the body from rejecting vaccine mRNA is protected by a patent and is manufactured by a single company. Even simpler vaccines tend to involve multiple companies and countries; almost no shot is made in one place.
But these obstacles are not insurmountable. Russia, for example, managed to transfer its technology to dozens of small businesses, including in the south of the world, in a matter of months, as Nature recently reported. The country’s strategy was not only to license its intellectual property, but also to send its experts to these companies to show them what to do.
Emerging technology promises to be simpler. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas, and his colleagues have developed what is called a recombinant protein vaccine. It can be grown efficiently in yeast cells, has no onerous storage requirements, and should be easy to mass produce anywhere. Univercells, a Belgian company, has built a vaccine manufacturing facility that can fit in a shipping container and can theoretically be deployed almost anywhere in the world. (The Financial Times called it “Ikea-style manufacturing” for vaccines.)