observers. “I am concerned about what I call vaccine nationalism,” CEPI executive director Richard Hatch- ett told the Los Angeles Times. “That’s the tension between obligations elected leaders will feel to protect the lives of their citizens” versus the imperative for global sharing. Some signs point to a possible rerun of the hoarding that accompanied the 2009 H1N1 influenza pandemic, when wealthy nations bought up virtually all vaccine supplies—denying them to poorer countries, and sometimes to one another. Operation Warp Speed has declared an “America First” policy for any vaccine arising from its efforts. Pharma giant Sanofi recently suggested that it would take a similar approach, since the U.S. was first to fund the company’s COVID-19 research. (Sanofi’s CEO backtracked after officials in France, where the firm is headquartered, pro- tested.) The Oxford group, which is partnering with British-based drug maker AstraZeneca, intends to prioritize Great Britain. Yet momentum is building for more generous strat- egies as well. In May, over 100 current and former world leaders, along with prominent economists and public health experts, issued an open letter calling for a “people’s vaccine” for COVID-19, which would be patent-free, distributed globally, and available to all countries free of charge. At the WHO’s annual World Health Assembly, all 194 member states accepted a resolution urging that vaccines for the disease be made available as a “global public good”—though the U.S. dissociated itself from a clause proposing a patent pool to keep costs down, which it argued might disincentivize “innovators who will be essential to the solutions the whole world needs.” Gavi, for its part, plans to launch a mechanism de- signed to encourage those innovators while promoting accessibility: an advance market commitment, in which countries pledge to purchase a vaccine, with no money down. Future contributions will be based on the value of the product to their health systems and their ability to pay.
A few private-sector players are stepping up, too. U.S.- based Johnson & Johnson, which has received nearly
The Biggest Challenge for a COVID-19 Vaccine
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