<html><head><meta http-equiv="Content-Type" content="text/html; charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; line-break: after-white-space;" class=""><i class="">Two important pieces below from Achal Prabhala, Alain Alsalhani and Winnie Byanyima…</i><div class=""><i class=""><br class=""></i><div class=""><br class=""></div><div class=""><a href="https://rdcu.be/cF5Bp" class="">https://rdcu.be/cF5Bp</a></div><div class=""><br class=""></div><div class="">
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<div class="column"><p class=""><span style="font-size: 26pt; font-family: Whitney;" class="">Developing countries can make the mRNA
vaccines they need </span></p>
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<div class="column"><p class=""><span style="font-size: 9pt; font-family: Whitney; color: rgb(177, 56, 98);" class="">To the editor </span><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">— Since the start of the
COVID-19 pandemic, it has been clear that vaccinating the world is not only a
moral priority, but also an epidemiological
necessity to break the cycle of infections and
mutations. Despite an impressive increase
in global production towards the end of last
year, we failed to produce enough doses to
cover the world through most of the year, </span><span style="font-family: MinionPro; font-size: 9pt;" class="">as well as to distribute those doses equitably
across countries.</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">One year after vaccines became widely
available, in January 2022, the world’s
low-income countries remain largely
unvaccinated, whereas high-income
countries are rushing to administer third
doses of mRNA vaccines in response to
Omicron. Although Omicron seems to
result in milder infections and fewer critical
cases, it substantially escapes antibodies
induced by existing vaccine doses — hence
the turn to booster doses. Moreover, we face the possible emergence of new variants
that may both escape immunity and be more aggressive. To withstand Omicron and
prepare for future threats, the world needs to
produce enough doses of the most effective,
adaptable and rapidly manufacturable
vaccines we have: mRNA vaccines, which
have been delivering on all these fronts for
the past year.
</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">Until now, mRNA manufacturing has
been controlled by three companies and
their contract manufacturers, almost all of which are based in North America and
Europe. This needs to change. Access to
this key resource must be geographically
distributed to facilities in Asia, Africa and
Latin America. This would allow every
region of the world to be equipped as
quickly as possible with the best available
defence, now and in the future. Worryingly,
there is no sign that this solution will
become our reality.
</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">Why the focus on mRNA vaccines?
Among the vaccine technologies on offer,
the mRNA platform involves routine
biochemistry — unlike traditional
vaccines, which rely on biology and the
production of cell-based components.
This means that mRNA vaccines are easier
to make. In fact, they already are being
made by pharmaceutical manufacturers </span><span style="font-family: MinionPro; font-size: 9pt;" class="">with no previous experience in biological
pharmaceutical agents (such as Rovi, </span><span style="font-family: MinionPro; font-size: 9pt;" class="">in Spain), which expands the number </span><span style="font-size: 9pt; font-family: MinionPro;" class="">of companies that can potentially make
them. In a recent report</span><span style="font-size: 5pt; font-family: MinionPro; color: rgb(59, 102, 157); vertical-align: 3pt;" class="">1</span><span style="font-size: 9pt; font-family: MinionPro;" class="">, we found </span><span style="font-family: MinionPro; font-size: 9pt;" class="">that over 100 companies in Asia, Africa
and Latin America could manufacture
mRNA vaccines, given that they currently
manufacture sterile injectable products, a
family of pharmaceutical products that are
an indicator of potential ability to make
mRNA technology.</span></p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">This also means that mRNA vaccines are
faster to make. It took between three and
seven days to manufacture a batch of the
active ingredient for the Pfizer–BioNTech
vaccine, as compared to two months for an
equivalent batch of the AstraZeneca vaccine</span><span style="font-size: 5.000000pt; font-family: 'MinionPro'; color: rgb(23.300000%, 39.900000%, 61.700000%); vertical-align: 3.000000pt" class="">2</span><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">.
</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">With the Omicron variant surging,
mRNA vaccines are crucial to both the
current, as well as the future, response. Data suggest that the two mRNA vaccines in use — those from Pfizer–BioNTech and
Moderna — show better results as boosters
than do other vaccines</span><span style="font-size: 5.000000pt; font-family: 'MinionPro'; color: rgb(23.300000%, 39.900000%, 61.700000%); vertical-align: 3.000000pt" class="">3</span><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">. Additionally, as the
need for a reformulated vaccine grows in
response to Omicron, mRNA technology
offers distinct advantages. In the recent<br class="">
past, it took Moderna 30 days to prepare a
reformulated version of its vaccine for trials,
as compared to 5 months for a reformulation
of a biological vaccine</span><span style="font-size: 5.000000pt; font-family: 'MinionPro'; color: rgb(23.300000%, 39.900000%, 61.700000%); vertical-align: 3.000000pt" class="">4</span><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">.
</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">Distributing the production of mRNA
vaccines across the world would serve both
low-income and high-income countries. </span><span style="font-family: MinionPro; font-size: 9pt;" class="">This requires Pfizer, BioNtech and Moderna
to engage other capable companies in the
developing world, which they have shown few
signs of wanting to do. The US and German
governments (who funded the development
of mRNA vaccines) can do much more to
encourage these companies to work with
others. But international organizations
aiming to increase vaccine equity also have a
responsibility to more accurately understand
the contours of the problem they are trying to
solve, so that they can find solutions that are
hiding in plain sight.</span></p><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">Their failure is that they think of </span><span style="font-family: MinionPro; font-size: 9pt;" class="">mRNA manufacturing capacity in the
developing world as something that has to
be built, rather than something that already
exists. When the Coalition for Epidemic</span><span style="font-size: 9pt; font-family: MinionPro;" class=""> </span><span style="font-family: MinionPro; font-size: 9pt;" class="">Preparedness Innovations estimated
vaccine manufacturing capacity across the
world, they did not fully account for the
differences between biological and mRNA
vaccines, and thereby excluded the largest
share of potential manufacturers of mRNA
vaccines: manufacturers of sterile injectable
products. In another instance, the World
Health Organization invited expressions of
interest from companies to join a series of
continental mRNA manufacturing hubs;
however, without any encouragement to
sterile injectable manufacturers to apply,
very few did — thereby reinforcing the
misguided idea that mRNA vaccines can be
made only by companies that are already
making biological vaccines.</span></p></div></div></div>
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<div class="column"><p class=""><span style="font-size: 9.000000pt; font-family: 'MinionPro'" class="">In the nearly two years that we have lived through the coronavirus pandemic, we have thought of mRNA vaccines as a luxury that only a few can make and
have. But an examination of the evidence
will force us to acknowledge that the
opposite is true, and this conclusion has the
potential to end the pandemic everywhere.
Prolonging the delusion that companies in
countries of the developing world are not
ready to make mRNA vaccines may serve a
handful of corporations, but it harms the world. </span></p></div></div></div></div></div></div></div><div class="">
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<div class="column"><p class=""><span style="font-size: 9pt; font-family: Whitney; color: rgb(177, 56, 98);" class="">Achal Prabhala</span><span style="font-size: 5pt; font-family: Whitney; color: rgb(177, 56, 98); vertical-align: 3pt;" class="">1 </span><span style="font-size: 9.000000pt; font-family: 'ArialUnicodeMS'; color: rgb(69.500000%, 22.100000%, 38.500000%); vertical-align: 3.000000pt" class=""> </span><span style="font-size: 9pt; font-family: Whitney; color: rgb(177, 56, 98);" class="">and Alain Alsalhani</span><span style="font-size: 5pt; font-family: Whitney; color: rgb(177, 56, 98); vertical-align: 3pt;" class="">2 </span><span style="font-size: 9.000000pt; font-family: 'ArialUnicodeMS'; color: rgb(69.500000%, 22.100000%, 38.500000%); vertical-align: 3.000000pt" class="">
</span><span style="font-size: 5.000000pt; font-family: 'MinionPro'; font-style: italic; vertical-align: 3.000000pt" class="">1</span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic" class="">Th</span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic" class="">e AccessIBSA project, Bangalore, India. </span><span style="font-size: 5.000000pt; font-family: 'MinionPro'; font-style: italic; vertical-align: 3.000000pt" class="">2</span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic" class="">Vaccines
and Special Projects, Access Campaign–Médecins
Sans Frontières, Paris, France.<br class="">
</span><span style="font-size: 8.000000pt; font-family: 'ArialUnicodeMS'; vertical-align: 2.000000pt" class=""></span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic" class="">e-mail: </span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic; color: rgb(23.300000%, 39.900000%, 61.700000%)" class=""><a href="mailto:aprabhala@gmail.com" class="">aprabhala@gmail.com</a></span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic" class="">; </span><span style="font-size: 8.000000pt; font-family: 'MinionPro'; font-style: italic; color: rgb(23.300000%, 39.900000%, 61.700000%)" class="">Alain.
<a href="mailto:ALSALHANI@paris.msf.org" class="">ALSALHANI@paris.msf.org</a> </span></p>
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</div></div><div class=""><br class=""></div><div class=""><br class=""><div class=""><br class=""><a href="https://www.nature.com/articles/s41562-022-01307-9" class="">https://www.nature.com/articles/s41562-022-01307-9</a> </div>
<div class="c-article-header"><header class=""><h1 class="c-article-title" data-test="article-title" data-article-title="">HIV or COVID-19, inequity is deadly</h1>
<ul class="c-article-author-list js-etal-collapsed js-no-scroll" data-etal="25" data-etal-small="3" data-test="authors-list" data-component-authors-activator="authors-list"><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="https://www.nature.com/articles/s41562-022-01307-9#auth-Winnie-Byanyima" data-author-popup="auth-Winnie-Byanyima" data-corresp-id="c1" class="">Winnie Byanyima<svg width="16" height="16" focusable="false" role="img" aria-hidden="true" class="u-icon"><use xlink="http://www.w3.org/1999/xlink" xlink:href="https://www.nature.com/articles/s41562-022-01307-9#global-icon-email"></use></svg></a> </li></ul>
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<div class="u-text-bold c-article-section__content c-article-section__content--standfirst" lang="en"><p class="">Breaking
pharmaceutical monopolies helped to address the HIV crisis. The same
could be done to end the COVID-19 pandemic, but we must act decisively,
writes Winnie Byanyima.</p></div>
<div class="c-article-section__content"><p class="">As we embark
on a new year of the battle between humanity and COVID-19, the virus is
still winning. Leaders of high-income nations have made huge and
ultimately inexcusable errors of judgement. They have failed to consider
vaccines and COVID-19 technologies as global public goods.</p></div><div class="c-article-section__content"><p class="">We
are witnessing the same deadly mistakes made in the mid-1990s, when
treatment for HIV became available. Pharmaceutical companies set the
extortionate price tag of US $10,000 per person per year, rendering this
life-saving treatment out of reach for the millions of people living
with HIV in the Global South. Between 1997 and 2006, UNAIDS estimates
that 12 million African individuals died because the medicines were
priced out of their reach by pharmaceutical monopolies and the greed of
profit versus public good.</p></div><div class="c-article-section__content"><p class="">It
was only when a movement of people living with HIV, healthcare
advocates, religious leaders and many other partners mobilized to
generate global political pressure that companies in developing
countries (Brazil, India and Thailand) were able to manufacture the
medicines by making use of the flexibilities within the World Trade
Organization’s (WTO) Trade-Related Aspects of Intellectual Property
Rights Agreement.</p></div><div class="c-article-section__content"><p class="">This
important tool allowed for competition within the pharmaceutical
market, which led to dramatic drops in the price of HIV medicines to
less than US $75 in some countries today, giving millions access to
life-saving treatment. But this took years to achieve, and many
countries still cannot access the generic market owing to trade
barriers. We cannot let that happen with COVID-19, and this time we must
act much faster.</p></div><div class="c-article-section__content"><p class="">However,
the world is currently failing to heed the lessons of the injustice
that took place with the AIDS pandemic, and leaders are still putting
narrow and ultimately self-defeating nationalism ahead of what is
needed. They are continuing to defend the profits and monopolies of
their pharmaceutical corporations, instead of sharing the successful
vaccines and the technologies that would scale up their production
worldwide.</p></div><div class="c-article-section__content"><p class="">It has
been a year since the first Pfizer-BioNTech vaccine was given, and yet
Africa has still only received enough doses to fully vaccinate around
10% of its population. This is in stark contrast to high-income
countries. In the European Union, for example, around 70% of people have
received at least two doses, with many countries now administering
third booster jabs to keep their populations safe.</p></div><div class="c-article-section__content"><p class="">High-income
nations have behaved appallingly, hording billions of doses of vaccines
while doctors in countries such as my own, Uganda, have faced COVID-19
unprotected and unvaccinated. Even when high-income countries do donate
some of their excess doses, it is too little, too late — often delivered
close to their expiry dates, and virtually unusable. Donations and
charity, though welcome, will never be enough.</p></div><div class="c-article-section__content"><p class="">At
least five million people have already died of COVID-19, while world
leaders have allowed companies such as Pfizer and Moderna to make as
much as US $1,000 profit a second, hiding behind their monopolies to
artificially restrict the supply of these vaccines and making them the
most lucrative medicine ever developed — creating new vaccine
billionaires instead of vaccinating billions.</p></div><div class="c-article-section__content"><p class="">Putting
profits first has also created an optimal breeding ground for new
variants, such as Omicron. One thing we know for sure is that the impact
of Omicron will be felt by the poorest worldwide. The poorest people
and low-income nations will be least able to take the actions needed to
combat it.</p></div><div class="c-article-section__content"><p class="">We know
that already scarce vaccines will become hugely scarcer. Being fully
vaccinated will soon mean having multiple doses, leading to
higher-income nations buying up all the vaccines for boosters. We may
discover that some existing vaccines are not able to face the challenge
of new variants, and, as new vaccines are developed, existing supply
capacity will be diverted to this aim.</p></div><div class="c-article-section__content"><p class="">There
are steps we can, and must, take to help to fix this. The proposed
temporary intellectual property waiver covering all COVID-19 vaccines
and technologies at the WTO remains a necessary precondition to defeat
COVID-19. The waiver could curb pharmaceutical companies’ global
monopolies, while still allowing them to be financially compensated.</p></div><div class="c-article-section__content"><p class="">We
also need to invest now in building vaccine-production capacity all
over the world, especially for the very successful mRNA vaccines. There
are more than 100 producers worldwide that could be making the
Pfizer-BioNTech vaccine today. Know-how must be shared: these vaccines
have been paid for by public money and they must be made a global public
good.</p></div><div class="c-article-section__content"><p class="">Everyone has
the right to health; we cannot afford to make the same mistakes we did
in response to the emergence of HIV. We need greater global equity in
healthcare and in access to health commodities and technologies, and we
need it quickly.</p></div><div class="c-article-section__content"><p class="">It
is madness to think that if we keep doing the same thing we can expect a
different outcome. This year has to be the year that we finally make
these incredible vaccines a global public good — the year that
high-income nations do the right thing and that pharmaceutical companies
share their successful vaccine recipes with producers all over the
world.</p></div><section aria-labelledby="author-information" data-title="Author information" data-gtm-vis-first-on-screen-50443292_563="20771" data-gtm-vis-total-visible-time-50443292_563="8400" data-gtm-vis-first-on-screen-50443292_562="20772" data-gtm-vis-total-visible-time-50443292_562="8400" class=""><div class="c-article-section" id="author-information-section"><div class="c-article-section__content" id="author-information-content"><div class=""><br class=""></div><div class="">Arthur Stamoulis<br class="">Citizens Trade Campaign<br class="">(202) 494-8826<br class=""></div></div></div></section></div></div></div><br class=""><br class=""><div class="">
Arthur Stamoulis<br class="">Citizens Trade Campaign<br class="">(202) 494-8826<br class=""><br class=""><br class=""><br class="">
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