Unrealistic expectation

I’ve been struggling to try and determine when we might get enough ampoules of a COVID-19 vaccine to inoculate at least 70 million people. I’ve read extensively, and the estimates are all over the place.

It normally takes an average of 10 years to develop, test, and release a vaccine. The quickest ever was four years for measles. Could seeking a COVID-19 vaccine be an exception? Things are happening at an unprecedented rate, with collaboration between competitive companies and governments. That has never happened before. There’s some talk of a vaccine being available late this year or early next year.

But vaccines are unlike cures; a cure is given to one sick person in the hope it will make them well. If there are side effects, they affect only that one person. Vaccines are given to millions of healthy individuals, so if there are side effects they can make many of those healthy people sick. Consequently, testing must be far more rigorous. Producing a provably safe vaccine that quickly could bring considerable risk—a risk that will have to be weighed against the benefits. The worst thing would be if politicians decide, not scientists. There’s talk that US President Donald Trump will force a success in October to try to win a reelection. This is a man who’s killed tens of thousands through his callous ineptness. Let’s hope he’s not allowed to add to that deadly list.

In a remarkable display of cooperation to try and provide a vaccine in record time, the pharmaceutical industry is collaborating to rapidly scale up manufacturing capacity for high-volume production, and is working together to establish risk-sharing models that include funding for manufacturing and advance purchase agreements.

Given this, you are looking at a minimum of two to three years before the Philippine population is free from risk. This is assuming that it will be one of the early countries to get the vaccine, which is a bold assumption.

There’s an attempt to reach a global agreement to govern the manufacture and distribution of a vaccine. Which, if it works, could greatly speed up identification, production, and distribution. But logistical constraints still have to be considered. We are talking about inoculating billions of people (China and India alone are 2.7 billion, the US another 328 million). No matter how efficient production is, there’s no pharmaceutical plant or plants capable of these volumes. They’re not even set up for whatever processes will be necessary to produce the vaccine. And that can’t be until the ingredients and how they’re to be mixed are known.

There may be cures found in a relatively short time, and that will certainly help to flatten the curve of deaths, if not of sickness. Eli Lilly & Co. is talking about a drug available this year. Dexamethasone, a commonly available steroid, has also been found to cure some patients. But cures don’t give the protection necessary to get the world back to (a new) normal way of life. And if the price of the drug is halved, will we get the cure or the vaccine?

The Philippines has an ill-considered executive order (EO 104) issued by the Department of Health that halves the price of essential medicines. A COVID-19 cure and vaccine are essential medicines, so their price will have to be drastically cut, too. They can’t be considered any more important than medicines for the heart or diabetes, which have had their prices slashed. So those for COVID-19 must be, too. With that, will the manufacturers put the Philippines high on the list of early recipients?

EO 104 needs to be talked through with the industry because there are other, more acceptable ways to get prices down. Already, we are not getting new drugs because of this.

Maybe the First World will step in to supply the Third World with a vaccine for free, but surely that will be after they’ve supplied their own populace and paid the producers for it. With many countries clamoring for the drug, can we risk being low on the list?

The IATF needs to do three things: 1) Think of ways to be an early recipient of the vaccine. 2) Plan on when to relax controls based on having a cure maybe in a year or so, but not having a vaccine in enough quantity for two or more years. 3) Put EO 104 on hold, or better cancel it as it has no part to play in a free market economy.

If it turns out to be better than this, we’re ahead. But if we plan on a quick vaccine solution, we could be consigning many Filipinos to an early death.

Email: wallace_likeitis@wbf.ph