Now, 24 COVID-19 vaccines near finish line: How poor countries can secure supplies

24 VACCINES IN PHASE 3 CLINICAL TRIAL: The finish line of the global race draws near. The scientific community is feverishly working to get a vaccine out of accelerated trials, and to make sure they're both safe and effective. As of November 12, 2020, there are 24 vaccines in final Phase-3 clinical trials, based on the WHO “draft landscape of COVID-19 candidate vaccines”. All of them had passed through Phases 1 and 2 stages to test safety and efficacy.

ORIGIN OF LEADING COVID-19 VACCINES: According to the WHO list, there are more than 200 COVID-19 candidate vaccines under development. Among the leading vaccines in the final, so-called Phase 3, trials include 4 from Sinovac (China), 3 from Sinopharm/Wuhan Institute of Biological Products (China); 2 from Sinopharm/Beijing Institute of Biological Products (China); 2 from Cansino/Beijing Institute of Biotech (China); 4 from University of Oxford/Astrazeneca (UK); 1 from Bharat Biotech (India); 2 from Gamaleya (Russia); 2 from Janssen Pharmaceuticals (US); 2 from Novavax (US); 1 each from Moderna (US) and 1 from BioNTech/Pfizer/Fosun Pharma (Germany/US/China). If they all get certified following Phase 3 trials (each with at least 30,000 volunteers), the world could potentially have multiple successful vaccines in multiple places, instead of just one.

VACCINE FOR THE RICH? As of November 12, 2020, wealthy nations have secured more than 2 billion doses of potential future COVID-19 vaccines via “advanced purchase agreements” (APAs). Meanwhile, more than 170 countries have joined the COVAX initiative, co-led by the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance. The US, under the Trump administration, has not contributed to the initiative.

SUPPLY CRUNCH: A supply crunch is expected in the initial stages immediately following the approval of the vaccine (or vaccines) for COVID-19. On Tuesday, November 11, 2020, US pharma giant Pfizer has announced its vaccine, developed by BioNTech and known as BNT162b2 (trial codename: NCT04368728) has demonstrated 90% efficacy. The company has applied for emergency-use authorization with the US Food and Drug Administration.

$18 BILLION FOR VACCINE WARCHEST FROM DEVELOPING NATIONS: Developing nations have raised $18 billion in a "solidarity" move to deploy a COVID-19 vaccine to their citizens. The initiative is called COVAX, whose goal is to have 2 billion vaccine doses available by the end of 2021. The COVAX program is led by the World Health Organisation (WHO); Gavi, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations (CEPI). China joined the countries that made a commitment. The US did not.

BETWEEN SCIENCE AND GENEROSITY: It’s been said that to beat the COVID-19 pandemic, the world needs more than a breakthrough in science — it also needs a breakthrough in generosity. | The vaccine against the COVID-19 coronavirus disease, developed by Russia’s Gamaleya Research Institute of Epidemiology and Microbiology.

PURCHASING POWER: By forming a sort of buyers' mega-coalition, less developed countries can bump up their purchasing power. This, it's also hoped, would eventually make per-unit prices of COVID-19 shots more affordable for all (like polio vaccine is priced at $0.50 per shot. The hoped-for result is that developing nations can have access to an approved vaccine that would be otherwise unaffordable. | A research scientist works inside a laboratory of India's Serum Institute, the world's largest maker of vaccines, which is working on vaccines against the coronavirus disease (COVID-19) in Pune, India, May 18, 2020. Picture taken May 18, 2020.

VACCINE CHEAPER THAN WATER BOTTLE: On August 4, 2020, Dr Krishna Ella, Bharat Biotech's managing director, vowed to supply Covaxin to the whole world, at a cost "less than a water bottle." The Covaxin trial was kicked off at the Institute of Medical Sciences and Sum Hospital in Bhubaneswar, Odisha, India.

11 VACCINES FROM CHINA: Currently, there are at least 11 candidate vaccines from China already in Phase 3 clinical trials, according a WHO list dated November 12, 2020. Most of them use the tried-and-tested inactivated vaccine platform, with the exception of Cansino/Beijing Institute of Biotechnology, which uses the Adenovirus Type 5 vector (attenuated vaccine). | A vaccine production plant of China National Pharmaceutical Group (Sinopharm) in Beijing. In the global race to make a coronavirus vaccine, the state-owned Chinese company is boasting that it gave its employees, including top executives, experimental shots even before the government OK'd testing in people. Photo released on April 11, 2020 by Xinhua News Agency.

ADVANCED PURCHASE: Rich countries have roped in the first 2 billion doses of yet-to-be-produced (still non-existent) coronavirus vaccines. By signing up billions of dollars worth of advanced purchase deals with Oxford/AstraZeneca, Pfizer/BioNTech, Moderna/NIH, CureVac — and other pharma giants whose candidate vaccines are in advanced human trials, and have the best chances of getting approved soon.

EUROPEAN, CHINESE SUPPORT FOR COVAX: On Friday, September 18, 2020, the European Commission said it will put $473 million into the COVAX programme aimed at procuring COVID-19 vaccines for lower- and middle- income countries. The commission will contribute an initial $272 million, enough to contribute 88 million doses of vaccines to eligible countries, followed by an additional $201 million.

SECURING SUPPLIES: At least 172 countries have joined the COVAX initiative, co-led by CEPI and Gavi, the Vaccine Alliance. The US has not contributed to the initiative, but has signed bilateral deals with various vaccine makers, including non-US pharmaceutical companies. | Vials of a COVID-19 vaccine candidate, a recombinant adenovirus vaccine named Ad5-nCoV, developed by Chinese biopharmaceutical firm CanSino Biologics Inc.