000318763 001__ 318763
000318763 005__ 20250220155612.0
000318763 0247_ $$2doi$$a10.1186/s12992-024-01017-z
000318763 037__ $$aARTICLE
000318763 245__ $$aWhich roads lead to access?$$ba global landscape of six COVID-19 vaccine innovation models
000318763 269__ $$a2024
000318763 336__ $$aJournal Articles
000318763 520__ $$aBACKGROUND: Unequal and inequitable access to Covid-19 vaccines in low- and middle-income countries (L&MICs) was a major political, ethical and public health failure in the pandemic. However, vaccine developers' practices were not monolithic, but rather, took diverse approaches to supplying different countries, with important implications for global access. RESULTS: Using data on R&D investments, regulatory approvals, manufacturing and purchase agreements, and vaccine deliveries, we identified six distinct innovation models that apply across the 14 COVID-19 vaccines with more international presence from 2020–2022. “Western Early Arrivers” Pfizer/BioNTech and Moderna supplied the largest volumes quickly and prioritized high-income countries (HICs) from registration to vaccine delivery. “Western Latecomers” Janssen and Novavax supplied intermediate volumes later, also prioritizing HICs but with a greater proportion to L&MICs. “Major Chinese Developers” Sinopharm and Sinovac supplied intermediate volumes early, primarily to middle-income countries (MICs). “Russian Developer” Gamaleya completed development early but ultimately supplied small volumes, primarily to middle-income countries (MICs). “Cosmopolitan Developer” Oxford/AstraZeneca supplied large volumes early to HICs and MICs at the lowest prices. Finally, “Small MIC Developers” CanSino, Bharat Biotech, Medigen, Finlay Institute and the Center for Genetic Engineering and Biotechnology (CGEB), exported relatively small volumes to a few MICs. Low-income countries (LICs) were not targeted by any developer, and received far fewer doses, later, than any other income group. Almost all developers received public funding and other forms of support, but we found little evidence that such support was leveraged to expand global access. CONCLUSIONS: Each of the six innovation models has different implications for which countries get access to which vaccines, how quickly, and at which prices. Each offers different strengths and weaknesses for achieving equitable access. Our findings also suggest that Western firms had the greatest capacity to develop and deliver vaccines quickly during the pandemic, but such capacity is rapidly becoming more globally distributed with MICs playing a significant role, especially in supplying other MICs. Given the critical role of public support in enabling pandemic vaccine development and supply, governments have both the capacity and responsibility to craft international rules that will make responses to future pandemics more equitable and effective.
000318763 542__ $$fOpen Access - Creative Commons Attribution 4.0 International License$$uhttp://creativecommons.org/licenses/by/4.0/
000318763 580__ $$aIn: Globalization and Health. - Volume 20(2024), article number 25, pages 1-24
000318763 6531_ $$aGlobal Health$$0319129
000318763 700__ $$aRuiz, Adrián Alonso
000318763 700__ $$aBezruki, Anna
000318763 700__ $$aShinabargar, Erika
000318763 700__ $$aLarge, Kaitlin Elizabeth
000318763 700__ $$aVieira, Marcela
000318763 700__ $$aSlovenski, Iulia
000318763 700__ $$aLiu, Yiqi
000318763 700__ $$aAgarwal, Surabhi
000318763 700__ $$aBecker, Anna
000318763 700__ $$aMoon, Suerie
000318763 8564_ $$96f9b9bb5-4448-4d04-8b3b-0fb6120f5ddb$$s3059855$$uhttps://repository.graduateinstitute.ch/record/318763/files/GHC_s12992-024-01017-z.pdf
000318763 901__ $$uInternational Relations - Political Sciences Department$$0319288
000318763 901__ $$uGlobal Health Centre$$0319295
000318763 901__ $$uInterdisciplinary Programmes$$0319283
000318763 901__ $$uGlobal Governance Centre$$0319297
000318763 909CO $$ooai:repository.graduateinstitute.ch:318763$$pGLOBAL_SET$$pIHEID:Explore
000318763 981__ $$aoverwrite