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Are COVID-19 vaccine purchases from private companies convenient?

From this moment on, the race began among different pharmaceutical companies to obtain a vaccine and as of March of 2020, the American biotechnological company, Moderna was the first to announce they had a development and would begin with the trials; that same day, the stocks of this company increased value.

In this scenario, in April of last year, the COVID-19 Vaccines Global Access (COVAX) was established as an alliance supported by private and public funds aimed at equitable access to COVID-19 vaccines and led by UNICEF.

The main public actors are the countries and international organizations such as the World Health Organization (WHO), and the World Bank (WB). Also, private, civil society, and philanthropic associations, such as the Gavi - the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), the Global Fund, the Bill and Melinda Gates Foundation, the Welcome Fund, the Foundation for Innovative New Diagnostics (FIND) and Unitaid, a global health agency engaged in finding innovative solutions to prevent, diagnose and treat diseases more quickly, cheaply and effectively, in low- and middle-income countries.

But additionally, to the COVAX mechanism, the developed countries such as the United States, France, the UK, and China, among others, donated great amounts of money to the pharmaceutical companies to accelerate the process and have their vaccines.

Colombia contributed US $214M to COVAX.

Many people question how vaccines that in normal conditions would have taken at least 5 years to develop were achieved in record times, that is, less than a year. This is explained by the technology using messenger RNA (mRNA) which was being tested on other vaccines and its mass production is relatively easy.

Without the pressure of having to solve the problem and without the great sums of money contributed by many governments these companies would not have developed these vaccines in such a short time. The other explanation is that the safety tests, which should have taken at least a year to identify long-term side-effects was shortened and there was only a three-month follow-up.

These explanations are necessary to contextualize what we want to convey in this article: vaccines do not only have consequences in the biological realm but also the political and economic scenario.

Although the pharmaceutical companies are for-profit-enterprises supported by a legal scope in every country, it is inconceivable that after the governments funded the development of a vaccine, they will end up selling at differential prices, giving priority to countries that purchase quantity and at a greater price.

Due to the pressure from local governments (Bogotá, Cali, and Medellín among others) and some businessmen, the Colombian government will issue a regulation that opens the door to the private sector to purchase vaccines.

On one hand, the sector says it wants to support the country with its vaccination plan, and with a successful experience in the United States and the UK, to accelerate the immunization process, and on the other, they want to purchase vaccines to immunize their employees and family members with the argument of not stopping production and therefore reactivating and recovering the already battered economy left by indiscriminate and prolonged quarantines. However, the pharmaceutical companies already have their production up to the second quarter of this year pledged, and if they sped-up and optimized the process, they will surely sell vaccines to private parties for the third quarter of this year.

From the technical perspective, purchasing vaccines should include rigorous logistical aspects such as storage, distribution, management, and waste disposal. The question is if these private sectors have the technology to guarantee the cold chain, or if they have the transportation or appropriate locations for their distribution, if they have qualified personnel to apply the vaccine and the medical staff to respond in case of an allergic reaction that requires immediate medical attention and finally if they have a plan in place to recover and adequately dispose of the waste of the vaccination program, such as syringes, needles, dressings, and non-used or deteriorated product.

This implies a big challenge which possible these companies are not prepared to take, accepting that the consequences of an unfortunate event could be catastrophic for public health and particularly to the Colombian Vaccination Plan.

In the economic aspect, this process would increase inequality, as access would be provided not for risk prioritization, but there would be a struggle for obtaining dosages at whatever price, and obviously, people with greater purchasing-power would be the ones getting the vaccines. It is suspected that the surpluses of these purchases will turn into a business for those who buy them, therefore there should be a price control in place, an aspect which has not been even considered yet.

Public health is the responsibility of the State and it is not convenient to commission the private sector.

We already know the consequences of privatizing healthcare. They could be vaccinating people that don’t need it (youngsters without con-morbidities, for instance) and then lose the objective of the national vaccination plan and access to the vaccines would be given due to market logic, in other words, offer and demand.



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