Why pooled procurement of Covid-19 vaccines is important

Roselyne Sachiti

Features, Health & Society Editor

Southern African Development Community (Sadc) chairman and Mozambican President Filipe Nyusi last Friday recommended the pooling of resources in the region for the collective procurement and distribution of Covid-19 vaccines for member states.

In a statement on the Covid-19 pandemic, President Nyusi said the initiative will be led by Sadc’s Committee of Health Ministers.
“In this regard, we recommend the Sadc Committee of Ministers of Health to establish a strong regional collaborative strategy which pools resources together to urgently acquire the vaccine for distribution to our citizens setting priorities in accordance with the level of risk and enhance vaccine research capabilities and develop regional manufacturing capacity for vaccines in the future,” President Nyusi said.
The SADC chairman also said the region must intensify cooperation and collaboration between member states, through increased data sharing, policy harmonisation and standardisation, pooled procurement of essential medical and non-medical equipment to address the pandemic in a more effective way.
Given the increasing Covid-19 cases and deaths on the continent and the SADC region in particular, President Nyusi’s call for pooled procurement is most welcome and the best way forward.
As at February 3 the SADC region had 1 715 854 cases, 49 849 deaths and 1 512 352 recoveries according to Africa Centres for Diseases Control and Prevention (Africa CDC).
South Africa had 1 458 958 cases, 44 946 deaths and 1 318 504 recoveries.
Zambia had 56 233 cases, 794 and 49 696 recoveries.
Zimbabwe had 33 814 confirmed cases, 26 794 recoveries and 1,254 deaths as at February 3.
Regional integration is needed to contain the Covid-19 pandemic and the 16 SADC member states should also collaborate in terms of pharmaceutical research.
The full implementation of the SADC Pooled Procurement Services for pharmaceuticals and medical supplies to provide sustainable availability and access to affordable and effective essential medicine and health commodities which was recommended at the start of the pandemic last year is also critical.
While the SADC secretariat cannot push Member States to implement the SADC Pooled Procurement Services for pharmaceuticals and medical supplies, but can only advise and provide information, it is more important than ever for Member States become each brother’s keeper.
The advantage of buying in bulk as a region means negotiating for economic prices, and there are opportunities to go and bid as a block and buy bulk commodities and negotiate for a good price.
To avoid procurement bottlenecks, it is also critical for Africa and the SADC region to develop its own vaccines.
Speaking during the official opening of the extra ordinary meeting of ministers of health and those
responsible for HIV and Aids on January 21 Sadc Executive Secretary Dr Stergomena Lawrence Tax called for heightened efforts in enhancing research and pharmaceutical capacities.

“In the last few months a number of vaccines have received regulatory approvals, and prequalification by the WHO. It is nonetheless, unfortunate that, we are yet to have a vaccine or cure that has been developed within the region, all the vaccines that have received regulatory approvals, and prequalification by the WHO are from non-SADC and non-African countries,” she said.
She added that under the circumstances, SADC and other African countries have to depend on the mercy of these countries.
“This calls for heightened efforts in enhancing our research and pharmaceutical capacities. Covid-19 has been one of the tests of lives, and a wake-up call for Africa, as a region we must establish strong regional collaborative strategies, which pools resources together for the enhancement of research capabilities, and capacitation of our pharmaceutical sub-sector, and regional manufacturing capacity in other sectors that are key to our socioeconomic development and the livelihoods of our people,” added Dr Lawrence Tax.
The chorus on the need to avoid ring fencing globally, especially by developed countries and to pool resources is getting louder with global experts speaking.
The African Union (AU) has also come out with strong statements that they want to see 60 percent of all African countries populations protected with vaccination. AU is pushing very hard with vaccine developers to try to get access to the vaccines through COVAX and their own negotiations. COVAX, is the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level.
Speaking after receiving South Africa’s first consignment of Covid-19 vaccines on Monday, South African President Cyril Ramaphosa who is also chairperson of the African Union (AU) said the regional block has been negotiating with manufacturers to secure vaccines for the entire continent on a pooled basis.

“Through the African Vaccine Acquisition Task Team of the African Union, we have to date secured 1 billion vaccines for the entire continent.
“Seven hundred million of these will come from the global COVAX facility and 300 million have been facilitated by the African Vaccine Acquisition Task Team. We will be getting other vaccines that will be donated by various private sector companies to add to the vaccines that our continent needs,” he said.

Speaking to journalists during a media roundtable at the International Aids Society (IAS) COVID-19 Conference: Prevention on Monday, director of the National Institute of Allergies and Infectious Diseases of the United States (NIAID), who is also one of the main researchers in Covid-19, Dr Anthony Fauci, said to stop the pandemic, every country in the world should be protected.

According to Dr Fauci, the impact of a vaccine is not only due to its efficacy, but also “to the coverage that we give to vaccination.”
He said if there is a reduction in efficacy it can be attacked if more people are vaccinated.

“But, we will only have light at the end of the tunnel if we implement a global programme to protect the whole world, not just the rich countries, the whole planet. If you only protect your country without protecting the world, the pandemic will go on and on,” he added.

He said: “When you’re in a public health crisis, you’ve got to pull together, everybody rowing in the same direction. Otherwise, you’re not going to stop what is now as we all know, this historically destructive pandemic that we’re dealing with.”
Dr Fauci, who is also US President Joe Biden’s top coronavirus advisor called for greater investments in vaccine production, saying it is in everyone’s interest for the world to be immunised as soon as possible.
IAS past president Dr Linda-Gail Bekker who is also an infectious disease specialist from the University of Cape Town, South Africa said: “If we know that the efficiency has gone down we must make sure that we reach more people, and thus the transmission will go down. That is why it is important to make sure that production increases and can reach all corners of the world.”

In an interview with The Herald, Community Working Group on Health (CWGH) Zimbabwe Executive Director, Itai Rusike, said many developing countries are facing the prospect of delays and significant cost barriers in accessing vaccines, medicines and diagnostics to control the Covid-19 pandemic.

He said in the face of the prospect of delays and cost barriers, the rapid scaling up of local production where feasible could make a big difference to pandemic control in developing countries.

“Scaling up of local production would be greatly facilitated by waiving compliance with the Section 1,4,5, and 7 of Part ll of the TRIPS Agreement (dealing with copyright, industrial designs, patents, and the protection of undisclosed information) in relation to Covid-19 and for the duration of the pandemic,” suggested Mr Rusike.

He added: “Three main arguments were brought forward by countries opposing the waiver when it first considered by the TRIPS Council: (i) that Intellectual property protection is not a barrier to wider access to Covid-19 health products (ii) that the flexibilities already provided for in the TRIPS Agreement are not well suited to the task of scaling up across a range of health products and involving collaborating groups of countries.”

In fact, Mr Rusike further suggested, the proposed waiver would only apply to Covid-19 products; would only apply for the duration of the pandemic; and would only apply to those countries who chose to make use of it.
“It is most unlikely that allowing limited waiver proposed would materially affect commercial incentives to invest in innovation for Covid-19 products during the pandemic.
“The proposed waiver would only apply to countries who chose to make use of it. Intellectual property rights would remain untouched in countries who chose not to make use of the waiver,” he added.
Mr Rusike said countries whose access to Covid-19 products is secure should not stand in the way of those countries who need the policy space to scale up local production in the face of the very real threat of delays and cost barriers and the consequential morbidity and mortality.

While recognising the need for countries to secure vaccines for their populations, there is equally a need for continued regional dialogue and measures to ensure strong cooperation on regional needs, and between relevant national authorities, appreciating that the region is not collectively secure until all its countries and communities are vaccinated.
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