Risk of a never-ending cycle of pandemics

While in many Western countries, a large proportion of the population has already received three vaccines and governments are even considering the merits of a fourth dose, more than 40 poorer countries have vaccination rates in the single figures. Many of these countries haven’t even yet managed to vaccinate health workers or high-risk groups.

“The world risks getting stuck in a never-ending cycle of pandemics, with new variants cropping up again and again,” says Holzscheiter.

global demand is rising sharply

She says there are two important steps we must take: sharing knowledge and technology across the world and temporarily lifting the patent on COVID-19 vaccines and treatments.

There have been calls to lift the patent from the moment the vaccines were developed. But Omicron has ignited the debate again, with countries such as India and South Africa calling for the patent to be lifted so that the vaccines can be manufactured elsewhere in the world and poorer countries will no longer be dependent on donated vaccines, which sometimes only reach the country shortly before their expiration date.

Boosters multiply demand

“It’s not about taking the vaccine away from the companies that developed it,” says Holzscheiter. “The argument that lifting the patent wouldn’t necessarily result in higher production has already been disproven.” She says a report by Human Rights Watch has shown that more than 100 companies outside of Europe and North America would be capable of manufacturing the mRNA vaccines on a large scale, including eight in Africa.

In 2021, around 11 billion vaccines were produced across all manufacturers, and in 2022 that number may well rise. “The argument is that enough vaccines are being produced, and that they simply need to be shared out — but that simply isn’t true,” says Elisabeth Massute from Doctors Without Borders, arguing that this estimation was based on the assumption that people would only need two doses each. “With boosters and the possibility of targeted vaccines against new variants, global demand is rising sharply."

It also seems that the Chinese vaccine, which billions of people have received, is significantly less effective against Omicron. This means that the mRNA vaccines produced by BioNTech and Moderna are even more important than before.

But those companies have their own plans to combat the shortage, especially in Africa. Instead of lifting the patents, they want to produce the vaccine locally themselves, for example in Rwanda, where BioNTech plans to manufacture 50 million doses in 2022.

In the long term, this capacity could rise to “hundreds of millions of doses”. That is the plan, at least. But it’s not clear when the first doses will be ready, and the companies did not respond to our requests for comment.

Not an easy way out

Until vaccines can be manufactured locally, the whole African continent will remain dependent on donations. That means many vaccine doses are being destroyed – most recently, more than a million doses of AstraZeneca in Nigeria, because they didn’t reach the country until shortly before their expiration date.

“The vaccine donations often come at short notice and are unreliable," Massute says. "Many poorer countries are not going to invest millions in a vaccination program if they’re not sure when they’ll receive the vaccines, or how many doses they’ll get.”

Manufacturers should assume liability for their own products.

She says that, where necessary, richer countries should offer financial, technical and logistical support. Another problem is widespread vaccine hesitancy in some countries.

What complicates the situation further is that donations of the BioNTech and Moderna vaccines have to first be approved by the manufacturer, as they want to minimize their liability in the target countries. It’s not clear what exact risk they’re looking to protect themselves against.

The EU is keeping the contracts under lock and key, and neither BioNTech nor Moderna will answer questions. Massute concludes: “Given the massive amount of data available from numerous studies, which show the vaccines are safe, it makes no sense for the manufacturers not to assume liability for their own products.”