World's most vulnerable at risk due to limited, unequal vaccine supplies: WHO

By Peter Kenny

GENEVA (AA) – Inequitable distribution continues to deprive the world’s most vulnerable people of vaccines, with poorer countries consistently struggling to access vaccines wanted by wealthier nations, according to a new World Health Organization report.

Limited vaccine supply and unequal distribution drive global disparities, the WHO said in its Global Vaccine Market Report released on Wednesday.

“The right to health includes the right to vaccines,” said WHO chief Tedros Adhanom Ghebreyesus.

“And yet this new report shows that free-market dynamics are depriving some of the world’s poorest and most vulnerable people of that right. WHO calls for much-needed changes to the global vaccine market to save lives, prevent disease, and prepare for future crises.”

Manufacturing capacity worldwide has increased but remains highly concentrated, as just 10 manufacturers alone provide 70% of vaccine doses, excluding those for COVID-19, according to the report.

Several of the top 20 most widely used vaccines come from mainly two suppliers.

- Affordability, concentrated production base

The human papillomavirus (HPV) vaccine against cervical cancer has only been introduced in 41% of low-income countries, even though they have much of the disease burden, compared to 83% of high-income countries.

Affordability is also an obstacle to vaccine access, said the WHO.

While prices tend to be tiered by income, price disparities see middle-income countries paying as much – or even more – than wealthier ones for vaccine products.

Around 16 billion vaccine doses, worth $141 billion, were supplied in 2021, almost three times the 2019 market volume (5.8 billion) and nearly three-and-a-half times the 2019 market value ($38 billion), according to the report.

The increase was primarily driven by COVID-19 vaccines, showing the incredible potential of how vaccine manufacturing can be increased in response to health needs, said the WHO.

This concentrated manufacturing base leads to the risk of shortages and regional supply insecurity.

In 2021, the African and Eastern Mediterranean regions were dependent on manufacturers headquartered elsewhere for 90% of their vaccine needs.

Entrenched intellectual property monopolies and limited technology transfer further limit the ability to build and use local manufacturing capacity, the WHO said.

- Vaccines for emergencies

The health of markets for vaccines that are used to respond to emergency outbreaks should be viewed individually, since the risk of a surge in demand is high, and the size of the need highly variable, the report said.

The continued limited investment in vaccines such as against cholera, typhoid, smallpox or monkeypox, Ebola, and meningococcal disease can devastate people’s lives, it added.

The WHO report highlights opportunities for alignment of vaccine development, production, and distribution with a public health plan.

COVID-19 proved that vaccines could be developed and distributed rapidly; a process that takes an average of 10 years and has never taken less than four years was compressed to 11 months, it added.

The pandemic also exposed the longstanding need to recognize vaccines as a fundamental and cost-effective public good rather than a commodity, the report further said.