The World Health Organisation (WHO)’s Global Vaccine Market Report 2022, the first to examine the impact of COVID-19 on the global vaccine market, shows that inequitable distribution is not unique to COVID-19 vaccines, with poorer countries consistently fighting to access vaccines in demand by wealthier countries.
The WHO stated that limited vaccine supply and unequal distribution is driving global inequalities. The human papillomavirus (HPV) vaccine against cervical cancer has only been introduced in 41% of low-income countries (LICs), despite representing most cases of the virus, compared with 83% of high-income countries (HICs), a European Pharmaceutical Review report says.
The report found affordability was another obstacle to vaccine access. While prices tend to be tiered by income, price disparities mean middle-income countries (MICs) are paying the same or even more than wealthier countries for several vaccine products.
“The right to health includes the right to vaccines,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “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 is calling for much-needed changes to the global vaccine market to save lives, prevent disease and prepare for future crises.”
COVID-19’s impact on vaccine access
The document showed that in 2021, approximately 16bn vaccine doses, worth $141bn, were supplied across 47 vaccines and 94 manufacturers. This is almost three times the 2019 market volume (5.8bn), nearly three-and-a-half times the 2019 market value ($38bn). This surge was primarily driven by COVID-19 vaccines, demonstrating the potential of rapid vaccine manufacturing scale up in response to health needs.
For instance, a process lasting an average of 10 years but never less than four years was compressed to 11 months.
WHO noted that although manufacturing capacity worldwide has grown, it continues to be highly concentrated. Ten manufacturers globally provide 70% of vaccine doses (excluding COVID-19). Several of the top 20 most extensively used vaccines, such as vaccines containing PCV, HPV, measles and rubella, currently rely primarily on two suppliers. It observed that this concentration can create the risk of shortages and regional supply insecurity.
Achieving Immunization Agenda 2030 goals
The report highlighted opportunities for more alignment of vaccine development, production and distribution with a public health agenda, towards achieving the Immunisation Agenda 2030 (IA2030) goals and informing pandemic prevention, preparedness and response efforts.
To drive ambitious action to deliver equitable vaccines access, the report called on governments to:
• Support the development of clear immunisation plans, more aggressive investment and stronger oversight of vaccine development, production and distribution
• Act on regional research and manufacturing hubs
• Pre-agree rules for government collaboration during shortages on vaccine distribution, intellectual property and the circulation of inputs and goods.
The report recommended that the industry focuses research efforts on WHO priority pathogens, ensuring transparency, facilitating technology transfer and committing to specific equity-driven allocation measures. It encouraged international organisations and partners to prioritise IA2030 goals, support country-driven initiatives and push for the application of resolutions on market transparency.
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