The COVID-19 pandemic is at a critical point, with at least two effective vaccines in the pipeline as a second wave of the pandemic rears its head. Indeed, the Pfizer/BioNTech vaccine has received the regulatory go-ahead for emergency use in the U.K., with U.S. approval expected to be close behind. Moderna is also close to bringing its version of a vaccine to market.
But without distributing the vaccine to low to middle-income countries, the economic damage from COVID-19 threatens to undo the economic progress of the entire world, according to the World Health Organization. PwC has published a report on “turning vaccines into vaccinations,” which is precisely the focus of organizations like the World Bank Group.
Meanwhile, as developed countries inch closer to a viable vaccine distribution strategy, the World Bank is warning us that much of the economic damage from COVID-19 has already been done. As many as 150 million people are at risk of falling into “extreme poverty” by year-end 2021, according to a recent update by World Bank Group President, David Malpass.
The vaccines are considered to be the solution to the one-two punch of COVID-feuled poverty and loss of life. Here is an urgency to reach everyone, including people in developing countries, as soon as these remedies become available. Countries like the United States, Canada, and the UK are preparing to distribute the vaccine straight away. These populations could be vaccinated in as little as six months’ time.
But now that the vaccines are close to being ready, there is yet another hurdle — getting them to developing countries and the low and middle-income populations of the world who so desperately need them. Otherwise, it could be years before the populations of the developing world are immunized. According to Malpass, there are things that can be gleaned from past pandemics that could pave the way for the mass distribution of vaccines.
The World Bank is stepping up to fill the funding gap, having green-lighted as much as USD 12 billion to be directed toward getting vaccines, tests, and treatments to developing countries. The World Bank’s private-sector development arm has earmarked another USD 4 billion for vaccine makers and relevant supplies for low and middle-income countries. They’ve also got a foothold in developing countries where they are sharing their expertise on issues ranging from healthcare to vaccine distribution logistics.
The Washington, D.C.-based organization has outlined a trio of themes that will be critical to reaching its goal of “supporting vaccination for up to a billion people.” This includes the logistics, delivery, and public acceptance of those vaccines.
On the logistics front, the World Bank is looking to governments to bolster their transportation and storage capacities to support “an unbroken cold chain for vaccines.” That is because the vaccines being developed by Pfizer and Moderna have very stringent storage requirements. The Pfizer product must be kept very cold, at minus 70 degrees Celsius in freezers that have earned the nickname “the pizza box,” while the Moderna version can be stored in a more traditional freezer at a temperature of minus 20 degrees Celsius. Getting Pfizer’s drug is expected to be more pricey and challenging, though Africa is a case study in what can be done.
Africa implemented a successful model for transporting the Ebola vaccine, which similarly required “ultra-cold chain storage,” according to Debra Kristensen, director of vaccine technology strategy and policy at PATH, cited by NPR. Western and Central African nations distributed the Ebola vaccine that needed to be stored at a temperature of negative 60 degrees Celsius, using a combination of dry ice packs and motorbikes to transport the vaccine to the remote forest regions in countries like Guinea.
The second rung to the vaccine ladder is delivery. While it is common for most countries to immunize babies, this practice is less prevalent among adults. So countries will need to develop their own priority list to determine who will be receiving the vaccine in what order, like healthcare workers and baby boomers, for instance, as well others who are most vulnerable, such as those with preexisting conditions.
This will place a strain on most countries as they also look to continue other healthcare services that have suffered as a result of COVID. For instance, Canada — which has already secured millions of doses — has said once the vaccine gets the necessary approvals, it will distribute it to the most vulnerable segments of its population first. But country officials reportedly admit that the nationwide rollout won’t be easy:
“In a country as geographically large and diverse as ours, we are facing some logistical complexities,” said Dr. Howard Njoo, Canada’s Deputy Chief Public Health Officer quoted by Reuters.
Complicating things further, getting the vaccine is not a one-time deal. Countries will need to implement tracking systems to be sure that the dosage is complete, given that a second dose of the vaccine will likely be needed. The World Bank uses Pakistan as an example, for which it supported the distribution of the polio vaccination via digital data tools that helped to identify infections, distribute vaccinators to them, and monitor progress. Digital technologies can help to curb theft and reduce the chance of fraud when handling these vital vaccines.
The third pillar is public acceptance. While it might seem like a foregone conclusion that governments would pursue the COVID vaccines, some might be hesitant to implement a new medicine that was developed as part of a project called “Operation Warp Speed” using emerging technology. Once again, the World Bank harkens back to the Ebola epidemic of 2018 in which trust in the immunizations was paramount. The Democratic Republic of Congo addressed this by infiltrating communities with its staff, educating the locals and religious leaders about the process, and dispelling the myths.
The World Bank is dedicated to a similar process in which it will assist in preparing dozens of countries to distribute the COVID-19 vaccines. A couple of countries that need the most attention are Yemen and Ethiopia, both of which are lacking adequate facilities, medical supplies, and equipment. The World Bank has already made a difference in the preparedness of Egypt and Afghanistan, in addition to helping countries in Latin America, Africa, and Eastern Europe purchase medical equipment.
Developing a COVID-19 vaccine is one thing. But “turning vaccines into vaccinations,” as described by PwC, is something else entirely. This is what The World Bank as well as many other organizations are trying to do.