Dr Seth Berkley, CEO of Gavi, the global alliance pursuing vaccine equity, wrote in the Financial Times in October 2022 of the need for improved access to vaccines. Dr Berkley has been CEO since 2011, during which time he has drawn on his epidemiology experience to “lead Gavi in its mission to improve access”. Despite the remarkable achievements of the organisation, he believes the vaccine community as a whole has a long way to go, particularly considering the increasing risk of future pandemics.  

A “taste” of the future 

Dr Berkley warns that despite the continued distribution of boosters and updated doses, “this pandemic is far from over”. When we do finally lift our heads above the parapet, he is concerned that there will be future threats to face.  

“Driven by climate change, migration, and other global trends, infectious disease is a growing threat to our lives and economies. Vaccines are our strongest defence by far.” 

Despite the recognisable benefits of rapid vaccine development, it is no use creating these powerful tools if they can’t be used globally. Dr Berkley identifies “geopolitical and economic factors” as determinants of vaccine equity.  

“One of the largest barriers to global, equitable access to vaccines – and arguably one of the biggest chinks in our pandemic-preparedness armour – is market failure.”  

Market failure 

Dr Berkley refers to the 2009 swine flu crisis, during which “a few wealthy governments rapidly bought up almost the entire global supply” of shots. Thus, during COVID-19, Covax was created. A “mechanism” for access, it was intended to “ensure ability to pay did not determine whether people received the protection they needed”. Although we can celebrate the successes of Covax, it “hasn’t been an easy journey”.  

“The scale of vaccine hoarding, export restrictions, and the complete lack of transparency among manufacturers seriously hindered the global supply of vaccines”  

Market failure is “not unique to pandemics”, Dr Berkley suggests. To deal with it, Gavi creates a “pool” of demand, which gives “certainty” to incentivise manufacturers. Furthermore, it encourages new vaccine developers to enter the market, which “stimulated innovation and competition”. As a result, more than 16 million deaths have been prevented. However, “more interventions” are needed in the future.  

“Covid has triggered a renaissance in vaccine development”. 

Regional supply 

Although the future of vaccines is busy, regional supply is another market failure that concerns Dr Berkley. He suggests that only 0.1% of the global supply of vaccines comes from Africa, despite a great need. Consequently, African nations struggle to compete for necessary vaccines, as we saw with the Covid jabs, which “cost lives”.  Going forward, there are more than 30 vaccine initiatives in Africa, one of which we explored here. Gavi is also contributing, trying to balance sustainable market entries with competitive development.  

“The increasing risk posed by infectious diseases means equitable access to vaccines must become a priority.” 

For Dr Berkley, this can’t be delayed. We must learn from our experience with COVID-19, in which millions died from a “vaccine-preventable disease”.  

“When science delivers, markets must too”. 

We will hear from several Gavi speakers at the World Vaccine Congress in Washington next year. If you would like to join us, get your tickets now.