'All for one, one for all' to get a Covid-19 vaccine - How about for climate change too?

Covax has nine candidate vaccines in development, with a further nine under evaluation.PHOTO: REUTERS

The annual cycle of regional and global summits that traditionally takes place every November sees a flurry of air travel on the part of leaders and their officials, and is an indicator of some of their pressing concerns – from trade deals to skills development.

Last year, Asean leaders and their key partners meeting in Bangkok resolved to press on to conclude a region-wide trade pact even as India dropped a bombshell by saying that it was pulling out of the deal.

Then, officials’ plans to make it to Santiago for the Asia-Pacific Economic Cooperation (Apec) summit and the United Nations Climate Change Conference, or COP 25, were scuppered as mass protests crippled Chile’s capital and forced these scheduled meetings to be aborted.

This year, as the coronavirus ground air travel to a near halt, face-to-face diplomacy has had to take a backseat.

Yet the pandemic has led to some positive outcomes.

It has pushed countries negotiating the Regional Comprehensive Economic Partnership past the finish line, as they signed the agreement one-by-one, virtually, at a summit hosted by Vietnam on Nov 15. This brings about the formation of the world’s largest free trade area.

Several days later, on Nov 20, Apec leaders reached agreement on a joint declaration – their first in three years, as their 2018 summit failed to reach consensus because of US-China trade tension.

Covid-19 appears to have given countries a hard reality check; not just on the need to remain open and work towards lowering barriers to trade, but also as a reminder of the need for multilateralism, and for stepped-up coordination and cooperation – from ensuring sufficient essential medical supplies and sharing information on diseases to developing and distributing vaccines.

This is crucial.

As the Apec leaders noted in the Kuala Lumpur declaration issued minutes after their virtual meeting ended a week ago: “Our coordinated action and cooperation are more important than ever to overcome the challenges of Covid-19 and realise new and emerging opportunities for prosperity for all.”

They also acknowledged that science, technology and innovation are important to the region’s post-Covid-19 recovery, saying: “We reaffirm the need to cooperate constructively on Covid-19 including the research and development, production, manufacturing and distribution of diagnostic tests, essential medical products and services, therapeutics and vaccines.”

The leaders added: “We highlight the importance of facilitating equitable access to safe, quality, effective and affordable vaccines and other medical countermeasures that are vital to safeguard people’s health and well-being, while incentivising innovation. We acknowledge that the role of extensive immunisation against Covid-19 is critical in order to bring the pandemic to an end.”

Vaccine multilateralism

The rapid global spread of Covid-19 – with over 61 million cases and more than 1.4 million deaths to date – underscores the importance of the widely repeated saying: “No one is safe until everyone is safe.”

As countries began locking down borders earlier this year, the World Health Organisation (WHO), various governments and a number of organisations joined forces to accelerate the development of tests and vaccines.

One significant outcome has been the Covid-19 Vaccine Global Access (Covax) facility, which works to support the research, development and manufacturing of a wide range of vaccine candidates, and negotiate their pricing.

Singapore has backed this effort, co-founding with Switzerland a Friends of the Covax Facility group that brings together a number of like-minded countries to underline the importance of vaccine multilateralism.

The concept behind Covax – started by Gavi, the Vaccine Alliance, a foundation that began 20 years ago to improve access to vaccination for children living in the world’s poorest countries; the Coalition for Epidemic Preparedness, which was launched in 2017 by the governments of Norway and India as well as the Bill and Melinda Gates Foundation; and the WHO – is that countries pool funds to invest in strong vaccine candidates, helping manufacturers scale up promising ones, and ensuring that participating countries get equal access to vaccines once these are developed.

The initial aim is to scale this up to two billion doses – a figure slightly over 25 per cent of the world’s population – of safe, effective vaccines that have passed regulatory approval, WHO pre-qualification, or both, by the end of next year.

If achieved, this should be enough to protect high-risk and vulnerable persons, including front-line healthcare workers.

Dr Seth Berkley, CEO of Gavi, explains: “We don’t just need Covid-19 vaccines, we also need to ensure that everyone in the world has access to them.”

Otherwise, “there is a very real risk that the majority of people in the world will go unprotected against Sars-CoV-2, and this would allow the virus and its impact to continue unabated”.

There is also the concern that larger and better-off countries would strike arrangements with manufacturers to monopolise a lion’s share of vaccines as they become available.

Under Covax, once any of the vaccines in its portfolio have successfully undergone clinical trials and proved themselves to be both safe and effective, and have received regulatory approval, available doses will be allocated to all participating countries at the same rate, proportional to their total population size.

A small buffer of about 5 per cent of the available doses will be kept aside for a stockpile to help with acute outbreaks and to support humanitarian groups, for example, those helping refugees who may not otherwise have access to a vaccine.

An advance market commitment also helps ensure that 92 middle- and lower-income countries which cannot afford to fund the vaccines themselves will get equal access to the vaccines as the 97 higher-income economies that can pay their way – and get them at virtually the same time.

Dr Berkley noted that the vast majority of vaccines undergoing development are likely to fail.

Based on previous vaccines, those at the pre-clinical trial stage have a roughly 7 per cent chance of succeeding, while the ones that make it to clinical trials have about a 20 per cent chance.

Covax has nine candidate vaccines in development, with a further nine under evaluation.

There are now more than 180 countries that have signed on to the Covax facility.

The United States, which has withdrawn from the WHO, is not one of them, having decided to strike its own deals with vaccine developers. America’s Operation Warp Speed has set the goal of delivering 300 million doses starting next January.

The environment matters too

January is also the month that America’s next president takes office. And while few expect Mr Joe Biden to change course entirely, there are hopes that he will signal greater support for multilateralism.

Mr Biden has pledged to reverse President Donald Trump’s decisions to withdraw from the WHO as well as the Paris Agreement on climate change.

The pandemic has deferred the next major UN climate gathering, COP 26, to next November, to be held in Glasgow. But it has also seen governments pay greater attention to the environment and sustainability.

The sharp drop in air travel has led to a reduction in emissions this year, and the disruption in supply chains forced many to revisit the issue of resilience.

It will likely be some time before we see a resumption of global, let alone regional, travel to 2019 levels, and before societies can dial back on measures such as safe distancing and mask wearing.

But when we do, we should not return to old patterns of operating that may have framed the issue as one of efficiency over health, or economics over the environment.

These are interlinked considerations that have to be carefully balanced, rather than be competing priorities.

Apec’s policy support group drew attention to this calibration that had to be struck in its report this month.

“Covid-19 has mercilessly exploited old challenges of environmental damage and growing inequality that have not been adequately addressed. Environmental damage through deforestation, logging and mining increases our exposure to diseases by increasing human-to-animal contact. Infectious diseases with zoonotic origins, such as Covid-19, are a side effect of unsustainable practices. The frequency and severity of diseases are also affected by changes in climate patterns, with rising temperatures providing ideal conditions for the spread of pathogens and disease vectors,” it said.

Regional cooperation and collaboration will have a key role to play in the process of rebuilding and recovery, the report added.

“In a year like no other, the region has been compelled to rethink how it works, how it learns, and what it prioritises. The region needs to invest in green jobs and infrastructure, shift away from a fossil fuel economy, and internalise environmental and climate impact into economic production.

“It needs to ensure equitable access to healthcare, infrastructure, technology, and education and skills development to enable all people to contribute to and benefit from economic opportunities. It needs to maximise the potential of the digital economy through innovation and competition, but at the same time address potential adverse impact on jobs and incomes in the pursuit of an equal and inclusive society.”

Investing in what is key, enabling innovation and competition and ensuring equal and inclusive access to benefits – these are also critical elements of the multilateral effort to vaccinate the world against Covid-19 and enable economies to rebuild and recover from their worst crisis in decades.

If the effort succeeds, as many are banking on it to, one hopes this will also provide the impetus for continued cooperation to tackle other global problems, including the climate challenge.