So, how can these vaccines be desirable to more people who need them? One way would be to subject them to a formal assessment by an international organization with technical experience. The problem today is that the World Health Organization’s own rules for vaccine certification are distorted in favor of wealthy, essentially western states.
WHO maintains a list of “strict regulatory authorities” that it relies on for quality control – all are European countries, except Australia, Canada, Japan and the United States. For the rest of the world, WHO maintains a service called prequalification. In theory, this is a way in which vaccines, say, from China or Russia could be placed on an equal footing with vaccines from the West. In reality, it is a costly and time-consuming process.
When a vaccine is developed and approved by a country on the WHO trusted list, the organization generally relies on this assessment to approve it quickly. But when a vaccine manufacturer anywhere else applies for prequalification, WHO conducts a thorough assessment from scratch, including a physical inspection of manufacturing facilities.
WHO approved the Pfizer-BioNTech vaccine in late 2020, less than two months after manufacturers requested consideration, and it is expected to decide on the Moderna and AstraZeneca vaccines this month. Chinese and Russian vaccines are still waiting in line, although review processes for those have started earlier.
During the review of the Pfizer-BioNTech vaccine, WHO worked closely with the European Medicines Agency and approved it about 10 days after EMA. There is no reason why WHO, while maintaining its standards, cannot also collaborate with health regulators in other countries to help local vaccine manufacturers go through the verification process. It must urgently give all vaccine-producing countries the attention they deserve.
Some doctors and activists have put forward proposals to increase the worldwide distribution of vaccines produced in the West. These links are well-intentioned, but they also assume that Western countries’ vaccines are the only ones worth having – and waiting for.
There is already a simpler solution: it is time to start relying on vaccines from other countries.
Achal Prabhala is coordinator of the AccessIBSA project, which campaigns for access to medicines, and a fellow at the Shuttleworth Foundation. Chee Yoke Ling is the executive director of Third World Network, an international policy research and advocacy organization based in Penang, Malaysia.