International Collaboration to Ensure Equitable Access to Vaccines for COVID-19: The ACT-Accelerator and the COVAX Facility.
International Collaboration to Ensure Equitable Access to Vaccines for COVID-19: The ACT-Accelerator and the COVAX Facility.
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DOI：
10.1111/1468-0009.12503
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Upton H
中科院分区：
文献类型：
--
作者：
Eccleston-Turner M;Upton H
在所有国家公平获得COVID-19疫苗仍然是一个关键的政策目标，但以往大流行的经验表明，尽管三种成功的候选疫苗迅速开发，但发展中国家的获得将受到限制。COVAX基金寻求解决这一重要问题，但疫苗民族主义的盛行可能会限制该基金实现其资金目标和雄心勃勃的疫苗采购目标的能力。如果不能充分解决发展中国家基础设施的根本缺乏问题，可能会进一步限制COVAX基金的成功。本集团一直致力研发新型冠状病毒疫苗，该疫苗被视为摆脱疫情的途径。这些努力大部分集中在COVAX上，这是一项多边倡议，旨在加速COVID-19疫苗的开发，并确保它们在低收入和中等收入国家（LMIC）中公平可用。本文代表了COVAX的第一个重要分析，以及它在多大程度上可以说已经成功地实现了这些目标。本文借鉴了COVAX倡议提供的公开政策文件，以及世界各国政府关于COVID-19疫苗和公平获取的立场文件和公开声明。我们分析了H1N1流感大流行期间有关疫苗获取的学术文献。最后，我们考虑世界卫生组织全球分配系统及其原则，旨在指导COVAX疫苗的部署。我们认为，COVAX支柱部署的资金机制似乎有效地促进了在临床疗效确认之前对研发和剂量生产的风险投资，但警告说，这对疫苗制造商来说是一个双赢的局面，无论他们的候选疫苗是否获得监管批准，都为他们提供了受益的机会。我们还认为，COVAX基金在公平获得疫苗方面的成功可能是有限的，主要是由于疫苗民族主义的流行，各国采取的政策严重优先考虑自己的公共卫生需求，而牺牲他人。目前通过COVAX的努力大大加快了针对COVID-19的疫苗的开发，但这些好处不太可能流向中低收入国家，主要是由于疫苗民族主义的威胁。
Equitable access to a COVID‐19 vaccine in all countries remains a key policy objective, but experience of previous pandemics suggests access will be limited in developing countries, despite the rapid development of three successful vaccine candidates. The COVAX Facility seeks to address this important issue, but the prevalence of vaccine nationalism threatens to limit the ability of the facility to meet both its funding targets and its ambitious goals for vaccine procurement. A failure to adequately address the underlying lack of infrastructure in developing countries threatens to further limit the success of the COVAX Facility. Significant effort has been directed toward developing a COVID‐19 vaccine, which is viewed as the route out of the pandemic. Much of this effort has coalesced around COVAX, the multilateral initiative aimed at accelerating the development of COVID‐19 vaccines, and ensuring they are equitably available in low‐ and middle‐income countries (LMICs). This paper represents the first significant analysis of COVAX, and the extent to which it can be said to have successfully met these aims. This paper draws on the publicly available policy documents made available by the COVAX initiatives, as well as position papers and public statements from governments around the world with respect to COVID‐19 vaccines and equitable access. We analyze the academic literature regarding access to vaccines during the H1N1 pandemic. Finally, we consider the WHO Global Allocation System, and its principles, which are intended to guide COVAX vaccine deployment. We argue that the funding mechanism deployed by the COVAX Pillar appears to be effective at fostering at‐risk investments in research and development and the production of doses in advance of confirmation of clinical efficacy, but caution that this represents a win‐win situation for vaccine manufacturers, providing them with opportunity to benefit regardless of whether their vaccine candidate ever goes on to gain regulatory approval. We also argue that the success of the COVAX Facility with respect to equitable access to vaccine is likely to be limited, primarily as a result of the prevalence of vaccine nationalism, whereby countries adopt policies which heavily prioritize their own public health needs at the expense of others. Current efforts through COVAX have greatly accelerated the development of vaccines against COVID‐19, but these benefits are unlikely to flow to LMICs, largely due to the threat of vaccine nationalism.
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影响因子：
2.1
作者：
Gostin, Lawrence O.;Karim, Safura Abdool;Meier, Benjamin Mason
通讯作者：
Meier, Benjamin Mason
影响因子：
0.6
作者：
Eccleston-Turner, Mark
通讯作者：
Eccleston-Turner, Mark
影响因子：
4.4
作者：
Hessel, Luc
通讯作者：
Hessel, Luc
DOI：
10.1016/s0140-6736(20)32623-4
发表时间：
2021-01-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Knoll MD;Wonodi C
通讯作者：
Wonodi C
影响因子：
3.8
作者：
Crommelin DJA;Anchordoquy TJ;Volkin DB;Jiskoot W;Mastrobattista E
通讯作者：
Mastrobattista E