School of Public Health, University of Nevada Reno, Reno, NV, USA.
Department of International Relations, Federal University of Paraiba, João Pessoa, Brazil.
Int J Health Policy Manag. 2022 Dec 19;11(12):3101-3113. doi: 10.34172/ijhpm.2022.6942. Epub 2022 Aug 20.
An effective response to the coronavirus disease 2019 (COVID-19) pandemic entails a comprehensive strategy that ensures equitable access to all COVID-19-fighting technologies. To achieve this goal, the international community has acknowledged immunization as a public good. However, a trend of grossly unequal dose distribution emerged, owing, among other factors, to pharmaceutical companies' profit-driven actions, jeopardizing the mechanisms built to increase vaccine access. The contradiction between public health interests and corporate discretion in determining vaccine dose distribution poses critical concerns about the health risks associated with lengthening the duration of the pandemic and the eventual liability of companies for violations of human rights.
To evaluate the risks posed to the COVID-19 immunization program, data on vaccine allocation and delivery, vaccine dose application, immunized populations, and the volume of Advanced Purchase Agreements (APAs) between countries and pharmaceutical companies were compiled and assessed. A descriptive analysis was then conducted to analyze the role of pharmaceutical companies in providing equitable access to COVID-19 vaccines.
When the data is broken down by income (as of June 2021), it shows that high-income countries (HICs) have already crossed the COVID-19 Vaccine Global Access (COVAX) 20% immunization threshold. However, countries of all other income levels have yet to achieve this mark for fully vaccinated people. Upper-middle-income countries (UMICs) have approximately 3%, low- and middle-income countries (LMICs) have approximately 2% and low-income countries (LICs) have less than 0.1% of fully vaccinated people per hundred. The supply shortage is expected to last until the second half of 2021.
As a result of the COVAX failure, a health gap emerged with countries living in a pre-immunization period for an extended time. The existing conflict between the international response to tackle COVID-19 and corporate profit-driven behavior contributed to prolonging pandemic, especially in Africa. Accordingly, there is a need to approve an international treaty that targets the activities of all actors, including the pharmaceutical companies, in protecting human rights and the right to health realms.
有效应对 2019 年冠状病毒病（COVID-19）大流行需要采取全面战略，确保所有人都能公平地获得所有抗击 COVID-19 的技术。为实现这一目标，国际社会承认免疫接种是一种公益事业。然而，由于制药公司的逐利行为等因素，出现了剂量分配严重不平等的趋势，这危及了增加疫苗可及性的机制。公共卫生利益与公司在确定疫苗剂量分配方面的自由裁量权之间的矛盾，对与延长大流行持续时间和公司最终侵犯人权的责任相关的健康风险提出了重大关切。
为了评估对 COVID-19 免疫计划构成的风险，汇编和评估了各国与制药公司之间的疫苗分配和交付、疫苗剂量应用、免疫人群以及预购协议（APA）数量的数据。然后进行了描述性分析，以分析制药公司在公平获得 COVID-19 疫苗方面的作用。
按收入（截至 2021 年 6 月）细分数据显示，高收入国家（HICs）已经超过了 COVID-19 疫苗全球获取（COVAX）20%的免疫阈值。然而，所有其他收入水平的国家尚未达到完全接种疫苗人群的这一标志。中上收入国家（UMICs）约有 3%，中低收入国家（LMICs）约有 2%，低收入国家（LICs）每百人中完全接种疫苗的人数不足 0.1%。预计供应短缺将持续到 2021 年下半年。
由于 COVAX 的失败，各国出现了健康差距，这些国家将在很长一段时间内处于免疫前阶段。国际社会应对 COVID-19 的行动与企业逐利行为之间的现有冲突导致大流行时间延长，特别是在非洲。因此，有必要批准一项国际条约，针对包括制药公司在内的所有行为者的活动，以保护人权和健康权领域。
