TOKYO -- As COVID-19 continues its devastating global rampage, countries are competing fiercely to secure vaccine supplies once they become available.
Rich nations are investing heavily to ensure they receive millions of doses, leaving developing countries in their wake.
Researchers around the world are working on more than 150 potential vaccines, and 26 possibles have already reached human trials.
A safe and effective vaccine is a prerequisite for nursing the global economy back to health in the shortest possible time.
Pfizer and BioNTech in the U.S. announced on July 31 an agreement to supply Japan with 120 million doses of an experimental coronavirus vaccine in the first half of 2021. That will provide two-dose inoculations for 60 million people.
The candidate vaccine has received U.S. Food and Drug Administration (FDA) fast track designation, and the two companies plan to apply for emergency use authorization from the FDA as soon as October.
The Japanese government is also in talks to secure some 100 million doses of a potential coronavirus vaccine being developed by British pharmaceutical giant AstraZeneca and Oxford University.
In Japan, AnGes, a biopharmaceutical startup spun out of Osaka University, is working on a potential vaccine with an eye to making enough for a million people available in the spring of 2021, and Shionogi is working toward sufficient vaccine doses for 30 million people in the autumn of 2021.
Japan's pharmaceutical companies will not, however, be able to satisfy the nation's needs completely. The only way to bridge the supply gap is massive purchases from foreign players.
The government's second supplementary budget for fiscal 2020 was enacted in June and contains 10 trillion yen ($94 billion) of additional reserve funds earmarked for efforts to tackle the coronavirus crisis. Some 2 trillion yen of that will be used to beef up national medical response capacity, which includes vaccine procurement.
"We can expect to win broad public support for spending to buy vaccines against the coronavirus," a senior government official told the Nikkei Asian Review.
The U.S. and Europe have pulled ahead of Japan in the lucrative vaccine derby. The U.S. government has reached a deal worth up to $2.1 billion with drugmakers Sanofi and GlaxoSmithKline (GSK) to support clinical trials for 100 million doses.
Washington has already spent more than $10 billion on COVID-19 candidate vaccines. The U.S. has secured more than 1.5 billion doses of vaccines under development, seven times the amount to be supplied to Japan.
The U.K. has also spent heavily, locking down 250 million doses -- nearly four times its population.
The U.S. and some European countries are scrambling for more vaccine doses than they have people because it is unclear yet which may work. Some vaccines also need to be administered more than once.
Alok Sharma, the British secretary of state for business, energy and industrial strategy, recently tweeted: "It is important that we secure early access to a diverse range of promising vaccine candidates to increase our chances of finding one that works."
China and Russia have their own strategies. China is supporting domestic pharmaceutical companies, such as CanSino Biologics, while Russia is racing to start inoculations ahead of the West.
Russian regulators are expected to approve a vaccine being developed by Moscow's Gamaleya Institute and the Russian Direct Investment Fund by mid-August for civilian use, according to news reports. No detailed information about clinical trials has been made available.
Developing countries are meanwhile being left behind, and will find it hard to find reasonably priced vaccines when wealthy countries are willing to pay $20-50 per dose -- putting mass inoculation well beyond the budgets of most African nations, for example.
There may be a break in the clouds, however. The Coalition for Epidemic Preparedness Innovations (CEPI), a partnership of public, private, philanthropic and civil organizations to support the development of vaccines against emerging infectious diseases, has committed itself to "equal access," and is backing a range of candidate vaccines. Those include one being developed by Moderna and the one GSK and Sanofi are working on.
CEPI financial support requires that vaccines be universally available at affordable prices.
The World Health Organization has floated the idea of lower prices for developing nations, but this has run into the basic problem of who will subsidize vaccines selling for below production costs.
Domestic production is often not an option. Few third world countries have companies and research capabilities geared up for vaccine production. This severely limits the use of compulsory licensing, a legal recourse that can be used by governments to suspend patents on a product in times of emergency or in the public interest.
Effective commitment to international cooperation will be crucial to making COVID-19 vaccines equally available worldwide.
Currently, African countries receive low-priced medicines from major Indian pharmaceutical companies that rely on China for 70% of their ingredients. China is showing interest in supplying COVID-19 vaccines through these channels.
Six vaccine candidates are now in phase three efficacy trials involving thousands of people to see if their immune systems can be made capable of recognizing and blocking the coronavirus.
Any vaccine's efficacy must be statistically proven, and so far none of the six candidates have come through.
The FDA and the WTO have already relaxed vaccine efficacy criteria, which normally demand 80-90% success rates. In the case of COVID-19, a vaccine that prevents or reduces the severity of the virus in 50% of those vaccinated would be acceptable. That means a vaccine might work for only half the people who receive it. One reason is that a vaccine with lower efficacy needs more time to produce antibodies. ]
Determining the efficacy of a new vaccine usually takes around six months to a year, but some developers are allocating only a couple of months to the process.
"More time should be spent on studying side effects and other safety issues," an executive at a Japanese pharmaceutical company told Nikkei.
An epidemiologist meanwhile stressed the significance of developing an effective vaccine in terms of the benefit of reducing public anxiety.
While none of the most promising vaccine candidates so far have shown serious side effects in early trials, that does not guarantee their safety in mass inoculations.