<div dir="ltr"><div class="gmail_default" style="font-size:large">

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><b><span lang="DE"><span></span></span></b></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">While official speeches emphasize

international solidarity in containing the corona pandemic, many countries are

focusing on national solutions for vaccine research.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">From Andreas Wulf (Medico Intl and PHM)<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">The Russian government is playing at full

risk. The first nationally approved vaccine Sputnik 5 against the Corona virus

has immediately attracted strong international criticism, as no transparent

data have been made public and the relevant phase 3 studies have only just

begun<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn1" name="_ftnref1" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[1]</a>.

Nobody knows whether this "Sputnik moment" for Putin will not turn

into a "Challenger Disaster" if the vaccine turns out to be less

effective or has even dangerous side effects. But at the same time countries

are already queuing up to test and use this vaccine, the Philippine President

Duterte wants to be the first to test it and if it works for him, it will be

good for the whole country<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn2" name="_ftnref2" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[2]</a>.

<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">This development of a vaccine nationalism can

be seen as a counterpoint to the brief 'spring of solidarity' when, on 4 May,

the WHO and the European Commission called with great fanfare for joint global

fundraising for the fight against the coronavirus. An impressive 15.9 billion

euros were raised until today, almost half of which was contributed by

"Team Europe" - the European Commission, the EU member states and the

European Investment Bank<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn3" name="_ftnref3" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[3]</a>.

The event was also memorable because Emmanuel Macron and Angela Merkel

designated a coronavirus vaccine as a "global public good". And EU

Commission President Ursula von der Leyen stressed that "governments and

global health organisations are pulling together in the fight against the

coronavirus".<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE"><span> </span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><b><span lang="DE">International

solidarity?<span></span></span></b></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">It sounded as if solidarity was written in

capital letters. Already in April, the WHO presented its "Access to

COVID-19 Tools (ACT) Accelerator"<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn4" name="_ftnref4" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[4]</a>,

an ambitious structure with the most important global health partnerships, in

which the development of vaccines, drugs and diagnostics as well as their

procurement and distribution were to be accelerated and coordinated. This

should also help prevent a deja-vu of the experience with the H1N1 influenza

pandemic in 2009: There should not be a repeat of the race for access to the

vaccine, with the rich countries winning out while the poorer countries are

supplied with "humanitarian crumbles" by the WHO.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">The U.S. government left this seemingly global

alliance early on by publicly launching a national ambitious vaccine program

for local pharmaceutical companies. Operation Warp Speed, which is worth ten billion

US dollars, is to develop and produce hundreds of millions of vaccine doses by

January 2021 at the latest, primarily for its own use, but also for the rest of

the world. But the USA is not the only country that is distancing itself from

the ACT Accelerator. Neither the Russian government with its Sputnik 5 nor the

Chinese government, which also promise an early success of their own vaccine

developments<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn5" name="_ftnref5" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[5]</span></span></span></span></a>, have

joined the WHO's Accelerator Initiative so far. India is also holding back,

which is all the more momentous because Indian vaccine production is currently

the most important in the Global South.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE"><span> </span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><b><span lang="DE">Who is

closest to himself<span></span></span></b></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">So the full-bodied invocation of global

solidarity lasted only briefly. And with every further announcement of a

promising vaccine candidate, the façade continues to crumble. For it is

becoming increasingly clear that global production capacities are also limited

and may not be able to be increased as quickly. This is exactly what the WHO

initiative wants to prevent. Not only the US government, also the

"Inclusive Vaccine Alliance of Germany, France, Italy and the

Netherlands", for example, has made its own deals with pharmaceutical

companies for purchase guarantees and delivery quantities for successful

vaccine candidates. The EU Commission has taken over the current negotiations

with Sanofi-GSK<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn6" name="_ftnref6" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[6]</a>.

Politicians like von der Leyen like to use phrases like "nobody is safe

until everyone is safe". But when it comes to getting out of the social

and economic crisis as quickly as possible, their own citizens are still a

little closer than the world community.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">And so the COVAX Facility, the vaccine pillar

within the ACT Accelerator, which is organized by the WHO together with the

Global Alliance for Vaccines and Immunisation (GAVI) and the Coalition for

Epidemic Preparedness Innovations (CEPI), is making little progress towards a

global "buying and distribution pooling mechanism" for effective

Covid19 vaccines. COVAX is currently focusing on a portfolio of nine vaccine

candidates from different vaccine classes (DNA/mRNA; viral vectors, proteins).

Through agreements with research institutions and companies that will produce

the vaccines in the USA, Europe, China and Australia, the risk of having backed

the wrong horse in the end is to be minimized. In addition, this multinational

cooperation is intended to ensure that a promising product is ultimately

cheaper than if individual countries negotiate with manufacturers alone. The

experience of the Global Fund in the pooled procurement of AIDS / TB /Malaria

drugs is the inspiration here. <span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">As a sign of global solidarity in the Covid19

crisis, the COVAX Facility aims to support the financially weakest countries

with funds from global and national development budgets in the procurement of

the vaccine. So far, however, no financial commitments have been made. And

among the 75 countries that have at least signalled a possible participation in

the budgets, most of the financially strong countries with their own vaccine

production capacities are missing - in Europe, for example, the heavyweights

France, Italy, Great Britain and Germany<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn7" name="_ftnref7" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[7]</span></span></span></span></a>

.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE"><span> </span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><b><span lang="DE">Priority

supply<span></span></span></b></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">But even in the COVAX Facility, not all

countries would be equal. The plan for the global distribution of a vaccine

envisages, as a first step, the simultaneous supply for 3% of the population in

every country, which should mainly include "indispensable key

persons", i.e. health, nursing and other professionals, in a first step...

Subsequently, in further tranches, 20 percent of the respective populations are

to be provided with the vaccine, with particular attention being paid to risk

groups such as the elderly and the chronically ill. However, "self-paying

countries" are already granted priority supply in this second procurement

round, while countries dependent on aid funds must wait until corresponding

quantities can be produced and paid for. On the way to a population-wide

supply, the differences in availability are widening more and more.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">It is also unclear whether GAVI actually has

the authority to negotiate successfully with the pharmaceutical companies.

There has been and still is great criticism of the fact that the manufacturers

are also represented with a seat and vote on the GAVI board. Experience from

the price and supply negotiations for the pneumococcal vaccines - GAVI's

flagship project - raises doubts: even after years, there is no real price

competition between the few manufacturers; the profits are enormous<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn8" name="_ftnref8" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[8]</span></span></span></span></a>.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE"><span> </span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><b><span lang="DE">Selfishness

also harms the rich countries<span></span></span></b></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">Sothe <span> </span>COVAX Facility is anyway only a model of

"Solidarity light". But even for this one, six months after the

beginning of the pandemic, there is no sufficient global support. Instead,

competition and mutual accusations are intensifying. US and British governments

are accusing Russia and China of stealing vaccine data. It may be convenient

for the European states to point the finger at the US president and his

"America first" policy. However, they do not want to be reminded that

they are not honouring their own commitments. It is to be expected that the

selfish impulses in the fight against the pandemic will hinder the longer-term

strategy also for the technologically advanced states. This is because the production

and supply chains have long since been globalized, even in vaccine production -

even states such as the USA are dependent on secure trade and supply contracts.

And even if a country could protect itself, it remains dependent on the world

with its sales markets and suppliers. If there were an "Island of the

Blessed", it would also suffer from a prolonged global recession and a

continuing pandemic<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn9" name="_ftnref9" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[9]</span></span></span></span></a>.<span></span></span></p>

<p class="MsoNormal" style="margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri"><span lang="DE">At the beginning of August, WHO

Director-General Dr. Tedros emphasized once again that in all probability there

would be no "silver bullet", i.e. a vaccine that is one hundred

percent effective in all people<a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftn10" name="_ftnref10" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:11pt;line-height:107%;font-family:Calibri" lang="DE">[10]</a>.

This is one of the reasons why it would be in the "enlightened

self-interest" of all players to consistently rely on cooperation. The

fact that the German government is not involved in either the COVAX initiative

or the Covid19 Technology Patent Pool for the global benefit of health

knowledge shows how questionable the role of a self-proclaimed "Global

Health Champion" is.<span></span></span></p>

<div><br clear="all">

<hr width="33%" size="1" align="left">

<div id="gmail-ftn1">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref1" name="_ftn1" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[1]</span></span></span></span></span></a><span lang="DE"> <a href="https://www.themoscowtimes.com/2020/08/12/russias-covid-19-vaccine-breaches-crucial-scientific-and-ethical-international-standards-a71121" style="color:rgb(5,99,193);text-decoration:underline">https://www.themoscowtimes.com/2020/08/12/russias-covid-19-vaccine-breaches-crucial-scientific-and-ethical-international-standards-a71121</a><span></span></span></p>

</div>

<div id="gmail-ftn2">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref2" name="_ftn2" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[2]</span></span></span></span></span></a><span lang="DE"><span>  </span><a href="https://www.dw.com/en/philippines-duterte-volunteers-to-be-putins-coronavirus-vaccine-guinea-pig/a-54523030" style="color:rgb(5,99,193);text-decoration:underline">https://www.dw.com/en/philippines-duterte-volunteers-to-be-putins-coronavirus-vaccine-guinea-pig/a-54523030</a><span></span></span></p>

</div>

<div id="gmail-ftn3">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref3" name="_ftn3" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[3]</span></span></span></span></span></a><span lang="DE"> <a href="https://global-response.europa.eu/index_de" style="color:rgb(5,99,193);text-decoration:underline">https://global-response.europa.eu/index_de</a><span></span></span></p>

</div>

<div id="gmail-ftn4">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref4" name="_ftn4" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[4]</span></span></span></span></span></a><span lang="DE"><span>  </span><a href="https://www.who.int/initiatives/act-accelerator" style="color:rgb(5,99,193);text-decoration:underline">https://www.who.int/initiatives/act-accelerator</a><span></span></span></p>

</div>

<div id="gmail-ftn5">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref5" name="_ftn5" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[5]</span></span></span></span></span></a><span lang="DE"> <a href="https://www.nytimes.com/2020/08/02/world/europe/russia-trials-vaccine-October.html" style="color:rgb(5,99,193);text-decoration:underline">https://www.nytimes.com/2020/08/02/world/europe/russia-trials-vaccine-October.html</a><span class="gmail-MsoHyperlink" style="color:rgb(5,99,193);text-decoration:underline"> ; </span><a href="https://www.nature.com/articles/d41586-020-02244-1" style="color:rgb(5,99,193);text-decoration:underline">https://www.nature.com/articles/d41586-020-02244-1</a><span></span></span></p>

</div>

<div id="gmail-ftn6">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref6" name="_ftn6" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[6]</span></span></span></span></span></a><span lang="DE"> <a href="https://ec.europa.eu/commission/presscorner/detail/en/ip_20_1439" style="color:rgb(5,99,193);text-decoration:underline">https://ec.europa.eu/commission/presscorner/detail/en/ip_20_1439</a><span></span></span></p>

</div>

<div id="gmail-ftn7">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref7" name="_ftn7" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[7]</span></span></span></span></span></a><span lang="DE"> <a href="https://www.who.int/news-room/detail/15-07-2020-more-than-150-countries-engaged-in-covid-19-vaccine-global-access-facility" style="color:rgb(5,99,193);text-decoration:underline">https://www.who.int/news-room/detail/15-07-2020-more-than-150-countries-engaged-in-covid-19-vaccine-global-access-facility</a><span></span></span></p>

</div>

<div id="gmail-ftn8">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref8" name="_ftn8" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[8]</span></span></span></span></span></a><span lang="DE"> <a href="https://msfaccess.org/analysis-and-critique-advance-market-commitment-amc-pneumococcal-conjugate-vaccines" style="color:rgb(5,99,193);text-decoration:underline">https://msfaccess.org/analysis-and-critique-advance-market-commitment-amc-pneumococcal-conjugate-vaccines</a><span></span></span></p>

</div>

<div id="gmail-ftn9">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref9" name="_ftn9" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[9]</span></span></span></span></span></a><span lang="DE"> <a href="https://www.foreignaffairs.com/articles/united-states/2020-07-27/vaccine-nationalism-pandemic" style="color:rgb(5,99,193);text-decoration:underline">https://www.foreignaffairs.com/articles/united-states/2020-07-27/vaccine-nationalism-pandemic</a><span></span></span></p>

</div>

<div id="gmail-ftn10">

<p class="gmail-MsoFootnoteText" style="margin:0cm 0cm 0.0001pt;font-size:10pt;font-family:Calibri"><a style="color:rgb(5,99,193);text-decoration:underline" href="#_ftnref10" name="_ftn10" title=""><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span lang="DE"><span><span class="gmail-MsoFootnoteReference" style="vertical-align:super"><span style="font-size:10pt;line-height:107%;font-family:Calibri" lang="DE">[10]</span></span></span></span></span></a><span lang="DE"> <a href="https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---3-august-2020" style="color:rgb(5,99,193);text-decoration:underline">https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---3-august-2020</a><span></span></span></p>

</div>

</div>

</div></div>