John Gilmartin comments on the impasse at WHA on proposed vaccine sharing agreement for future pandemics
Editor's Note: Readers may have seen two articles we posted yesterday concerning the World Health Assembly and the seeming deadlock over the draft agreement on preparations for future pandemics. If you missed them, click here and here.
I asked John Gilmartin to give us his views on the issues, and particularly the issue between developed countries and less developed over vaccine sharing.
Here is John's reply. If you have thoughts to share, please comment.
Hi Tom,
Honestly, I don’t follow the many many WHO meetings that touch on vaccine supply and related issues. I’m not a diplomat. I’m now an old out of touch 'supply guy.’ My battles in the global vaccine supply arena were around concepts like CVI, the Children’s Vaccine Initiative, polio eradication, and local manufacture which became a somewhat important side issue during the Summit for Children. The founding of GAVI, which I think in hindsight was a brilliant idea, contributed to the success of Covid vaccine response, needs to be much more broadly studied.
The notion that WHO and its many suborganizations of policy development should declare that there is an urgency to complete a treaty for vaccine sharing before the Biden Trump contest on November 5 this year is, in my view, absurd, and naive.
As lawyers wil tell me quickly, what is the ’standing’ of the WHA, WHO or any body working within that grouping to form a “treaty” that determines a future vaccine distribution in a future pandemic. Vaccine supply involves science in a wonderful sometimes astonishing manner, but the actual commitment to supply involves big money, government agreements, large and small vaccine producers, and eventually pointed headed bureaucrats who risk their careers signing contracts on those rare occasions for unproven new vaccine.
Vaccine supply is a lot of fun when everything goes well. I can say from experience the moment a new vaccine has a hint of a poor outcome, accusations fly. It gets very ugly when the press declares “that new vaccine is killing xyz children. (I’ve been there)
To begin an agreement on future supply of a future vaccine for a future disease has to include an agreed standing for the parties to make that agreement. It must include an understanding for managing adverse event accountability if/when things go wrong, and an honest appraisal of funding and resourcing those funds. None of this mentions the need to inform the public and private science and medical groups who actually develope these products that there is a fair, innovative, helpful, set of guidelines and mechanisms to allow these groups to work effectively together.
I was lucky, by chance I was one of the Unicef staff on hand to participate in some of the early thinking around these ideas. CVI was the initial initiative, and that quickly gave way to GAVI, which created a good mechanism to organize the Advance Purchase Agreements which was one of the key components in the actual covid vaccine supply that worked in the covid crisis. GAVI had already put in years of work and effective staffing to enable governments, like DJT’s, quickly put funding and contracting into still untested vaccines. The Moderna and Pfizer vaccines would never have been put into international use without these preworked arrangements. The governments, eg UK and Norway in particular, and financial orgs that made GAVI a viable working partner were critical to the actual arrival of these vaccines.
The execution of these supply arrangements was very difficult from what I’ve heard from those who had to complete the work. It did work. It did not work well enough, and it was not smooth or understood by the public or I think most of the governments that actually received these vaccines.
One of the WHO groups mentions as a failure the seven million deaths from covid. Honestly, pandemics, eg the Plague, the Spanish flu of 1918, kill much larger numbers than seven million. Europe lost around half its population in the plague. The 1918 flu was more deadly that WWI.
The science teams, and the individuals behind the new covid technology did not receive anything like the recognition they deserve for their work.
I would encourage the WHO and Unicef to sponsor a very independent assessment of what worked and what didn’t during the covid vaccine response and to then form a mechanism to respond better for the next one. WHO and UNICEF can not objectively evaluate their own work in this multiyear crisis. It will only be credible if the evaluation is carried out by something that is independent and able to provide useful feedback to the public and members of the UN system.
I realize I forgot to mention the role of the NGO sector and major private donor groups in this field today. They are now the major players in this field. In many ways the private donor groups are able to overtake the ‘official’ sounding groups like WHO and steer the processes in their own ways.
Well, I’ve already said too much. But, there’s an early glimpse of what I think worked in the recent events, and some of the past groundwork behind it.
Yes, you can run this or edit it for clarity for the x unicefer’s.
Thanks for asking me, John
Hi Tom,
Honestly, I don’t follow the many many WHO meetings that touch on vaccine supply and related issues. I’m not a diplomat. I’m now an old out of touch 'supply guy.’ My battles in the global vaccine supply arena were around concepts like CVI, the Children’s Vaccine Initiative, polio eradication, and local manufacture which became a somewhat important side issue during the Summit for Children. The founding of GAVI, which I think in hindsight was a brilliant idea, contributed to the success of Covid vaccine response, needs to be much more broadly studied.
The notion that WHO and its many suborganizations of policy development should declare that there is an urgency to complete a treaty for vaccine sharing before the Biden Trump contest on November 5 this year is, in my view, absurd, and naive.
As lawyers wil tell me quickly, what is the ’standing’ of the WHA, WHO or any body working within that grouping to form a “treaty” that determines a future vaccine distribution in a future pandemic. Vaccine supply involves science in a wonderful sometimes astonishing manner, but the actual commitment to supply involves big money, government agreements, large and small vaccine producers, and eventually pointed headed bureaucrats who risk their careers signing contracts on those rare occasions for unproven new vaccine.
Vaccine supply is a lot of fun when everything goes well. I can say from experience the moment a new vaccine has a hint of a poor outcome, accusations fly. It gets very ugly when the press declares “that new vaccine is killing xyz children. (I’ve been there)
To begin an agreement on future supply of a future vaccine for a future disease has to include an agreed standing for the parties to make that agreement. It must include an understanding for managing adverse event accountability if/when things go wrong, and an honest appraisal of funding and resourcing those funds. None of this mentions the need to inform the public and private science and medical groups who actually develope these products that there is a fair, innovative, helpful, set of guidelines and mechanisms to allow these groups to work effectively together.
I was lucky, by chance I was one of the Unicef staff on hand to participate in some of the early thinking around these ideas. CVI was the initial initiative, and that quickly gave way to GAVI, which created a good mechanism to organize the Advance Purchase Agreements which was one of the key components in the actual covid vaccine supply that worked in the covid crisis. GAVI had already put in years of work and effective staffing to enable governments, like DJT’s, quickly put funding and contracting into still untested vaccines. The Moderna and Pfizer vaccines would never have been put into international use without these preworked arrangements. The governments, eg UK and Norway in particular, and financial orgs that made GAVI a viable working partner were critical to the actual arrival of these vaccines.
The execution of these supply arrangements was very difficult from what I’ve heard from those who had to complete the work. It did work. It did not work well enough, and it was not smooth or understood by the public or I think most of the governments that actually received these vaccines.
One of the WHO groups mentions as a failure the seven million deaths from covid. Honestly, pandemics, eg the Plague, the Spanish flu of 1918, kill much larger numbers than seven million. Europe lost around half its population in the plague. The 1918 flu was more deadly that WWI.
The science teams, and the individuals behind the new covid technology did not receive anything like the recognition they deserve for their work.
I would encourage the WHO and Unicef to sponsor a very independent assessment of what worked and what didn’t during the covid vaccine response and to then form a mechanism to respond better for the next one. WHO and UNICEF can not objectively evaluate their own work in this multiyear crisis. It will only be credible if the evaluation is carried out by something that is independent and able to provide useful feedback to the public and members of the UN system.
I realize I forgot to mention the role of the NGO sector and major private donor groups in this field today. They are now the major players in this field. In many ways the private donor groups are able to overtake the ‘official’ sounding groups like WHO and steer the processes in their own ways.
Well, I’ve already said too much. But, there’s an early glimpse of what I think worked in the recent events, and some of the past groundwork behind it.
Yes, you can run this or edit it for clarity for the x unicefer’s.
Thanks for asking me, John
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