The WHO has published the Global Vaccine Market Report 2022, showing inequitable distribution is not unique to COVID-19 vaccines with poorer countries consistently struggling to access other vaccines that are in demand by wealthier countries.
In a statement, the WHO said that limited vaccine supply and unequal distribution drive global disparities. The human papillomavirus (HPV) vaccine against cervical cancer has only been introduced in 41 per cent of low-income countries, even though they represent much of the disease burden, compared to 83 per cent of high-income countries.
Affordability is also an obstacle to vaccine access. While prices tend to be tiered by income, price disparities see middle-income countries paying as much - or even more - than wealthier ones for several vaccine products.
"The right to health includes the right to vaccines," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "And yet this new report shows that free-market dynamics are depriving some of the world's poorest and most vulnerable people of that right. WHO is calling for much-needed changes to the global vaccine market to save lives, prevent disease and prepare for future crises."
Approximately 16 billion vaccine doses, worth USD 141 billion, were supplied in 2021, almost three times the 2019 market volume (5.8 billion) and nearly three-and-a-half times the 2019 market value (USD 38 billion). The increase was primarily driven by COVID-19 vaccines, showing the incredible potential of how vaccine manufacturing can be scaled up in response to health needs.
"Although manufacturing capacity worldwide has increased, it remains highly concentrated. Ten manufacturers alone provide 70 per cent of vaccine doses (excluding COVID-19). Several of the top 20 most widely used vaccines (such as PCV, HPV, measles and rubella containing vaccines) each currently rely mainly on two suppliers," the WHO said.
This concentrated manufacturing base leads to risk of shortages as well as regional supply insecurity. In 2021, the African and Eastern Mediterranean regions were dependent on manufacturers headquartered elsewhere for 90 per cent of their procured vaccines. Entrenched intellectual property monopolies and limited technology transfer further limit the ability to build and using local manufacturing capacity.
The health of markets is also concerning for several of the vaccines commonly needed for emergencies, such as against cholera, typhoid, smallpox/monkeypox, Ebola, meningococcal disease, where demand surges with outbreaks and is hence less predictable. The continued limited investment in these vaccines could be devastating for people's lives.
The report highlights the opportunities for more alignment of vaccine development, production and distribution with a public health agenda, towards achieving the Immunization Agenda 2030 (IA2030) goals and informing pandemic prevention, preparedness, and response efforts.
COVID-19 proved that vaccines can be developed and distributed rapidly, with a process lasting an average of ten years but never less than four years, compressed to 11 months. The pandemic also exposed the longstanding need to recognise vaccines as a fundamental and cost-effective public good rather than a commodity.
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