Thank you for giving me this opportunity and organizing this very informative and valuable summit. I was asked to give a perspective from the World Bank on the COVID-19 vaccine supply chain challenges. I will say five things, mostly from the perspective of low- and middle-income countries (LICs/LMICs) who the World Bank finances.
First, I want to say that we are very concerned about vaccine access for LICs/LMICs. Most available supply has been booked by rich countries. I want to reiterate the need to donate doses and do this in an equitable way. COVAX could play a role in allocating these doses.
Second, countries need to support manufacturing and supply chains by allowing free flow of final products and supplies. In this context, all free flow “inhibitors” should be done away with.
Third, lack of clarity around demand has to do with lack of transparency around contracts. Countries and manufacturers need to agree to be transparent around what has been committed to whom to clarify the true level of committed demand and what is open to discussion and negotiation.
Greater transparency into vaccine suppliers’ supply chain plans, such as reviewed and approved manufacturing sites, intended or approved affiliates (e.g., CMOs), and other contracting and licensing arrangements, would help facilitate contract discussions and a greater understanding of challenges facing suppliers during delivery phases. This would ultimately support the design of the best possible approaches.
Fourth, there is little grant funding (whether on the "push" or "pull" side) to "unblock" (through funding) constraints within the supply chain and for improving access to the vaccines in low income countries. The International Finance Corporation has been in discussions with various parties to encourage leveraging of grant funding through innovative and blended finance mechanisms. Investments from Multilateral Development Banks in potential bottleneck elements of the supply chain, e.g. production of glass vials and lipids, can make a huge difference.
Fifth, standardization. There was a lot of discussion about how standardization of regulatory reviews, vials, doses per vial, GMP approvals, and labelling could help. To this, we would add standardization of contracts. Developing standardized contracts, delivery and price terms for each supplier can help minimize bespoke contract efforts, normalize expectations across countries, and help improve transparency.
In the short term, there is a need to expand the existing production capacities, including repurposing of existing capacities targeted at delivering quality vaccines to the lower income economies. However, it is clear that the current concentrated nature of the vaccine supply chains poses a great risk to low income countries in accessing the vaccines, not only to fight the COVID-19 pandemic but also to continue the fight against the other existing communicable disease challenges (HIV, etc.).
In the medium term, to increase resilience in developing countries, production and distribution capacities in emerging markets need to be strengthened. Less than 5% of the vaccine manufacturing capacity is in Africa and Latin America. Engaging stakeholders to co-create commercially viable vaccine manufacturing especially in Africa needs to be a priority.
