LONDON -- As the race intensifies for a vaccine against the new coronavirus, rich countries are rushing to place advance orders for the inevitably limited supply to guarantee their citizens get immunized first -- leaving significant questions about whether developing countries will get any vaccines in time to save lives before the pandemic ends.
Earlier this month, the United Nations, the International Red Cross and Red Crescent, and others said it was a "moral imperative" that everyone have access to a "people's vaccine." But such grand declarations are unenforceable, and without a detailed strategy, the allocation of vaccines could be inequitable and extremely messy, said health experts.
"We have this beautiful picture of everyone getting the vaccine, but there is no road map on how to do it," said Yuan Qiong Hu, a senior legal and policy adviser at Doctors Without Borders in Geneva. Few measures have been taken to resolve numerous obstacles to achieving fair distribution, she said.
In the past, Hu said, companies have often applied for patents for nearly every step of a vaccine's development and production: from the biological material such as cell lines used, to the preservative needed to stretch vaccine doses and even how the shots are administered.
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"We can't afford to face these multiple layers of private rights to create a 'people's vaccine,'" she said.
Speaking at a vaccine summit earlier this month that addressed the issue of equitable distribution, Ghanaian President Nana Akufo-Addo agreed.
"Only a people's vaccine with equality and solidarity at its core can protect all of humanity from the virus," he said.
At a summit Wednesday with African leaders, Chinese President Xi Jinping said countries in Africa would be "among the first to benefit" once a covid-19 vaccine is developed and deployed in China, but no deals were announced to back up his promise.
Worldwide, about a dozen potential vaccines are in early stages of testing.
CLAIMING DIBS
Britain and the U.S. have spent millions of dollars on various vaccine candidates, including one being developed by Oxford University and manufactured by AstraZeneca. In return, both countries are expected to get priority treatment; the British government declared that if the vaccine proves effective, the first 30 million doses would be earmarked for Britons.
Separately AstraZeneca signed an agreement to make at least 300 million doses available for the U.S., with the first batches delivered as early as October. In a briefing Tuesday, senior Trump administration officials said there will be a tiered system to determine who in America is offered the first vaccine doses. Tiers likely would include groups most at risk of severe disease and workers performing essential services.
Last week, the European Union moved to ensure its own supply. On Saturday, AstraZeneca struck a deal with a vaccines group forged by Germany, France, Italy and the Netherlands to secure 400 million doses by the end of the year.
Among several global efforts underway to try to ensure developing countries don't get left behind is an "advance market commitment" from the vaccines alliance GAVI, whose CEO has warned countries about the dangers of vaccines not being available globally.
"Even if a few countries go ahead and have vaccines, if there are raging outbreaks in other places ... that is going to continue to threaten the world and the return to normality," said Seth Berkley, the GAVI CEO.
The World Health Organization and others have called for a covid-19 "patents pool," where intellectual property rights would be surrendered so pharmaceuticals could freely share data and technical knowledge. Numerous countries including Australia, Brazil, Canada and Germany have already begun revising their licensing laws to allow them to suspend intellectual property rights if authorities decide there is an overwhelming need given the pandemic.
Executives at Pfizer and some other major drug makers say they oppose suspending patent rights for potential covid-19 vaccines.
Health officials worry what that might mean for divvying up supplies of a vaccine arguably needed by every country on the planet.
"We can't just rely on goodwill to ensure access," said Arzoo Ahmed, of Britain's Nuffield Council on Bioethics, noting that precedents of how innovative drugs have been distributed are not encouraging. "With HIV/AIDS, it took 10 years for the drugs to reach people in lower-income countries."
African nations have already been at the back of the line for medical supplies in the pandemic and "it will be worse if a vaccine is found," Winnie Byanyima, head of the U.N.'s AIDS program, said Thursday. "We can't afford to be in the back of the queue."
SURGES IN EUROPE
Meanwhile, Europe grappled Thursday with local spikes in coronavirus infections as the continent's lockdown restrictions eased, after hundreds of cases were found at one meatpacking plant in Germany and Greece had to impose a total seven-day lockdown on one village.
The developments came even as a new outbreak in Beijing saw a decline in daily cases and Hong Kong Disneyland reopened after a major drop in infections in the Chinese territory.
In western Germany, health officials in Guetersloh on Wednesday said the number of new covid-19 cases linked to the Toennies slaughterhouse in Rheda-Wiedenbrueck had risen to 657, a significant regional spike for a country that has recorded daily nationwide infections in the low hundreds lately.
Greek authorities on Thursday imposed a full lockdown on Echinos, which has a population of around 3,000, in the northeastern province of Xanthi, after a spike in cases and deaths, while the small Balkan nation of Montenegro reported new infections after weeks of having no positive cases.
In China, an outbreak detected in a wholesale market in the capital last week has infected at least 158 people in the country's largest resurgence since the initial outbreak was brought under control in March. Beijing reported 21 new cases of covid-19 on Thursday, down from 31 on Wednesday. City officials said close contacts of market workers, visitors and other connections were being traced to find all further cases as quickly as possible.
The United States, meanwhile, has been increasing pressure on China's leaders to reveal what they know about the pandemic.
Secretary of State Mike Pompeo "stressed the need for full transparency and information sharing to combat the ongoing covid-19 pandemic and prevent future outbreaks," the State Department said about his meeting with the Communist Party's top diplomat, Yang Jiechi.
Pompeo has joined President Donald Trump in criticizing China's response to the outbreak, including claiming that the virus may have emerged from a Chinese laboratory in Wuhan.
India recorded its highest one-day increase of 12,281 cases, but Prime Minister Narendra Modi rejected imposing a new lockdown, saying the country has to think about further unlocking the economy.
Honduran President Juan Orlando Hernandez was hospitalized with covid-19 and pneumonia as the country struggles under the pandemic's strain and cases rise sharply.
Mexico's cases keep increasing at near-record levels as the economy starts reopening.
More than a week after New Zealand declared itself virus-free, the country has confirmed three new cases: a man who arrived from Pakistan and two women who returned from Britain.
MASKED IN U.S.
In the U.S., California on Thursday started requiring people throughout the state to wear masks in most indoor settings and outdoors when distancing isn't possible as the coronavirus continues to spread.
"Science shows that face coverings and masks work," Gov. Gavin Newsom said in a statement about the new order. "They are critical to keeping those who are around you safe, keeping businesses open and restarting our economy."
States including Michigan, New York, Maine, Delaware and Maryland already have statewide mask orders in place.
Separately, a group of leading scientists is calling on a journal to retract a paper on the effectiveness of masks, saying the study has "egregious errors" and contains numerous "verifiably false" statements.
The scientists wrote a letter to the journal editors Thursday, asking them to retract the study immediately "given the scope and severity of the issues we present, and the paper's outsized and immediate public impact."
The letter follows criticism of two other major coronavirus studies in May, which appeared in the New England Journal of Medicine and The Lancet. Both papers were retracted over concerns that a rush to publish coronavirus research had eroded safeguards at prestigious journals.
The study now under fire was published June 11 in the journal Proceedings of the National Academy of Sciences. The lead author is Mario Molina, who won the Nobel Prize in chemistry in 1995, with two other scientists, for finding a link between man-made chemicals and depletion of the atmosphere's ozone layer.
The study claimed that mask-wearing "significantly reduces the number of infections" with the coronavirus and that "other mitigation measures, such as social distancing implemented in the United States, are insufficient by themselves in protecting the public." It also said that airborne transmission was the primary way the virus spreads.
Experts said the paper's conclusions were similar to those from others, but they objected to the methodology as deeply flawed. The researchers assumed that behaviors changed immediately after policy changes, for example, and the study failed to take into account the seismic changes occurring across societies that may have affected the reported incidence of infection.
"There is evidence from other studies that masks help reduce transmission of covid-19, but this paper does not add to that evidence," said Linsey Marr, an expert on airborne transmission of viruses at Virginia Tech. Molina was Marr's postdoctoral adviser.
A Proceedings of the National Academy of Sciences spokeswoman said: "The journal is aware of concerns raised about this article and is looking into the matter."
Many scientists believe that social distancing is a big factor in reducing transmission of the virus, and that airborne transmission, while it may occur, is not the primary means by which the virus spreads.
Information for this article was contributed by Danica Kirka, Lauran Neergaard, Linda A. Johnson, Cara Anna, Elena Becatoros, Ken Moritsugu, Frank Jordans, Kathleen Ronayne and Amy Taxin of The Associated Press.