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Senior officials warn the EU will fall well short of pledged donations of coronavirus vaccines to poorer countries, risking both the spread of deadly new variants and a loss of geopolitical weight.

Driven by the recognition that the coronavirus pandemic can only be defeated if all countries have access to enough vaccines, the EU has pledged to deliver 500 million vaccines by mid-2022, of which 250 million by the end of this year.

In September, European Commission President Ursula von der Leyen raised the bar by announcing the donation of 200 million additional doses by the middle of next year, stressing that fighting “injustice” in the global vaccine supply was “one of the great geopolitical issues of our time.”

Yet, just over two months from the end of the year, actual vaccine deliveries are significantly behind schedule: according to the latest figures, the bloc has only given around 56 million doses to poor countries, i.e. less than a quarter of what he promised to deliver. year.

This stark discrepancy between words and deeds has triggered warnings from senior officials responsible for international cooperation and development aid.

“The EU and its Member States must now do more,” wrote Jutta Urpilainen, European Commissioner for International Partnerships, and Tomas Tobé, Chairman of the European Parliament’s Development Committee, in a joint editorial for POLITICO.

“Given that we have already obtained sufficient doses to cover the entire European population, including a third booster dose of COVID-19, we can and must step up vaccine donations to our most vulnerable partners”, they wrote.

The German Ministry of Health made this point clear in a pointed letter to the European Commission dated Monday. The world, the ministry wrote, risks facing a “global allocation emergency” which “would be totally unacceptable and must be avoided by all means”.

EU leaders meeting in Brussels on Thursday and Friday plan to “call for the rapid removal of obstacles hindering the global deployment of vaccines”, according to the draft European Council conclusions consulted by POLITICO. These obstacles have included liability issues, a short retention period, and heavy paperwork.

The emergency has deep geopolitical reasons: already in July, EU foreign policy chief Josep Borrell warned that “insufficient” vaccine deliveries to Africa and Latin America meant that the bloc risked losing its influence to the benefit of China.

“Who is the big supplier of vaccines to Africa? China. Who is the big supplier of vaccines to Latin America? China,” Borrell said, adding that “the problem” with the actions of the EU ” is not just commitment but efficiency ”.

Positive turning

Three months later, the problem has become even more pressing, according to Udo Bullmann, a German Social Democrat and member of the European Parliament’s Development Committee. “The EU and the Member States urgently need to honor their international commitments,” he said, warning that Europe “will be very sorry if others take their place and offer themselves as partners”.

Low vaccination rates in African countries like Ethiopia or Nigeria, where less than 2% are fully protected against COVID-19, or Haiti, where only 0.25% of people are fully vaccinated, also raise concerns. health problems.

“A rapid and comprehensive global immunization strategy is a humanitarian imperative,” Bullmann said. “Any further failure will turn against us. Ever new and increasingly dangerous changes also compromise the level of security we have achieved so far.”

In a statement released on Monday, von der Leyen tried to remedy the EU’s underperformance by putting the numbers on a positive note: she said the bloc had shipped more than a billion doses of the vaccine globally. over the past 10 months – although the bulk of injections produced in the EU have been sold to wealthy countries like Canada or New Zealand, not given to poorer countries.

“We have always shared our vaccines fairly with the rest of the world. We exported as much as we delivered to EU citizens,” said von der Leyen.

She also said the EU had “provided around 87 million doses to low- and middle-income countries through COVAX,” a program for equitable global access to vaccines.

When asked about that number, however, a spokesperson admitted that, in fact, not all of those 87 million doses were donations from the EU to poorer countries, as von der Leyen’s statement seemed to suggest. . Instead, that number included doses purchased by COVAX itself from factories in the EU. The actual number of doses given by the EU to the poorest countries, the spokesperson said, was 56 million.

Liability issues

EU countries insist that it is not a lack of political will that prevents them from giving more. Instead, said an EU diplomat, there are many “bureaucratic hurdles to overcome to get vaccines delivered”.

The main issue on the way from promise to delivery is the same issue that plagued the EU’s own negotiations with vaccine developers – liability. “One of the main difficulties in negotiating the [contract] was around responsibility, ”explained a government adviser from an EU country involved in the negotiations.

Several people familiar with the negotiations described how the issue of accountability played an important role in the negotiations. Ultimately, before doses are donated by an EU member country to COVAX, responsibility must shift to the country receiving the doses, said a development official with knowledge of COVAX’s work.

In an attempt to rationalize donations, three framework contracts have been established: one with Sweden for doses of the Oxford / AstraZeneca vaccine; a second with Belgium for Johnson & Johnson and a third with France for the BioNTech / Pfizer jab. The aim is for member countries to channel their donations through these agreements rather than having 27 agreements for each vaccine.

The EU diplomat, however, said the wording of the contract had raised fears that it left the donor country on the hook.

A Finnish diplomat explained that, for Finland, “it was of the utmost importance that sufficient attention be paid to putting in place sound legal and administrative arrangements so that no surprises arise later”.

The German Ministry of Health explained these concerns in its letter on Monday, warning that “the terms and conditions of the purchase agreements negotiated by the European Commission for donation and resale could prove to be a substantial obstacle to a redistribution. fair and needs-based world. vaccines.

Loopholes in purchasing agreements, the letter said, allowed manufacturers to “dictate minimum selling prices, impose exaggerated compensation regimes on recipients, reject trade-in procedures, or ban distribution to consumers. International organisations”. The situation, he added, makes “a rapid response to requests for international assistance almost impossible.”

The ministry urged the Commission to “increase the pressure on manufacturers to show more flexibility with regard to donation and resale”.

Many countries have simply decided to donate smaller batches directly, without going through COVAX. Yet again, liability issues have been a sticking point. “There is no doubt that this is the main topic,” said the government adviser.

Donation issues

While the EU is no stranger to bureaucracy, vaccine donations appear to be particularly onerous. The Finnish diplomat stressed that “the amount of paperwork has been significant, both internally and towards COVAX and the manufacturers”.

Case in point: The Irish Department of Health has highlighted its goal of donating another million vaccines through COVAX, saying it is working to finalize legal documentation in “the coming weeks”.

In addition to bureaucratic hurdles, there is also the issue of limited shelf life. COVAX generally only accepts doses that are at least two months before the expiry date. Vaccines near their expiration date may end up being destroyed, as happened with 385,000 doses delivered by COVAX discarded between June and September 24, according to a document seen by POLITICO.

The concern about shelf life is linked to another conundrum: COVAX has been reluctant to receive doses directly from countries, failing injections in EU warehouses. Although it is technically possible for EU countries to donate doses already supplied by the manufacturer, the threat to cold chain integrity and expiration date issues make this “very difficult to do. “said the development manager.

Countries need to give “clearer and more transparent commitments and trajectory when committing to donate,” the government adviser said. Manufacturers must also be “more transparent about what they will deliver to COVAX”.

Those working with these donations are mostly optimistic that deliveries will resume as processes are streamlined. But another challenge looms: once doses start to be delivered in larger quantities, countries may be unable to absorb them quickly enough.

“That will be the next challenge,” said the development manager.

This article is part of POLITICSThe premium police service: Pro Health Care. Whether it’s pricing for drugs, EMA, vaccines, pharmacy and more, our expert journalists keep you up to date on the topics that drive the political agenda in healthcare. E-mail [email protected] for a free trial.

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