52
Trade Therapy: Deepening Cooperation to Strengthen Pandemic Defenses
quickly enough. Accelerating their arrival by one, two, or three months could have saved an estimated hundreds of thousands of lives and trillions of dollars of economic activity (Athey et al. 2022). Also, the distribution of COVID-19 vaccines was skewed toward the regions where doses were manufactured (as noted earlier), which is why many have called for efforts to diversify vaccine manufacturing capacity globally to better prepare for future health emergencies. Furthermore, the scale of production was too small. The lack of sharing meant that less than 10 percent of the population in poor countries were inoculated by the end of 2021. New demand for boosters along with waste of unused and expired doses pushed the overall need for capacity far above 11.5 billion doses. Getting a new vaccine from beginning to end requires investment in sizable sunk costs (figure 1.22). These include the scientific research to invent the vaccine; the clinical trials to develop and check that it is effective and safe; the creation of a dedicated Figure 1.22
The vaccine value chains
Vaccine origination and development
1
Research and development
License Vaccine manufacturing formula to
3
Send vaccine formula for testing
Drug substance and drug product formulation Inputs Send drug product to
4
Fill and finish Inputs
2
Cliinical trials
Capital equipment
Raw and single-use materials
• Bioreactors • Pumps • Filtration units
• Bioreactor bags • Cellular material • Filters
Capital equipment
Other inputs
• Vial-filling equipment
Send vaccine doses to
Other pharmaceutical ingredients • Adjuvants • Lipids • Preservatives • Excipients
• Glass vials • Stoppers • Refrigeration
Delivery
5
Distribution
Equipment Inputs
• Needles • Syringes • Diluents • Antiseptic wipes
Source: Bown and Bollyky 2022. ©John Wiley and Sons. Reproduced with permission from John Wiley and Sons; further permission required for reuse. Note: Stages and inputs depicted illustrate the general vaccine production process and are not comprehensive.