Vaccine nationalism undermines pandemic response, AstraZeneca chairman says

Leif Johansson says inequality of distribution of shots has slowed Covax programme

Employees unload AstraZeneca Covid-19 vaccines under the Covax scheme from a cargo plane in El Salvador. Reuters

Vaccine nationalism is having a devastating impact on the global response to the Covid-19 pandemic, particularly the Covax programme to supply poorer nations, and has hurt major manufacturers' ability to supply jabs across borders, the chairman of Anglo-Swedish pharmaceutical company AstraZeneca said.

“What we did not expect was to see vaccine nationalism building the way it did,” Leif Johansson, the non-executive chairman of the UK's biggest listed company told The National.

“That has limited our ability to cross-supply between different continents, which I hope we won't see again.”

As the Omicron variant bears down and the pandemic approaches its third year, the continuing surge of cases is a result of the unequal distribution of vaccines, the World Health Organisation has said.

Vaccine nationalism — in which wealthier countries vie for first access to doses — is a major contributor. WHO Director General Tedros Adhanom Ghebreyesus called inequitable vaccine distribution “a failure for humanity”.

AstraZeneca has been the biggest supplier of Covid-19 shots to Covax, an initiative aimed at providing equitable access to vaccines. This is according to data from Gavi, the vaccine alliance that co-manages the programme with the WHO.

The programme has so far delivered more than 757 million shots to nearly 150 countries, of which more than 220 million are from AstraZeneca and about 160 million from Pfizer.

But in the first quarter of next year Pfizer is set to become the biggest supplier, Reuters reported, citing figures on future supplies.

“No one would be happier if [Pfizer] were doing that than I would be because they haven’t been so far,” Mr Johansson said of being overtaken as a leader in the Covax programme.

Covax focused on the cheaper and easier to transport AstraZeneca vaccines at the beginning of the pandemic. The shot typically costs less than $4 a dose compared to $10-20 for Pfizer, according to publicly available records. AstraZeneca doses are easier to move and store because they do not need to be kept as cold. But supply problems and export restrictions from top producer India gradually reduced its reliance, Reuters reported.

Mr Johansson said that “given the limitations that sometimes came out of this vaccine nationalism” Covax has “been less quick to be able to do what they wanted to do” in distributing vaccines widely.

“We should think highly of all the people who participated in creating Covax but I would like to have seen it quicker and bigger,” he said, speaking on the sidelines of Expo 2020 Dubai.

Unlike Moderna and Pfizer, whose stock prices got a boost on the back of successful roll-outs of mRNA vaccines against Covid-19, AstraZeneca's share price has been muted, with the stock largely unchanged compared to the start of the market rally in May 2020.

But suppositions that developing Covid-19 treatments are outside the core business of the company, which has historically made its money in oncology and cardiovascular treatments, are “no longer true”, Mr Johansson said.

A little more than a year after entering into an exclusive licensing agreement with Oxford University for the Covid-19 vaccine it had developed, AstraZeneca announced it would open a new division for vaccines and antibody therapies.

The new business will be led by executive vice-president of Europe and Canada, Iskra Reic, to combine research and development, manufacturing, as well as commercial and medical teams, Reuters reported at the time.

AstraZeneca has sold the vaccine at a not-for-profit price and stood up 17 global supply chains to enable widespread distribution. The model has required entering into several licensing agreements with large manufacturers, including the Serum Institute of India.

While this is the company's status quo during the pandemic, AstraZeneca said as the coronavirus becomes endemic it will begin to make a profit off the jab, which it expects will happen sometime in 2022.

Mr Johansson said the new vaccine division, as well as its newly opened £1 billion ($1.3bn) R&D centre in Cambridge, UK, are part of a push to do more “druggable science”.

The booming field of life sciences and the rapid reduction in the time and cost of genomic mapping over the last decade are making it an exciting time in the pharmaceuticals industry, he added, with patient data representing one of the biggest untapped opportunities.

“In many parts of the world, we are too shy or we are being asked the wrong question,” he said. “Would you want to have all of your data collected in such a way that industry or the healthcare provider or anyone could use it for a meaningful scientific effort? People hesitate with that for privacy reasons.

“But if you ask them instead, do you want to get the best treatment when you become sick and especially in an emergency room, 95 per cent of people will say yes.”

The chairman at AstraZeneca for over nine years, Mr Johansson has led some of Sweden's biggest companies including Electrolux, Volvo and Ericsson.

The pandemic was a new proving ground, much different from the energy crises and recessions he has weathered in the past, he said.

“I said at the beginning that I will not hire people and I won't make very large acquisitions.”

Instead, he's tapped three new board members and in July finalised the $39bn takeover of Alexion Pharmaceuticals, a lucrative portfolio of immunology medicines and a foray into rare diseases.

While Mr Johansson has proven he can be more productive working remotely (“40 per cent more meetings compared to 2019"), and plans to reduce corporate travel for both himself and the wider business, he said the biggest lesson has been the value of multilateral trade agreements and global supply chains, even in the face of crisis.

“The rational arguments for doing this multilaterally and on a global scale are ear-deafening,” he said.

So far, not enough are listening.