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Too Stingy, too slow: How the EU could have avoided their vaccine rollout fiasco

DOCTORS AND NURSES OF THE INTENSIVE CARE HOSPITAL, FIGHTING COVID-19 EMERGENCY IN PESARO - ITALY. THEY ARE PORTRAITED AT THE END OF THEIR LONG WORKSHIFT. 12 HOURS WITH NO DRINK AND NO TOILETBREAK, DUE TO THE PROTECTIVE SUIT THEY WEAR. THE SIGNS ON THEIR FACE ARE CAUSED BY THE MASKS THEY HAVE TO WEAR TO PROTECT THEMSELFES FROM COVID VIRUS. IN THE PICTURE: Annalisa Silvestri, Doctor anaesthetist

Jack Hodges in a two-part Roar News x European Horizons collaboration on how the European Union bundled their vaccine rollout.

On Tuesday 2nd March the Danish and Austrian governments said that they would “no longer rely” on the EU alone to provide them with COVID-19 vaccines and were in the process of seeking to source them with the help of Israel. This is just another in a series of blows to the European Union’s Joint Vaccine Procurement strategy. Just a few weeks earlier, the European Commissioner, Ursula von der Leyen, created a short-lived diplomatic crisis after she appeared to threaten to place restrictions on the Irish border to make up for some of their vaccine shortage.

This then begs the question, how could such a large bloc, with all its technocratic expertise and economic leverage have ended up in such a position where their own members are breaking rank to secure their own vaccines?

In theory, a policy of pooling resources to negotiate a better price for a vaccine in a time of incredibly high demand sounds like a sensible idea. In fact, in some ways, the policy has been a success. The EU has negotiated far lower prices for its vaccines and has been able to guarantee a supply of them to all of its member states, albeit slower than many other comparable nations. They have also avoided major internal competition between their members emerging and a potentially devastating descent into vaccine nationalism, with all the corrosive effects that would have on European Unity.

However, it is also true that by virtually every other measure, this policy has been a failure. They have currently administered 30 million vaccine doses. Whilst still a significant number, the UK alone has administered over 30 million, despite having a population one-sixth the size. Serbia, who also opted out of the Joint Program, has gained a large early lead on vaccinations compared to the EU as well. These failures have resulted in a significant political backlash towards Brussels which whilst not the vaccine nationalism they sought to avoid, is still a significant problem. This has only made worse the economic and public health damage such a slow rollout has brought.

By looking at a timeline of how the crisis unfolded, we can see how the EU under the Joint Procurement Scheme consistently fell behind its peers.

In February of last year, it first became apparent that COVID-19 was going to become a global pandemic. As such, governments around the world began the scramble to secure orders for vaccines as they were being developed. In the US, the Trump administration, though very much downplaying the virus publicly, was beginning to make contact with the pharma giants. On 11th February, they teamed up with Johnson & Johnson to secure a vaccine and made a similar deal with French giant Sanofi. On the 3rd of March, they began talks with German manufacturer CureVac for exclusive vaccine access, though backed off after this created a row in Brussels. The US were not alone in early talks with big Pharma, the UK government secured a partnership between AstraZeneca and Oxford University, placing an order of 100 million doses by 17th May.

By contrast, the EU had still not gotten its act together and it took another month for them to have announced their policy of acting in unison to negotiate a deal. In the meantime, many of the big players in Europe had lost their patience. By April, France and Germany had begun to work together to secure vaccines and by June had created a buyers club alongside the Netherlands and Italy. Though this ultimately was wound down in place of the EU scheme which was finally created in mid-June under the Emergency Support Instrument, it again highlights the sluggishness with which the EU approached acquiring vaccines.

This Instrument allows the commission to act on behalf of its members in talks with pharmaceutical companies without having to constantly go back and forth gaining their consent. It also fully utilises the market power of Europe, giving far greater leverage to the EU in negotiations with the vaccine manufacturers who ordinarily would have been able to play one off against the other. Finally, on 31st July, the European Commission concluded its first order of 300 million vaccines from Sanofi and at the end of August concluded a deal with AstraZeneca – more than three months after the UK.

These were not the end of such delays either. The negotiations were dragged out by European insistence on driving down price and upholding their policy of holding pharmaceutical companies liable for anything which may go wrong down the line. Once the negotiations were over and the vaccines were finished and submitted to regulators, the EU was slow. The EU consistently took longer to approve vaccines than its peers. Whilst this was borne out of a desire to maintain its high standards, it brought with it far longer delays for getting needles in arms.

The costs of such a wait have been great. The frustration member states have felt at seeing others begin vaccination has created a political rift between Brussels and the national capitals. The economic cost has been sizeable too; any delay has only prolonged the crippling lockdowns and the economic pain they bring. The highest cost though is the human one. Every day longer of the pandemic means more infections, more hospitalisations and ultimately, more deaths.

Faced with such an outcome, what could have been done differently?

Clearly, the EU should have acted earlier and more decisively forming the Scheme. In fact, they first considered exercising their powers under the Emergency Support Instrument fairly quickly. As early as the 2nd of April it was proposed that the Instrument could be used to give out €2.7 billion in funding to healthcare systems across the continent. However, this did not happen. The knock-on effect of such slow action has that any production ‘glitches’ found in vaccine manufacturing plants have had far less time to be ironed out. As a result, the EU has found much of its supply disrupted, receiving less than 60% of some of its orders. This could likely have been avoided had the Support Instrument been utilised to its full potential when first proposed, allowing negotiations between the manufacturers and commission to begin more than two months earlier.

Another change that could have been implemented is a policy of mutual recognition of vaccine approval within a group of allies, the G7 for example. Such an alteration in policy would have sped up the approval and distribution of the vaccines once created by allowing the vaccine to be used once any of these nation’s medical regulators had approved it. The effects would have been dramatic. The Moderna vaccine could have been deployed in Europe 18 days earlier, Pfizer/BioNtech 19 days and the AstraZeneca vaccine a whole month earlier. The number of these vaccines ordered by the EU is well over 1.5 billion and their earlier approval and distribution would have saved thousands of lives.

Not only this, but it would have avoided the compounding of frustrations that followed the approval and use of these vaccines in other nations. This was particularly evident following the delay to approve the BioNtech vaccine, the first to be put to regulators across the world. The delay was so infuriating to member states that many began to publicly criticize the scheme and threatened to begin vaccinating early before the planned ‘V-day’ of European unity in which all states would begin inoculating their citizens at once. The political costs of these delays are clear – another kick for a shaking EU.

Finally, the EU should have abandoned its short-sighted strategy of driving down prices-per-dose of vaccines as low as it could. Whilst this did yield results, the Union pays under half what the US does per dose for some vaccines, it came at considerable cost. It prolonged negotiations and has made pharmaceutical companies far less receptive to the EU’s changing needs and requests. The economic benefit is also unclear, with many arguing that the costs of higher deaths and lengthier lockdowns outweighs that of cheaper vaccines considerably. Instead, a change to a policy closer to that of Israel’s would have been better. Their policy of ‘whatever it takes’ has allowed them to race ahead in the vaccine race and ultimately begin lifting many of its COVID restrictions well before Europe

In all, this policy by the EU, though good in principle has been lethargic and miserly in its execution and has not made use of possible efficiencies in approval. The result has been longer lockdowns and increased deaths. One can only hope if another pandemic arises, the EU and the Commission, in particular, will spring to action faster and more efficiently.

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