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Register at https://duke.zoom.us/webinar/register/WN_GIx_EdfsT2mh95ZOp-QQiw

And we're off. I'll do a little live tweeting. We're discussing manufacturing & supply of COVID-19 vaccines worldwide.

Matt Johnson @TheDHVI is moderating. If you have any questions, let me know and I will post them to the panelists in the chat. FANTASTIC PANEL.

IMHO, this global vaccine inequity should keep us up at night. It is a catastrophic moral, ethical & global public health failure. At the current rate of vaccine roll-out, this pandemic will last years. Are we OK with that?

This slide from Matthew Johnson is GREAT : summarizes positives & negatives. The webinar today will address these big issues. MFG: manufacturing, IP: intellectual property, LMIC: low- & middle-income countries

Great example of 'force field analysis' (I teach this in my class)

Dr Krishna Prasad summarizes "the 4 main vaccine platforms that have percolated to the top."

Blimey, this is such a fantastic presentation. Here Dr Prasad compares the pros and cons of the 4 main COVID-19 vaccine technology platforms.

The speed of the mRNA platform, says Dr Prasad, is a huge advantage. If we need new versions of COVID-19 vaccines (e.g. against a particular variant), he says mRNA vaccines have an advantage.

Next up, one of the world's leading experts on IP & global health, Arti Rai. She discusses the request for a waiver on copyright, industrial design, patents & trade secrets. The 'patent waiver' has received the most attention, she says. Patents were a barrier on access to ARVs.

Dr Rai: "it's not entirely clear that patents are the key issue."

She says: there are lots of patents on mRNA vaccines, especially the delivery mechanism. BUT some companies e.g. Moderna have pledged NOT to enforce patents, and AZ has licensed its patents "fairly liberally."

"The main event is trade secrecy," and not patents, she says. Trade secrets are of 2 types, she says:

-explicit, codified knowledge
-tacit knowledge (only in the brains of skilled scientists & technicians)

Some explicit knowledge, says Prof Rai, is in the hands of regulators. What S Africa & India are asking for is for their regulators to be allowed to share this knowledge. There would also be domestic laws that regulators would need to take into account in whether to share.

Tacit knowledge: the only way it gets transferred, says Prof Rai, is via technology transfer agreements.

Trade secrecy is harder to discuss than patents, because, well, it is secret.

The no. of patents on mRNA, especially the DELIVERY SYSTEM, has exploded in recent years.

Moderna challenged this patent on mRNA delivery (lipid formulations for nucleic acid delivery).

Next up, my colleague Andrea Taylor @DukeGhic. She has been at the very forefront of an amazing Duke project tracking doses and manufacturing ( https://launchandscalefaster.org/ )

Andrea Taylor thinks the projections by vaccine manufacturers are "wildly optimistic" for 2021. They keep scaling back their predictions. Lack of raw materials (e.g. filters) is a big barrier. Export restrictions means many doses projected to be made in 2021 will NOT get exported

"The need for boosters could exacerbate inequalities" worldwide. She thinks that what will happen is that rich nations will end up keeping the manufactured doses to themselves, for boosters, making global vaccine inequity worse.

Wow, that is so freaking depressing to think about

Andrea Taylor shows the current global manufacturing landscape.

People, sorry to be a bit shouty here, but THE OXFORD VACCINE IS A VACCINE FOR THE WORLD! It is safe, efficacious & both my parents got it. Take a look at where it is being manufactured in comparison with Moderna

Hey, look at this: Sinovac and Sputnik V are also being manufactured in many low and middle income nations.

But there are bottlenecks in getting raw materials to make these vaccines.

Next up is Dr Morena Makhoana. He says we need to stop thinking only about vaccine manufacturing hubs just for this current COVID-19 pandemic. These need to be long term hubs for a wide range of vaccines!

We have to get a system in place NOW to make access to vaccine raw materials globally equitable and to make vaccine manufacturing globally equitable.

@AfricaCDC and @_AfricanUnion have unveiled the Partnership for African Vaccine Manufacturing to "make Africa sustainable"

Note there will be 5 research AND manufacturing hubs across the continent. "Hopefully in the next 3-5 years there can be a redress, but it must include supplies." The factories must be kept warm: "you can't just activate them during a pandemic."

PANEL Q AND A:

Ha ha, they are taking *my* question first. I asked how quickly manufacturing of COVID-18 vaccines can be globalized.

Fill-finish can be scaled fast, says Dr Makhoana, but not drug substance. He also says WHO put out an RFP for a hub & spoke model for mRNA vax

Dr Rai gets asked about the TRIPS waiver.

"The issue of whether trade secret information as a domestic matter can be disclosed is a tricky one." The US, for example, has a trade secrets act.

Voluntary and cooperative agreements, says Matt Johnson @TheDHVI, is arguably going to be the way forward here. You still need investors in new technologies, he says, including for future pandemics, and "you don't want to scare them away."

Panelists talk about public investment in COVID-19 vaccines & whether this means the vax should be a *global* public good. Andrea Taylor says: if the USG invests, it clearly will prioritize US citizens when the vaccines are made! US will never make these vaxx a GLOBAL public good