→ Huub Schellekens, Professor of pharmaceutical biotechnology at Utrecht University: “We need 20 billion doses for the entire world population.”

Is Sanofi the only company that has the capacity to distribute a Covid-19 vaccine in Europe?

The important question we are facing now is: who can provide the quantities that are needed for global immunisation programs? The development of a vaccine is not rocket science, the most pressing issue now is production and distribution. And at this point, Sanofi is the only company in Europe that can produce a vaccine for 400 million European people. Everyone would require three shots, so that would amount to more than one billion doses. Sanofi is the only company that can produce that many vaccine doses right now. Other companies could also produce this amount, perhaps, but this would mean that they would have to stop the production of the other drugs that they produce, which would result in shortages of other drugs.

Is this a major handicap in the global race for a Covid-19 vaccine?
Let’s take the scenario that a classic vaccine can be made for Covid-19, which still seems likely at this stage. If this is indeed the case, development of a vaccine is not the problem, in Oxford for instance scientists are already doing clinical research and will test volunteers soon. But if you then think about the global scale, you have to ask: what about production and distribution? We need 20 billion doses for the entire world population. How will these be produced? Well, the answer is: only big pharma can do it. That’s the dilemma we are currently facing, the entire supply of drugs and vaccines is centralised, so if we actually want to produce something for the whole world within a short period of time, that means that we will have to be dependent on big pharma. 

Is this a handicap? If you take into account the ways that big pharma has, in the past and up to today, been successful in maximising their prices for vaccines and drugs, then there is indeed a very big problem. If they will ask a normal price for the Covid-19 vaccine, which could be between 40 and 50 euro’s per dose, possible, then there is no way we can afford 20 billion doses, that would just be too expensive. I do not think that this will be the case, however, mostly because of what’s happening in the US at the moment. In the US a lot of people who are sick do not have health insurance. And fifty percent of the big pharma market is in the US. So possibly big pharma now realise that if they don’t do something about Covid-19, people there won’t be able to afford the prices of other drugs anymore. And that would be a dangerous situation for the pharmaceutical industry. So the realisation that they need to make sure that the market for our other medicines is maintained might play a role in their current decisions on a Covid-19 vaccine.

Does this mean that they only think about economic interests?

Yes, however, when I think of Johnson and Johnson at the moment, I think they’re really working on providing an affordable vaccine. I have acquaintances there and have read the press releases, and they have another tone than usual, so I think they’re really trying to contribute something to the epidemic that’s also affordable. But of course one could also say that the companies have to do something, otherwise they will lose their other markets.

Do you think that Europe is investing enough in the development of the vaccines? If not, why?

Well, again, the development of the vaccine is not the problem, the European countries are raising so much money now. That’s very sweet of them but also not really necessary. Let those people in Oxford and Johnson and Johnson do their thing; development is not the problem anymore, the problem is the production of the vaccines and the vaccination itself, during distribution. Policymakers have to think carefully about these topics: how are we going to distribute the doses? So it would be good to spend money on this question. For instance: a vaccine needs a cold chain, it needs to stay cool when distributed. In many parts of the world this is can create huge problems. In the past, many doses of a vaccines have been spoilt along the way during distribution. And these numbers of spoilt doses were not trivial, on the contrary. So when the vaccine for Covid-19 has been developed, these are the questions that need to be solved and it would be wise to already start thinking about this now and spending money on this in advance.

In 1978 we managed to eradicate a virus, that year saw the last case of smallpox. The success of a vaccine is not only a technical issue, but also a political and social one. Only think of the social pressure against vaccinations now in many countries. These questions are already very heavily politicised in society, so you have to think about how to navigate these societal and political pressures too.