Equity and local production are highlighted on the first day of the pandemic prevention summit

Discussions around equity in access to vaccines and its connection with local production, funding and cooperation were some of the key points of discussions on the first day of the Global Pandemic Preparedness Summit (GPPS 2024), organized by Department of Health, Fiocruz and the Coalition for Epidemic Preparedness Innovations (Cepi). The event, which took place in Rio de Janeiro from 7/ 29 to 7/30, had, in its opening, the participation of health authorities, such as the Director-General of the World Health Organization (WHO), Tedros Adhanom; the executive officer of the WHO Health Emergencies Program, Mike Ryan; the Health Minister, Nísia Trindade; the President of Fiocruz, Mario Moreira; and the President of Cepi, Jane Halton. 

The president of Fiocruz, Mario Moreira, participated in the opening of the summit (photo: Peter Ilicciev)

At the panel that debated the 100-Day Mission, which foresees that during this period it will be possible to respond to a new viral threat, Mario Moreira emphasized that there are numerous challenges, such as research, development and production scale-up in a timely manner. According to him, something that is also worrisome is the challenge of ensuring access for everyone. “We have gathered knowledge and capacity to develop vaccines in an increasingly shorter time, but that is not the biggest issue,” he stated. “The challenge is to ensure that the vaccines developed can be produced on a global scale and be distributed equitably.” 

'The country only vaccinates if it produces the vaccines'

Enabling equitable access through local and regional production was precisely the theme chosen for one of the panel discussions of the day. In it, the Secretary of Science, Technology, Innovation and of the Health Economic-Industrial Complex, Carlos Gadelha, highlighted that the pandemic showed that countries without productive and technological capacities are unable to face crises. “Brazil only vaccinates when it has local production,” he said. He recalled the concentration of supplies in rich countries during the Covid-19 pandemic and stated: “I wanted to emphasize the link between production capacity and universal access to health. In Brazil, local production saved 200,000 lives. We owe this to Fiocruz and Butantan, which working along with private networks allowed this.”

For Gadelha, it is necessary to “see the Global South not just as a consumer, but as the place of abundance of people and technology that can cooperate in a network of innovation and production in health.”

The Director of the Immunobiological Technology Institute (Bio-Manguinhos/Fiocruz), Mauricio Zuma (photo: Peter Ilicciev)

The agreement between Cepi and Fiocruz for Fiocruz to join the Coalition's global network of vaccine manufacturers, signed during the Summit, was classified by the Director of the Immunobiological Technology Institute (Bio-Manguinhos/Fiocruz), Mauricio Zuma, as a “great responsibility” and as a possibility of demonstrating the Foundation's commitment to global efforts to provide equitable access to vaccines. 

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“We are in a great moment to reinforce regional production, but we know that this is not enough. The development of technological capabilities demands other requirements that are not so simple to obtain”, stated Zuma: “We need to have more freedom to operate, fewer intellectual property restrictions, more access to capital to continue to invest and modernize our facilities of research and development”. He added that more collaboration and coordination are also needed: “And on this topic, I believe that international organizations have an important role so that we can achieve what we are debating here (equity).” 

Zuma explained that the production of Bio-Manguinhos during the pandemic was the result of a long learning path. “It was based on technology transfer processes, and now we are focusing on the development of our products, with strategic partners”, he said. “If we don’t have this (local production) capacity, we won’t have a future.”  

Financing and cooperation in the Global South

The General Director of CDC Africa, Jean Kaseya, highlighted in a panel about surveillance that, more than thinking about the future, it is necessary to face the present, given a situation of infectious diseases' outbreaks, such as Mpox, on the continent. “I'm not thinking about what will happen, but about what we are experiencing today,” he said, emphasizing that there are gaps to overcome. Kaseya highlighted the importance of coordinated actions between African countries. Today, according to him, Africa would not be able to adequately face a pandemic, due to the fact that investments are needed on several fronts, such as research and reinforcement of health systems. “At a global level, the response (to Covid-19) was not ideal”, he recalled, highlighting that he hopes that the Pandemic Treaty will be concluded and accepted to ensure less unequal access to supplies, for example.

The issue of funding returned to the debate at the panel regarding the 100-Day Mission. The president of the FIND organization, Ayoade Alakija, led the discussion on how to prepare to face a crisis or invest in local production capacity without enough funds. “How are we going to produce, to regulate? We need to look back and understand our history in order to look forward”, referring to the inequities during the pandemic. Like Kaseya, she drew attention to the ongoing outbreaks in Africa and the difficulty in diagnosing cases: “We are facing threats now, diseases that no one is talking about.” 

The ministry of Heath, Nísia Trindade (photo: Peter Ilicciev)

Also reflecting on the differences in access to health supplies during the pandemic, Mario Moreira emphasized that the 100-Day Mission will only be possible with a “new global arrangement”. The president of Fiocruz also highlighted the Foundation's tradition of collaboration in Latin America and Africa, especially with countries from the Community of Portuguese Language Countries (CPLP) in the field of education, by offering training and specialization courses, and supporting the structuring and reinforcement health systems. 

A study presented by the President of Cepi showed that, if the 100-Day Mission had been implemented and successful before Covid-19 emerged, 800 million infections would have been avoided. “That’s why we are committed to accelerate and sustainably support the research, development and the capacities around the world. Every country, regardless of their wealth or geographic location, should be able to protect its population,” said Jane Halton. “Collaboration is not optional. When it comes to an infectious disease, a threat to one is a threat to all.”

Richard Hatchett, CEO of CEPI, emphasized that, in order to achieve the 100-Day Mission, it is necessary "to develop capacities with medical countermeasures and to globalize access to these technologies", taking advantage of new tools such as Artificial Intelligence to eliminate bottlenecks. "Facing pandemics is essential for the well-being of the world's population, and Brazil's leadership can make a significant impact in this regard."
Painful lesson

The event was opened by Minister Nísia Trindade, who, as a member of the Coalition's board, participated in the first Cepi summit, in 2022, in the middle of the pandemic, when she was still the President of Fiocruz. The Minister defended the need for steady and robust funding for initiatives to fight against health emergencies and for the development of technologies concerning diagnostic tests and medicines.

“Much was said about the speed of the vaccines' development during that period, as a result of constant research funding for laboratories, which made the difference in the fight against the pandemic. But it is necessary for research and development to be more equitable, focused on global challenges”, he emphasized, recalling difficult times that the country went through, and highlighting that “science has returned to Brazil”. 

The UN Secretary-General admitted that Covax, the mechanism for supplying vaccines to poor countries during the pandemic, was not fast enough. “We cannot allow the same thing to happen next time. And there will be a next time. It's not a question of 'if', but 'when'”, said Tedros Adhanom, in a video. He mentioned initiatives such as technology transfer for mRNA platform vaccines and the WHO's Hub for Epidemic and Pandemic Intelligence in Berlin. “We still have a long way to go. But together, we are making the world more prepared than ever,” he added.

The General Secretary of the Pan American Health Organization, Jarbas Barbosa, agrees that the world is better now than it was before the pandemic, but it is still far from where it needs to be.” We have a clear vision of our weakness. Countries have more realistic views of the matter. It was a painful lesson,” he said.

'We will not do better in the next pandemic by preparing for the last one'

At many times during the day, participants emphasized that preventing pandemics involves constant preparation and reinforcement of health systems. 
Comparing the Covid-19 pandemic to a ship crossing a storm, the executive officer of the Health Emergencies Program and Deputy Director-General of the WHO, Mike Ryan, warned that it is necessary to emerge with a renewed sense of purpose and daily work that lets us chart a way in order to navigate future epidemics. 

“We will not do better in the next pandemic by preparing for the last one. We will only do better if we can collectively predict, prevent, detect and respond collectively to health emergencies every single day. If we build together more resilient health systems that can absorb shocks while scaling up and protecting the workforce. We can only do better by investing in our communities,” Ryan said.

To him, the high connectivity of the world ends up exposing itself. “We are the most connected population in history. It takes only hours to move between urban centers around the world. This connection has brought us many benefits in terms of human development, but it also leaves us vulnerable. The pathogen spreads quickly among us, just as the spread of misinformation. It's a double-edged sword. While dealing with the pandemics, it may be our greatest weakness, but I say it is our greatest strength. The path we take now will determine the extent to which we can protect our world from the next pandemic threat,” said the deputy director-general. “We must rethink our approaches and reimagine our future if we are to face the storms to come,” he advised.