Illustration Credit: Chappatte, Le Temps
In an effort to reduce COVID-19 vaccine inequality in Latin America and the Caribbean, the World Health Organization (WHO) and the Pan-American Health Organization (PAHO) have announced plans to manufacture COVID-19 vaccines within the region. Dr. Carissa Etienne, a native of Dominica and director of the PAHO, declared last week that the PAHO has reviewed roughly 30 proposed manufacturing schemes for Latin American and Caribbean states. The program—formally entitled the Regional Platform to Advance the Manufacturing of COVID-19 Vaccines and other Health Technologies in the Americas (RPAMA)—has as its mission the coordination of vaccine production and distribution across Latin America and the Caribbean. In a recent PAHO meeting, Dr. Etienne emphasized the importance of an internationalist approach to vaccine production in the region, inviting private and public manufacturers to develop vaccines and distribution methods that serve both domestic and regional vaccination efforts. The PAHO, a WHO subsidiary, has also stated that the vaccine production program would manufacture messenger RNA vaccines, similar to those produced by Moderna, Pfizer, and BioNTech, favored for their efficacy and flexibility in the face of emergent variants of the virus. In late August, both Pfizer and BioNTech agreed to collaborate with Brazil’s Eurofarma Laboratories to produce mRNA vaccines in Latin America, with the aim of eventually producing and distributing over 100 million doses annually, with Pfizer and BioNtech’s assistance. (Notably, however, Pfizer will not produce mRNA materials in Brazil, even though the lack of laboratories capable of producing mRNA material and other essential elements of non-mRNA vaccines has contributed to distribution issues in low and middle-income countries worldwide.) While most manufacturing facilities capable of producing COVID-19 vaccines are located in the U.S., Western Europe, Russia, China, and India, several Latin American nations, including Mexico and Chile, have begun construction on facilities designated for domestic vaccine production.
The PAHO’s vaccine production program, and joint ventures like the Pfizer-BioNTech-Eurofarma partnership, highlight the growing divide in vaccination rates between wealthy and low-income states. While the European Center for Disease Prevention Control reported this week that the European Union has fully vaccinated 70 percent of its eligible adult population, Haiti has yet to fully vaccinate even one percent of its adult population. Intraregional inequality has also troubled Latin American states. According to The New York Times, although Chile and Uruguay have each fully vaccinated over 70 percent of their eligible populations, Peru and Bolivia, among other nations, remain below 25 percent. The gap between smaller, poorer countries and larger, wealthier countries is even more starkly visible in Central America and the Caribbean, regions currently struggling to contain a rise in infections even as cases decline across much of South America. Only three percent of eligible Nicaraguans have been fully vaccinated, along with just seven percent of eligible Guatemalans, less than five percent of eligible Jamaicans, and less than ten percent of eligible Saint Vincentians.
The PAHO already plays a central role in Latin American and Caribbean vaccine distribution through its role as the official procurement institution of COVAX, the world’s largest multilateral partnership for COVID-19 vaccine distribution. Many Latin American nations, however, have voiced frustration and dissatisfaction with the COVAX system. In July, Paraguayan President Mario Abdo Benítez declared that COVAX “did not work” for Paraguay, adding that “[Paraguay] bet on the COVAX mechanism to generate equity,” but to no avail. In late July, Paraguay followed the precedent set by wealthy nations by forging a direct agreement with Pfizer and Moderna to purchase COVID-19 vaccines. Meanwhile, Dr. Etienne of PAHO has expressed her hope that the RPAMA initiative will help to alleviate vaccine deficits endured by Paraguay and other nations throughout the Western Hemisphere. “We must expand regional pharmaceutical production,” she said, “so we can be in the driver’s seat.”