WHO set to approve a COVID-19 vaccine by end of 2020—increasing hopes for equitable access

The United Kingdom’s emergency approval of a COVID-19 vaccine is an historic milestone in the global fight against the pandemic. But vaccine experts warn that the move may trigger a domino effect as other countries jockey for approvals—one that could reduce access for poorer nations for months or even years.

To better ensure equitable distribution, the World Health Organization and one of its major partners—the European Medicines Agency (EMA)—are now moving into their final stages of evaluation for the Pfizer-BioNTech vaccine, which the U.K. approved on December 2. A day earlier, the EMA accepted Pfizer’s application for authorization and is expected to conclude its assessment no later than December 29. An identical review was also launched for Moderna’s vaccine candidate. Its completion is expected on January 12.

“We are co-reviewing with them, so we're on a similar time table to what the EMA timetable is,” Katherine O’Brien, the WHO director of immunization, vaccines and biologicals, told National Geographic on Friday. “We can't guarantee what the outcome of those reviews will be, but they are ongoing.”

The decision shows just how much the vaccine race has accelerated in the wake of Britain’s emergency authorization. But that endorsement also adds uncertainty about when richer countries—such as the United States—will receive their doses once they approve the vaccine.

“As the manufacturing capacity ramps up month by month, it is not entirely clear which countries have dibs, so to speak,” says Krishna Udayakumar, founding director of Duke University’s Global Health Innovation Center. ...

In recent months, wealthier nations have pre-purchased huge amounts of the vaccines promised by frontrunner producers, such as Pfizer, Moderna, and AstraZeneca. Of the billions of doses that vaccine-makers have committed to make, three of every four already have been bought. By beating the rest of the world to approval, the U.K. has put immense pressure on other well-off nations and the WHO to authorize COVID-19 vaccines so they don’t have to wait for the limited early supply. Pfizer expects to manufacture about 50 million doses in 2020 and 1.3 billion next year.