Yemen, which was already the poorest country
in the world before 2015, the Saudi-led coalition
bombing of the country, COVID is also spreading
there, and unlike most of the world, 25% of
the people who contract COVID-19 in Yemen
die.
That’s five times more than the global average.
So, if you could talk a little bit about — you’ve
been working, attending a conference that
looks at the development of a vaccine for
COVID-19 and how to ensure access to the vaccine
in the countries that have been most vulnerable
to its spread, including Brazil.
So, could you tell us where that stands now?
Yes.
That’s a very good question.
So, Brazil now is going to test two vaccines.
So, there is an agreement that was signed
with a Chinese pharmaceutical company and
with a vaccine from Oxford.
And then there are also groups in Brazil developing
different types of vaccines.
So there’s a different effort in different
fronts.
Now, the key issue for low- and middle-income
countries will be, if we imagine a scenario,
hypothetical scenario, that we get a good
vaccine — whatever “good” means, that’s
a different discussion — and it’s ready to be 
produced at scale and then for a vaccination at scale.
So, the first item, production at scale, right?
So, if the production is going to be restricted
to the high-income countries, it does raise
the question: Who is going to get it first?
And we saw this before, when we had the H1
and N1, that the rich countries got the vaccine
first, because they could pay for it or they
were producing it, and then the others had to wait.
That is the first discussion.
That’s why it’s so important for those
agreements, international agreements, that
are being made, so that countries can have
access to all the science behind the vaccine
development, but they also can have access
to the vaccine being produced.
Brazil is unique in the sense that they do
have at least two public institutions — and
I’ll go back to this point in a moment — but
they have Butantan Institute, and they have
a FIOCRUZ, that they already produce most
of the vaccines distributed in the country.
They can do it.
However, it depends what type of coronavirus
vaccine we’re going to have.
There are different types of them, and each
one of them demands a different type of industrial
plant to be able to produce.
So, again, what countries should be doing
now — and there are some European countries
doing this — is the ones that have the industrial
capacity to produce the vaccine, they should
be trying to find ways to expedite the industrial
production,
so the moment something is ready, they can do it.
Again, not every country will be able to do
this, and they will depend on the countries
producing the vaccine to have access to it.
The second thing is, it depends on how the
vaccine will be distributed.
Is it a type of vaccine that is very stable
and easy to carry?
Is it a type of vaccine that is not very stable
and it’s going to be much more tricky to
go around the country and to the very isolated
areas to distribute?
We don’t know that yet.
But that can bring challenges to the whole
logistic process of doing vaccination at scale.
The other thing is, we don’t know how many
doses we’re going to need.
And we don’t know how countries, inside
each country, they will prioritize who is going to get first.
Now, again, the case of Brazil is interesting
because we do have a universal health system.
Everybody gets access to care and to vaccination
for free.
You don’t pay a penny for it.
So, in theory, every person in Brazil will
be eligible to receive this vaccine once it’s available.
But if it takes a long period of time to produce
the vaccines— right?
We have 8 billion people in the world.
So, how long is it going to take to produce
8 billion doses?
Well, if you can only produce 1 billion per
year, you can imagine that we’re going to
have to set priorities, both on inside each
country who is going to get first and how
countries will make agreements on how many
doses they are going to receive.
So, the vaccination at scale is going to be
extremely complicated.
