WMA Resolution on Equitable Global Distribution of COVID-19 Vaccine

Adopted by the 71^st WMA General Assembly (online), Cordoba, Spain, October 2020

PREAMBLE

The SARS-CoV-2 pandemic has a tight grip on the world. Over a million people have died worldwide and millions more are still suffering the effects of this virus and the disease it causes.

A vaccine is widely seen as the best way to stop the spread of the virus, gain control of the pandemic and save human lives.

WMA policy clearly states that “vaccination and immunisation have been acknowledged as an effective and safe preventive strategy for several communicable diseases. And vaccine development and administration have been the most significant intervention to eradicate infectious diseases and influence global health in modern times”.

While there are currently no approved vaccines for COVID-19, an unprecedented global effort is underway, both in terms of scale and speed, to develop a safe and effective vaccine and to optimise procurement and distribution to ensure that all regions of the world stand to benefit as quickly as possible. Some current predictions anticipate an initial COVID-19 vaccine rollout in the first half of 2021. Due to intensive efforts to produce effective vaccines and fast track them for market authorisation, many clinical trials have been placed on extremely accelerated schedules. Processes usually requiring years are being condensed into months, which could potentially pose a threat to the ethical principles outlined in the WMA Declaration of Helsinki.

Questions arose quite early in the pandemic about how to distribute a potential new vaccine quickly and equitably. Many higher-income countries have already signed bilateral agreements with pharmaceutical companies to supply or distribute COVID-19 vaccine candidates, which, given the limitations on production capacity, could leave developing countries at a disadvantage as they strive to protect their populations.

It is a fact that a pandemic cannot be contained by one country alone; it requires a collaborative, global effort, as the WMA has outlined in its Statement on Epidemics and Pandemics and the Statement on Avian and Pandemic Influenza.

In the same spirit, GAVI, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO) have initiated the COVAX platform in order to guarantee that all participating countries, regardless of their income, have equal access to new COVID-19 vaccines once they are developed.

RECOMMENDATIONS

The World Medical Association

1. welcomes multilateral solutions in the global battle against COVID-19, in particular the COVAX platform, for ensuring equitable, global distribution of a safe and effective COVID-19 vaccine;
2. emphasises that no country should be left behind in the race to vaccinate its population against this global threat;
3. stresses the need to balance between the desire of each country to protect its citizens and the need for the vaccine to be distributed worldwide;
4. reiterates that all clinical trials must follow the ethical principles for medical research involving human subjects as set forth in the WMA Declaration of Helsinki;
5. states that longer-term, formal safety monitoring is necessary in cases where clinical trials have been accelerated to fast track vaccines for market authorisation;
6. calls attention to the heightened risk faced by health workers and vulnerable populations in a pandemic situation and therefore urges that these individuals be among the first to receive a safe and effective vaccine;
7. renews its call to all constituent members to increase awareness of immunisation schedules and calls upon individual physicians to pay special attention to addressing the concerns of vaccine-hesitant patients;
8. reaffirms its warning on vaccine hesitancy (April 2019) and reiterates the importance of maintaining other important routine vaccinations, e.g. against polio, measles and influenza;
9. calls for coordinated efforts to increase public trust in vaccination in the face of disinformation campaigns and anti-vaccine movements which undermine the health of both children and adults.