Why Swiss participation in WHO’s Covid-19 vaccine plan matters

Multiple Covid-19 vaccines are currently being tested but no one knows yet which will be safe and effective. A WHO vaccine pool helps countries to hedge their risk. Keystone / Bagus Indahono

The second wave of coronavirus is making the race for viable vaccines even more urgent. In an unprecedented move, the Geneva-based World Health Organization (WHO) this summer launched COVAX, a vaccine pool that aims to ensure equitable access for all countries.  

Switzerland, which has also signed two bilateral deals with vaccine companies, seemed to hesitate in signing up but has done so. What is COVAX, and why is Swiss participation important? 

Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers (IFPMA), says Swiss participation is vital. Given its role as host country to the WHO and the Gavi Vaccine Alliance organisation, as well as co-chair (with Singapore) of the Friends of COVAXExternal link, “I personally feel that Switzerland was a little bit late in announcing its support for the COVAX Facility,” he told swissinfo.ch.  

Switzerland was not on the WHO’s initial list on September 21 of countries that had signed up, causing a few raised eyebrows. However, it announcedExternal link a few days later that it had joined the vaccine pool. A spokesman for the Swiss Federal Office of Public Health (FOPH) told swissinfo.ch that the delay was due to the “signing process” and that Bern’s commitment is “firm”. 

“Self-interest” 

COVAX needs funding support if it is to work properly. And as well as showing international solidarity, experts agree that it is also in Switzerland’s self-interest to join. “I think it’s the right decision,” says Suerie Moon, co-director of the Global Health Centre at the Graduate Institute in Geneva. As a small country, Switzerland does not have the negotiating clout of high-income countries with large populations like the US, UK, Japan and the European Union, where “there may be a much bigger commercial interest for any individual vaccine company”. With COVAX “Switzerland has a channel through which to get access to a basket of vaccines for its national use”, she told swissinfo.ch. 

But as a rich country, Switzerland has more influence than some other countries with small populations and has already signed two bilateral deals with vaccine companies. In August it announced a deal with US biotech firm Moderna to secure early access to 4.5 million doses of a Covid-19 vaccine currently in development. The doses are to be produced in Switzerland through a partnership with Lonza. And in October it announced it had signed a deal with British pharmaceutical company AstraZeneca to pre-order up to 5.3 million doses of another Covid-19 vaccine also under development. 

A number of other countries have also been concluding bilateral deals, notably the US, which has not signed up to COVAX.  

“We are working to advance treatments and therapies as a global public good – and backing efforts for a people’s vaccine available and affordable everywhere,” UN Secretary-General Antonio Guterres told the UN General Assembly in September. “Yet some countries are reportedly making side deals exclusively for their own populations. Such ‘vaccinationalism’ is not only unfair, it is self-defeating. None of us is safe, until all of us are safe.” 

Hedging your risk 

The Swiss government says joining the COVAX initiative is a “complementary measure” to its bilateral deals.  It can be complementary, because no-one yet knows which vaccines will work, says Moon. Even if those being developed by Moderna and AstraZeneca pass the finishing line, Switzerland “may get access to other vaccines that might work better, or which may work better in different subgroups of the population”, she explains. “It is possible, for example, that one vaccine is proven to be safe and effective in younger adults and another is proven to be safer or more effective in older people.” 

On the other hand, the risk is that vaccine companies that do bilateral deals might not provide vaccines, or enough vaccines to COVAX, she warns. “And I really hope the government is engaging in that kind of political advocacy, because what we really need is for all the big firms to agree to reserve a proportion of their supply for COVAX, for all the developing countries that cannot access the vaccine through bilateral muscle.” 

Buying in to COVAX “gives you a pretty good assurance that you will have access to one or several vaccines that will work”, says Cueni of the IFPMA, which is also based in Geneva. “It is not an insurance policy. It is hedging your risk, because if you wait until you know which vaccines make it, you will have to wait until companies have serviced these bilateral deals.” 

What is COVAX? 

“COVAX is the only global initiative that is working with governments and manufacturers to ensure Covid-19 vaccines are available worldwide to economies of all financial means,” according to Gavi, the Vaccine Alliance that is chairing the initiative along with the Coalition for Epidemic Preparedness Innovations (CEPI)External link and the World Health Organization (WHO)External link – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, civil society organisations and others.  

More than 90 higher-income countries including Switzerland have now joined as self-financing members.  They are joined by 92 low- and middle-income economies eligible for support for the procurement of vaccines. The aim is to procure two billion doses of vaccines from a range of manufacturers by the end of 2021. 

But if it works, this will only cover 20% of the population – mainly health workers and the people most vulnerable to the disease. That no doubt explains the desire of richer countries to sign additional deals.

Two pots

Switzerland is providing CHF20 million ($22 million) from development assistance in support of the initiative to provide vaccines to low-income countries. This is “part of a CHF400 million packageExternal link approved by the Federal Council for the global fight against the pandemic”, according to public health office FOPH. 

Self-financing countries also have the option to contribute additional funds to a second COVAX “pot” to secure Covid-19 vaccines for their own populations.

Asked if Switzerland is doing this, the FOPH told swissinfo.ch that “in September 2020, Switzerland confirmed its participation as a self-financing country in the COVAX initiative in order to procure vaccines for up to 20 percent of the population. The payment as a self-financing participant in the COVAX Facility will ultimately depend on the choice of vaccine(s)”. 

Responsible business? 

Cueni says the IFPMA is an “actively engaged partner of the COVAX Facility”. There are multiple vaccine candidates in the pool, including some of its members. “With the leverage they have, I would expect that the Facility will be able to secure a very good price,” he told swissinfo.ch. “We as an industry cannot discuss individual prices or general price policy, but you have seen public statements from a number of large companies that during the pandemic they will work on a not-for-profit basis or socially responsible pricing.”  

This sounds too good to be true. But Cueni says the Covid-19 pandemic is a unique global challenge, and there are high expectations on big pharma to help. “For pharma, it’s also about responding to this sense of responsibility,” he told swissinfo.ch. “But then there’s a second expectation that pharma doesn’t exploit this. This is a unique situation, it’s not the time to put profits before people.”