WHO publishes the first data on the global market for vaccines against COVID-19

• This is the first report outlining the implications of COVID-19 for vaccine markets.
• Despite progress in recent decades, the dynamics of the global vaccine market are not entirely conducive to the development, supply and access to vital vaccines for public health.
• Vaccines prioritized by the WHO are not being developed or fully invested in due to limited profit potential.
• Lower-income countries have had trouble accessing critical vaccines — such as the 2021 COVID-19 vaccine and the cervical cancer vaccine — that wealthier countries are clamoring for.
• Some regions are almost entirely dependent on others for vaccine supplies.
• WHO calls on governments, manufacturers and partners to take ambitious measures to guarantee equitable access to vaccines and improve responses to future pandemics.

WHO Global Vaccines Market Report 2022published today, shows that inequitable distribution is not unique to COVID-19 vaccines, with poorer countries constantly struggling to access vaccines that are in demand in richer countries.

The limited supply of vaccines and uneven distribution cause global disparities. The human papillomavirus (HPV) vaccine against cervical cancer has been introduced in only 41% of low-income countries, even though they represent a large share of the disease burden, compared to 83% of high-income countries.

Affordability is also a barrier to vaccine access. While prices tend to depend on income, price differences show that middle-income countries pay as much – or even more – than wealthier ones for several vaccine products.

“The right to health includes the right to vaccines,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general. “Yet this new report shows that free market dynamics are denying some of the world’s poorest and most vulnerable people that right. WHO is calling for much-needed changes in the global vaccine market to save lives, prevent disease and prepare for future crises.”

Approximately 16 billion vaccine doses, valued at US$141 billion, were shipped in 2021, nearly three times the 2019 market volume (5.8 billion) and nearly three and a half times the 2019 market value (38 billions of US dollars). The increase was primarily driven by vaccines against COVID-19, which shows the incredible potential for how vaccine production can be scaled up in response to health needs.

Although production capacity worldwide has increased, it remains highly concentrated. Only ten manufacturers provide 70% of vaccine doses (excluding COVID-19). Several of the 20 most commonly used vaccines (such as PCV, HPV, vaccines containing measles and rubella) currently rely mainly on two suppliers.

This concentrated production base leads to the risk of shortages as well as regional supply uncertainty. In 2021, the African and Eastern Mediterranean regions were dependent on manufacturers based elsewhere for 90% of their vaccine procurement. Entrenched intellectual property monopolies and limited technology transfer further limit the possibility of building and using local production capacities.

Market health is also a concern for several vaccines that are typically needed in emergencies, such as cholera, typhoid, measles/monkeypox, Ebola, meningococcal disease, where demand rises with outbreaks and is therefore less predictable. Continued limited investment in these vaccines could be devastating to people’s lives.

The report highlights opportunities for greater alignment of vaccine development, production and distribution with the public health program, as achieved Immunization Plan 2030 (IA2030) goals and reporting on pandemic prevention, preparedness and response efforts.

COVID-19 has proven that vaccines can be developed and distributed quickly, with the process taking an average of ten years but never less than four years, condensed into 11 months. The pandemic has also exposed the long-standing need to recognize vaccines as a fundamental and cost-effective public good, rather than a commodity.

To encourage ambitious action to provide equal access to vaccines, the report calls on governments to act on: clear immunization plans and more aggressive investment and stronger oversight of vaccine development, production and distribution; regional research and production centers; and pre-agreed rules for government cooperation in times of scarcity on issues such as vaccine distribution, intellectual property, and the circulation of inputs and goods.

Actions recommended for industry include: focusing research efforts on WHO priority pathogens, ensuring transparency, facilitating technology transfer and committing to specific equity-based allocation measures. International organizations and partners should prioritize the goals of the 2030 Immunization Agenda, support state-led initiatives and encourage the implementation of market transparency resolutions.