“There's no point in running, you have to start on time.
"If only the fable of the hare and the tortoise by Jean de la Fontaine could apply to the race in which the European Union has embarked ... After several delays in the ignition, the 27 Member States, to begin by France, dream of finding a cruising speed in the production of vaccines.
The ace!
The American laboratory Pfizer announced two weeks ago the first production delays.
This Tuesday, it was the turn of the British laboratory AstraZeneca to revise its ambitions downwards: 40% less doses for its European deliveries in the first quarter.
A delay that the European Commission considers inadmissible, requiring the laboratory to "keep its promises".
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So how can we redress the bar and achieve the set objectives year after year?
First, no doubt, by noting our failures.
“How can we be surprised that we are lagging behind when we produce only 20% of reimbursed drugs in our territory?
Asks economist and health specialist Nathalie Coutinet.
A bitterness shared by Frédéric Tangy, head of the vaccine innovation laboratory at the Institut Pasteur, and author of the book "The Man Shaped by Viruses" (with Jean-Nicolas Tournier, published by Odile Jacob).
"We could not hold the road like the United States, lamented the scientist Thursday evening in the show C to you.
We did not have sufficient billions, no European policy, and research centers and laboratories did not work together enough.
"
Stopping the #Pasteur vaccine: a commercial, industrial or scientific decision?
Frédéric Tangy's response from the vaccine innovation laboratory to @ InstitutPasteur ⬇️ # Cà Vous pic.twitter.com/tzVwqZvL7g
- C to you (@ cavousf5) January 28, 2021
In an attempt to bounce back, the French government now wants to favor collaboration.
At least the time that tricolor vaccines see the light of day.
He therefore asked the Sanofi laboratory to make production lines available to its competitors, the American Pfizer and the German BioNTech.
This will be done next July in its factory in Frankfurt.
Other associations could emerge depending on the marketing authorizations.
On the European side, the Commission wants to set up a "task force", like the American BARDA (Biomedical Advanced Research and Development Authority).
Last November, it announced the creation of its own agency: HERA (Health Emergency Response Authority), which is also able to pool the resources mobilized in research and development.
Except that while waiting for these various initiatives to be put in place, there is an emergency.
Here are ten questions what could also be implemented to hope to stay in the race.
1. Can we get more vaccines right away?
No, the rule is simple: first come, first served!
The decision-making process of the European Union has been (too) long.
The first orders were placed in November with Pfizer.
When the United States, Israel or the United Kingdom, they jostled each other last summer.
“Laboratories honor their first contracts above all, before serving others.
The first to have placed an order would not understand why they would be deprived of their vaccines ”, supports Patrick Biecheler, partner at Roland Berger, specialist in the pharmaceutical industry and health.
In addition, the delivery targets set in the contracts are generally spread over a quarter, rather than a week.
2. Therefore, can we order more?
In theory, yes, France could contact the laboratories directly.
The problem is, the price would be very high.
"Our country has not funded research for years: there will be no backlash, warns Nathalie Coutinet, health economist.
A collective purchase is the best strategy, the prices are more advantageous.
It remains then that the labs, at saturation, can meet the desired quantities.
"
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In early January, Europe doubled its orders by requesting 300 million additional doses of the Pfizer-BioNTech vaccine.
3. Are there any tensions on commodities?
Achieving a messenger RNA vaccine requires enzymes and nanoparticles, produced by biotechnology laboratories, mainly based in Asia.
“We are totally dependent, underlines Nathalie Coutinet.
We have production capacities, but minimal.
"
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There are many players, but the gigantic demand and logistics chains can be complex.
“We have to bring some from the other side of the world.
A grain of sand could collapse the whole chain, ”warns Patrick Biecheler.
In the summer of 2020, for example, the supply of raw materials had become scarce after the closure of Chinese factories.
4. Are sanctions or penalties possible?
"Yes, financial penalties can appear in European contracts, in the event that the laboratory does not meet the deadlines set in terms of delivery," confirms Marie Albertini, lawyer specializing in commercial litigation.
Their amount cannot be known since the contracts are confidential and fall under business secrecy.
One can however imagine that it would be significant, so that the sanction is dissuasive.
"
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If the delays accumulate, is a trial possible?
"No one would gain, when the urgency is to quickly manufacture the doses, not to put a spade in the wheels of the labs", underlines Me Albertini.
5. Can other laboratories collaborate?
“It is possible, estimates Guillaume Roty, spokesperson for the European Commission in France.
But it is up to each company to ensure that it is able to deliver the vaccines ordered and to find the necessary means.
We believe that the agreements made provide a sufficient framework to ensure that the entire European population is vaccinated on time.
"
According to Europe, it would therefore not be up to it to play the policeman, or the great production manager, but up to the laboratories themselves to agree to wait for the objectives set.
Like what Sanofi has just put in place with BioNTech in Germany.
“Even if it does not happen with a wave of a magic wand, one observes in the entourage of Agnès Pannier-Runacher, the Secretary of State for Industry.
These are very complex processes.
"
6. Can Sanofi make its French production lines available?
In theory yes, since the lines, for a time considered in France, were not finally mobilized.
But in reality, it seems unlikely that Sanofi will make other sites in France available.
According to various internal sources, the reason is simple: the French laboratory now wants to mobilize all its resources and all its teams for the future production of its own vaccines - one based on recombinant protein and the other on messenger RNA - which have fallen behind.
7. Can we impose that European production be reserved for Europe?
"It is an important subject which was the subject not later than Monday, of an announcement on behalf of the European Commissioner of Health, the Cypriot Stella Kyriakides, explains Guillaume Roty.
We will indeed set up a transparency mechanism for the export of vaccines outside the European Union (EU).
This mechanism will require laboratories to notify their vaccine exports.
"The EU is committed to letting manufacturers honor their contracts abroad," adds Agnès Pannier-Runacher's cabinet, "but it is thus acquiring the means to ensure that it is served. in a fair manner.
"
8. Should the patents be blown up?
Some elected officials, like Fabien Roussel, secretary general of the Communist Party (PCF), are campaigning for vaccines to fall into the public domain.
This option could threaten the quality of the doses produced, warns Marie Albertini.
“Lifting the patents means that any country could manufacture these vaccines according to their regulations.
However, all states do not have the same technique or expertise to manufacture doses.
The quality of the product and its effectiveness could be compromised.
"
9. Do we need new syringes?
Several types of needles and syringes are approved for use with Pfizer BioNTech and Moderna vaccines.
But being able to take the famous sixth dose in the Pfizer bottles involves optimizing the suction of the liquid.
BD (Becton Dickinson), one of the world leaders in injection devices, confirms that the equipment used must have "a low dead volume".
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This is the case of "the BD Flu + syringe, specifically designed for the administration of vaccines which has been very widely ordered by many states including France", specifies a spokesperson for the American group who does not identify " no risk of shortage to date ”on this equipment.
10. Are the logistics well adapted?
"Logistics is clearly our weak point in this vaccination campaign," says Nathalie Coutinet.
We are failing in the distribution of doses and their delivery throughout the territory.
A priori, we did not have the capacity to keep the vaccine doses at such a low temperature and to secure them.
It is improving, but we are still far from the level of our neighbors.
"
An observation shared by François-Michel Lambert, LEF (Liberté Écologie Fraternité) deputy, president of the National Logistics Commission between 2015 and 2019: "Just look at the rate of use of vaccines, ie the relationship between stocks and what is injected.
On January 24, it was 52%.
This is far too little to achieve our goals.
Another indicator according to the specialist should be given: the loss rate.
“It's 0.1% in Israel.
Here, impossible to know him.
"
