Gates Package — page 1043

But during the pandemic, companies accelerated the deals. In less than two years, a single manufacturer, AstraZeneca, signed second-source deals involving twenty-five factories in fifteen countries. (Recall that AZ also agreed to forgo its profits on the COVID vaccine.) Novavax signed one with Serum Institute of India, or SII--leading to a vaccine now being widely used in many countries--and Johnson & Johnson inked one with the Indian company Biological E. Limited. All told, second-source deals led to the production of hundreds of millions of additional COVID vaccine doses. And in the future, they could be done even faster if companies that have them now can maintain their relationships with each other, so they don't have to start from square one in the next outbreak. I'm also hopeful that this is yet another type of problem that mRNA vaccines will help solve. Many of the conventional ways to make vaccines are pretty arcane, which means there are many Is to dot and Ts to cross in making a second source deal. But because the basic approach to mRNA is pretty much the same--you just swap out your old mRNA for the new one--it should be easier to transfer between companies. There are also some new technologies in the pipeline that, if they prove out, will make it cheaper and easier to build and run factories. This would make them more flexible, able to adapt as needed to make different types of vaccines. Finally, there are a couple of steps that a global body like the WHO could take. One is to standardize the labels that go on vials, so companies don't have to make bunches of different labels for the same vaccine. The other is to buy up raw materials for making vaccines and vials ahead of time, and distribute them later to the manufacturers with the most promising candidates. CEPI did this with glass vials during COVID, ensuring that there would be a reserve supply if any companies hadn't acquired enough on their own. ***