Publication: Regional Vaccine Manufacturing and Development: Indonesia Country Case Study
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2023-06-16
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2023-06-16
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COVID-19 has had a devastating effect on the ASEAN region, which has recorded over 27 million cases of the virus. Despite rapid development of a range of COVID-19 vaccines using innovative technologies, access to these vaccines has been a challenge, with manufacturing mostly concentrated in the US and Europe for high-value mRNA vaccines, and China and India for traditional platforms and high-volume production. Countries with domestic COVID-19 vaccine manufacturing capacity prioritized domestic vaccine requirements over foreign needs, putting countries with limited production capabilities at a disadvantage. ASEAN countries, which overall have made limited investments in research and development of vaccines and biologicals, were highly dependent on imports, resulting in heightened vulnerability during COVID-19 surges. Despite the existence of an established framework for ASEAN coordination on vaccines, there has been minimal coordination between member states to collectively procure COVID-19 vaccines. Consequently, ASEAN countries have experienced a common set of challenges in navigating the complex global vaccine market to ramp up COVID-19 vaccination. Leaders of ASEAN member states have recognized the need for the region to be self-sufficient in vaccine research and manufacturing to effectively address future pandemics and build regional vaccine security. ASEAN must build regional capacity to develop, test efficacy, and scale up manufacture of vaccines, building on existing country-level strengths and avoiding duplication. While some evidence on regional vaccine manufacturing capacity for ASEAN exists, there has been limited research on the technical, operational, financing and strategic partnership opportunities that exist in the region and might be leveraged to advance regional vaccine security. To address this knowledge gap, the United Kingdom Foreign, Commonwealth and Development Office (UK FCDO) and the World Bank initiated the ASEAN Vaccine Development and Manufacturing Research Project. This project complements the ASEAN Vaccine Security and Self-Reliance (AVSSR) Initiative and the Coalition for Epidemic Preparedness Innovations (CEPI) 2021 plan, and supports the November 2019 declaration of ASEAN leaders on regional vaccine security and self-reliance.
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“World Bank. 2023. Regional Vaccine Manufacturing and Development: Indonesia Country Case Study. © World Bank. http://hdl.handle.net/10986/40374 License: CC BY-NC 3.0 IGO.”
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Publication ASEAN Regional Vaccine Manufacturing and Development(Washington, DC: World Bank, 2023-04-18)This report is organized into six chapters. The first chapter provides an introduction and presents a brief situation analysis of current research and development and manufacturing capacities in the region based on detailed desk review. The second chapter describes the importance of coordination in ensuring regional vaccine security and presents different complementary pathways for achieving the AVSSR vision. The third chapter comprehensively describes the vaccine value chain in the ASEAN region, covering both backward and forward integration aspects, including logistics and delivery. The fourth chapter describes strategic priorities relevant to regional vaccine eco-system development and describes existing strengths and weaknesses within selected ASEAN countries that could influence such development. The fifth chapter summarizes findings of an economic analysis of investing in late-stage clinical trials, manufacture, and regulatory strengthening for a limited set of priority diseases. A strong economic case is made for investing at the regional level compared to the national level by using cost benefit ratios. The concluding chapter summarizes feedback from key stakeholders in both public and private sectors and utilizes this feedback to present a way forward by listing specific tasks for ASEAN member state governments, the Secretariat, and the World Bank Group.Publication ASEAN Vaccine Manufacturing Research Project(Washington, DC: World Bank, 2023-06-16)The COVID-19 pandemic has had a devastating effect on the ASEAN region, which has recorded over 27 million cases of the virus. Despite rapid development of a range of COVID-19 vaccines using innovative technologies, access to these vaccines has been a challenge, with manufacturing mostly concentrated in the US and Europe for high-value mRNA vaccines, and China and India for traditional platforms and high-volume production. Countries with domestic COVID-19 vaccine manufacturing capacity prioritized domestic vaccine requirements over foreign needs, putting countries with limited production capabilities at a disadvantage. ASEAN countries, which overall have made limited investments in research and development of vaccines and biologicals, were highly dependent on imports, resulting in heightened vulnerability during COVID 19 surges. Despite the existence of an established framework for ASEAN coordination on vaccines, there has been minimal coordination between member states to collectively procure COVID-19 vaccines. Consequently, ASEAN countries have experienced a common set of challenges in navigating the complex global vaccine market to ramp up COVID-19 vaccination. Leaders of ASEAN member states have recognized the need for the region to be self-sufficient in vaccine research and manufacturing to effectively address future pandemics and build regional vaccine security. ASEAN must build regional capacity to develop, test efficacy, and scale up manufacture of vaccines, building on existing country-level strengths and avoiding duplication.Publication ASEAN Capacity for Vaccine Research and Development and Production(Washington, DC: World Bank, 2023-06-16)COVID-19 has had a devastating effect on the ASEAN region, which has recorded over 27 million cases of the virus. Access to COVID-19 vaccination has significantly reduced the spread of the disease and limited the number of severe COVID-19 cases, but it has also impacted routine immunization coverage. Countless strategies have been developed to ensure vaccine equity, which were swiftly translated from political assessment to practical action; however, they failed to address the sustained growth of the COVID-19 pandemic and the emergence of variants of concerns, requiring ongoing vaccine booster doses. The pandemic revealed weaknesses in ASEAN's regional vaccine capacity, including in research and development, manufacturing infrastructure and human resources, which made the region particularly vulnerable during COVID-19 surges, as it was highly dependent on vaccine imports. Despite the existence of an established framework for ASEAN collaboration on vaccines, there has been minimal coordination between member states to collectively procure COVID-19 vaccines. Initial consultations with various stakeholders involved in vaccination and equitable access in the ASEAN region highlighted several gaps related to ensuring a sustained supply of quality vaccines throughout the life cycle, as well as several critical areas that require immediate attention. The political commitment to address these issues has been shaped by the evolving pandemic scenarios. The ASEAN Vaccine Security and Self-Reliance (AVSSR) initiative was launched just before the COVID-19 pandemic began and was agreed upon and endorsed by the region's ten leaders during the 34th ASEAN Summit in November 2019. Future regional strategies, policies and plans must ensure consistency with this important ASEAN initiative.Publication ASEAN Capacity for Vaccine Research and Development and Production(Washington, DC: World Bank, 2023-06-16)COVID-19 has devastated the ASEAN region, threatening two decades of human and economic development gains. With a population of more than 600 million, the region has reported more than 13 million COVID-19 cases as of October 2021, with Indonesia, the Philippines, Malaysia, and Thailand leading in number of confirmed cases. In the absence of effective treatment options, vaccination and preventative behaviors remain cornerstones for ASEAN governments to stop COVID-19’s spread, save lives, and revive economies. Despite rapid innovation and development of mRNA, viral vector, and protein subunit vaccine technology platforms, low and middle-income countries (LMICs) continue to struggle to access vaccines. ASEAN countries have remained net importers of essential vaccines, notwithstanding strong potential for local research and manufacture. Consequently, COVID-19 vaccination coverage varies widely, ranging from 10 percent in Myanmar to 80 percent in Singapore. These disparities render the region vulnerable to new variants, surges, and vaccine escape. To contain COVID-19 and respond to future pandemics, ASEAN must build strong regional capacity to develop, test, and scale up manufacture of vaccines, building on country-level strengths and avoiding duplication. Galvanizing ASEAN vaccine development and manufacturing efforts aligns with the November 2019 declaration of ASEAN leaders on regional vaccine security and self-reliance.Publication Investing in Vaccine Security in the ASEAN Region(Washington, DC: World Bank, 2024-06-20)Vaccine security and self-sufficiency have received increased global attention in the wake of the COVID-19 pandemic, as low- and middle-income countries were heavily dependent on high-income countries (HICs) and international organizations for vaccine supply, resulting in global competition for vaccines and huge inequities. Achieving vaccine security and self-sufficiency is of high importance to Southeast Asia. To achieve this goal, the Association of Southeast Asian Nations (ASEAN) established the ASEAN vaccine security and self-reliance (AVSSR) initiative. Building on the efforts of ASEAN leadership, the World Bank commissioned this study to estimate the public health and economic benefits arising from investments in AVSSR, specifically in vaccine research and development (R&D), manufacturing, and regulation. The study assumes that five ASEAN countries - Indonesia, Malaysia, the Philippines, Thailand, and Vietnam - make public and private investments to strengthen vaccine security. Applying a societal perspective, the study considers four different investments scenarios. Scenario 1 assumes that costs will be shared between these five countries and that these countries alone will benefit from the vaccine security efforts, while Scenario 2 assumes health and economic benefits to the other five ASEAN countries (Brunei, Cambodia, Laos, Myanmar, and Singapore) as well. Scenario 3 assumes that only one country of 100 million people produces and prioritizes vaccines for its population, while Scenario 4 assumes a pandemic of COVID19 magnitude. The findings of the study clearly show that regional investments in clinical trials, manufacturing and regulatory capacity building will have a substantial public health impact and offer high benefit-cost ratios. Findings from this study align with the AVSSR Strategic and Action Plan 2021-2025, which makes the case for stronger regional vaccine capacity, enhanced vaccine manufacturing capacity, and human resource development to realize the goal of self-reliance.
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