On Feb 20 2019 @DukeCPIGH attended a joint @WorldBank @CEPIvaccines consultation in DC on 'Financing COVID-19 Vaccine Development.' We co-authored a background paper on funding vaccine development & manufacturing. I just looked back at what we said 1/n

https://centerforpolicyimpact.org/wp-content/uploads/sites/18/2020/03/COVID-19-funding-and-manufacturing-working-paper-1.pdf

"There is uncertainty about what will happen next, e.g., the pandemic could involve multiple waves (i.e., simultaneous epidemics) of COVID-19 over 1-3 years, and/or SARS-CoV-2 could become a globally endemic virus." 2/n

At the time that we wrote the report, there had been 826,222 confirmed cases of COVID-19 & 40,708 deaths. 3/n

We said:

"We need to prepare for a worst-case scenario, in which the rapid development and scale-up of COVID-19 vaccines is critical to reducing the morbidity, mortality, and economic damage associated with a pandemic."

@DrRHatchett was VERY concerned. He was VERY right. 4/n

We said development costs will be high (CEPI estimated the costs of clinical development & “scale-out” alone as up to US$2 B), but "the costs of inaction are much larger (the economic costs of COVID-19 in China alone are estimated to be US$62 B in the first quarter of 2020)" 5/n

We noted: "The poor are hit “first and worst” by outbreaks, and any access model that ends up giving only high-income countries access to the vaccine would clearly be unacceptable." 6/n

"It will be critical to avoid a scenario in which high-income country governments enter into bilateral purchase contracts with manufacturers, thus monopolizing the vaccine."

Sadly, such monopoly behavior is a now a major threat to ending the global pandemic. END