Europe’s stumbling vaccine rollout offers a lesson in EU politics
Ursula von der Leyen, European Commission president.
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LONDON – The President of the European Commission, Ursula von der Leyen, said it herself: “The start was difficult.”
The European Union has had a bumpy introduction of Covid-19 vaccines. The campaign has sparked complaints that regulators were too slow to approve the shots and sparked a simmering argument with AstraZeneca as the pharmaceutical company repeatedly cut its delivery obligations.
More recently, several countries have temporarily stopped using the Oxford-AstraZeneca vaccine for safety reasons. This has baffled health professionals and raised questions about future intake.
The World Health Organization earlier this week expressed concern that the ongoing coronavirus crisis in the region now appears “more worrying” than it has for several months. The warning comes as many countries introduce new measures to contain a third wave of infections.
The health department also described the vaccination campaign in Europe as “unacceptably slow” and said it was crucial to accelerate the rollout as the number of new infections is currently increasing in every age group with the exception of those over 80.
It is a chaotic picture, made even more complicated by the uniqueness of European politics.
“There have been several problems with the system, and it is a complex system. I think the important thing is not to point a finger at a particular bug, but to realize that it is very complex,” said Linda Bauld, professor for public health at the University of Edinburgh, said CNBC.
The European Commission, the executive branch of the EU, was responsible for negotiating contracts with pharmaceutical companies on behalf of the 27 member states. The institution is also responsible for overseeing the exports of the shots produced in the block.
However, health policy matters are the responsibility of the Member States, which means that the 27 capitals can organize the vaccinations in their own countries and ultimately decide to buy Covid shots, for example outside of the agreements made by the Commission.
This juxtaposition between national and EU institutions has often damaged the bloc’s reputation in broader vaccination efforts.
“There are problems that have to do with both (national and EU institutions). There is clearly politics in it and we have all heard about it in the media, but there are also problems with decision-making and attitudes the commissions have to do and the priorities of the member states, “Bauld told CNBC.
AstraZeneca weft suspension
This was highlighted recently when 13 EU countries decided to stop using the Oxford AstraZeneca shot while investigating possible side effects.
At the time, the European Medicines Agency – the medicines agency for the entire 27-member region – recommended that countries continue to use the vaccine, despite reviewing data on blood clots in some vaccinated people. However, some member states preferred to be cautious and used their sovereign power to stop the use of this vaccine as the EMA completed its review. The Safety Committee of the Medicines Agency concluded in a preliminary review that the benefits of the vaccine continue to outweigh the risk of side effects.
It has also been the case that heads of state have used the institutions in Brussels to complain about the hiccups in the process. At the beginning of March, the Austrian Chancellor Sebastian Kurz said the decision to distribute the vaccines in the Commission’s steering committee was “secret”.
The group, chaired by the Commission, has representatives from all Member States, including Austria.
“Why do you get this idea when you know that Austria, like the 26 other member states, is a member of the steering committee and how the others have been informed about the previous allocations?” An EU official from another Member State who did not want to be named due to the sensitivity of the issue asked during a CNBC interview in March.
The vaccines are distributed proportionally, depending on the population of the countries. However, some EU states were particularly interested in getting more of the AstraZeneca shot, as it’s cheaper and easier to store than the Pfizer BioNTech vaccine.
“If a Member State decides not to start its pro-rata allocation, the doses will be shared among the other interested Member States,” the Commission said in a statement in March.
We also know that AstraZeneca has unfortunately produced too little and delivered too little. And this, of course, painfully reduced the speed of the vaccination campaign.
Ursula von der Leyen
President of the European Commission
Vaccine distribution has become an issue due to AstraZeneca’s repeated cuts in supplies.
While the EU was expecting 90 million doses of the shot by the end of the first quarter, the pharmaceutical company said it could only deliver 40 million doses during that period. This was later reduced to 30 million cans.
AstraZeneca has blamed low yields at European plants for lower shipments. In addition, the drug maker has said it can only administer 70 million doses between April and June when the EU was expecting 180 million over the same period.
“We also know that AstraZeneca has unfortunately produced too little and delivered too little. And of course this has painfully reduced the speed of the vaccination campaign,” said von der Leyen at a press conference in March.
Stricter export rules
To address this problem, the Commission proposed stricter rules for the export of ingot-made shots.
Since the end of January, the 27 countries have been able to stop delivering Covid vaccines if a company does not meet delivery targets with the EU. In this way the Italian government prevented a shipment of AstraZeneca shots from going to Australia in March. Between the end of January and the end of March, the Commission received 315 applications for vaccine exports, but only this one was rejected.
However, as EU officials are concerned about further delivery delays, the Commission decided to tighten export regulations from the end of March.
I think the EU definitely prioritizes its population first, but it is no different from other high-income countries or regions.
Coordinator at Medecins sans Frontieres
The Commission will not only examine whether the pharmaceutical companies deliver on time, but also whether the recipient country has bans or restrictions on Covid vaccines produced there and whether this country also has a better epidemiological situation than the EU.
“At the political level, the entire discussion about export restrictions, controls or even bans is rather worrying,” Dimitri Eynikel, coordinator at Medecins sans Frontieres, told CNBC. He added that this could create further barriers, divisions and delays in vaccine distribution.
Ultimately, the supply chain is international and if a nation stopped sending raw materials to the EU, for example, it could undermine the production of the shots within the bloc.
The EU’s attempt to have tighter control over where vaccines go has sparked criticism of vaccine nationalism.
“I think the EU definitely prioritizes its people first, but it is no different from any other high-income country or region. The US is doing the same thing, the UK is doing the same thing, in that sense (the EU) is no different.” Said Eynicle.
International Monetary Fund data has shown that China, India and the EU are among the largest exporters of Covid shots, while the US and UK have not yet exported any.
Hopes for the second quarter
Despite several problems, the EU is confident that the next three months will prove to be a turning point in the vaccination program.
In total, the commission expects 360 million doses of Covid shots between April and June, meaning it is well positioned to meet its target of vaccinating 70% of the adult population before the end of summer.
“Despite the fact that things could have gone faster, we have had great success. The alternative of not having bought vaccines together would be that we would compete between European member states and possibly some of us did not.” Vaccine at this point too, “Malta’s Minister of Health Chris Fearne told CNBC’s Squawk Box Europe on Tuesday.