One significant reason many countries were unprepared for the COVID-19 pandemic was the chronic underinvestment in pandemic preparedness and public health infrastructure. Despite numerous warnings from previous outbreaks such as SARS in 2003, H1N1 in 2009, MERS in 2012, and Ebola between 2014 and 2016, global health security remained underfunded and inadequately prioritized.

Governments often face limited budgets and must balance various pressing needs such as education, defense, infrastructure, and healthcare. Pandemic preparedness, which requires significant investment in surveillance systems, healthcare infrastructure, stockpiling medical supplies, and funding R&D for vaccines and therapeutics, often falls low on the list of immediate priorities. The infrequency of pandemics can lead to complacency, with policymakers prioritizing short-term economic gains over long-term health security.

Investing in pandemic preparedness does not yield immediate visible benefits, making it less attractive to politicians seeking short-term achievements to showcase to their constituents. The benefits of such investments are only realized when a pandemic occurs, leading to a lack of sustained political commitment. International organizations like the WHO have limited authority and funding to enforce compliance with International Health Regulations (IHR). The absence of binding mechanisms to ensure countries invest adequately in preparedness contributes to global vulnerability. The private sector, including pharmaceutical companies, historically underinvests in vaccine development for emerging infectious diseases due to low expected returns on investment. Diseases that predominantly affect low-income countries may not promise lucrative markets, disincentivizing R&D efforts.

The economic framework for COVID-19 vaccine development was characterized by an unprecedented infusion of public and private capital. Governments and organizations like the CEPI and Gavi played crucial roles in financing vaccine R&D and de-risking early-stage investments.²⁶ These funding mechanisms ensured that vaccine developers could scale up production even before receiving regulatory approvals (Table 4).

The COVID-19 pandemic showed how important it is for the government to get involved in vaccine research and development as early as possible. Public investments sped up the process of making vaccines, but there were doubts about making sure that prices were fair and that everyone got their share. In the event of future pandemics, governments and global organizations may need to come up with long-term ways to pay for things, like pooled funding or new ways to get money (like vaccine bonds), so that development can happen quickly while also being affordable and easy for everyone to get.

There was an issue between international cooperation and vaccine nationalism in response to the distribution of vaccines around the world. Initiatives like COVAX, which was led by Gavi, the WHO, and CEPI, tried to make sure that everyone in the world had equal access to vaccines.²⁹ However, vaccine nationalism, in which wealthy countries got doses before others, got in the way of the program’s goals. HICs, like the US, UK, and EU members, were able to get large amounts of vaccines early due to agreements to buy them ahead of time.³⁰ This meant that LMICs had to rely on late shipments from projects like COVAX, which had trouble with production and supply.

Figure 3 shows the global vaccination rates for different regions. It shows the percentages of fully and partially vaccinated people as a share of the total population. Latin America and the Asia-Pacific region have the highest vaccination rates, at 82%. This means that a large portion of their populations have been fully vaccinated. Even though these places have high rates, the U.S. and Canada are very close behind with 81% vaccination rates. Europe has also made a lot of progress; 70% of its people have been vaccinated, but it is still behind the Americas and the Asia-Pacific.

In the Middle East, on the other hand, only 58% of the population has been vaccinated, which means it will be harder to reach a large population. Africa has the lowest vaccination rate, at 37%. This shows how different it is around the world to get vaccines and get them to people who need them. There are big differences in the levels of vaccination in different parts of the world. Generally, wealthier areas have higher rates, while places like Africa and the Middle East still have a long way to go before they are fully vaccinated. This difference shows that the global system for distributing vaccines isn’t working well enough to make sure everyone has equal access. LMICs are the ones who have to deal with delayed shipments, higher costs, and other problems with logistics.

The differences in the rates of vaccine distribution between high-income areas like North America and Europe and low-income areas like Africa and Latin America show that global health governance needs to be changed.³² If these changes are made, fair access could be given more weight than national interests. This would help create global supply chains that make sure everyone, no matter their income, has access to vaccines.

COVAX was created as a global effort to make sure that everyone could get the COVID-19 vaccines, especially people in low-income countries.³³ Even though COVAX had good intentions, it ran into several problems, such as not being able to get enough vaccine doses, having trouble getting vaccines to remote areas, and manufacturing taking longer than expected.³⁴ It is hard to rely on a single platform for fair vaccine distribution, especially when wealthy countries bid more than COVAX for early supplies because of vaccine nationalism.

The COVID-19 pandemic showed that we need stronger international systems that put international cooperation and fair access to vaccines at the top of the list.^35,36 It is time for global health organizations to rethink how they distribute vaccines. They should focus on making global supply chains more resilient and pushing for financing models that do not favor rich countries over poor ones. This is very important for getting ready for future pandemics. This thematic analysis shows how the economic strategies used during the COVID-19 pandemic were both new and, in some cases, unfair. PPPs and large financial investments helped make it possible for vaccines to be made and distributed quickly. However, differences in access to vaccines around the world slowed down these efforts. In the future, public health policies should include stressing the need for fair, collaborative, and financially stable ways to make and distribute vaccines.

One of the biggest problems during the pandemic was that the world did not have enough factories to make a lot of vaccines. Usually, the process of making vaccines is very well thought out. But during the pandemic, there was an unprecedented need for billions of doses, which overwhelmed the manufacturing infrastructure that was already in place.³⁷ Because of this higher demand, production was held up, and global supply chains were messed up. The newer mRNA vaccines had the most trouble getting made because they needed specialized production facilities and materials, like lipid nanoparticles.³⁸ As vaccine makers rushed to make more, these delays caused doses to be sent to fewer countries, especially low- and middle-income ones that were usually the last in the queue to get them.

A good cold chain is a temperature-controlled system that keeps vaccines safe and is needed to store and handle vaccines properly.³⁹ When the vaccine is made, it is stored in a cold place. The cold chain then goes through transport and delivery and finally ends with proper storage at healthcare facilities until the vaccine is given.⁴⁰ If this chain is broken, the vaccine might not work as well. Keeping the right storage conditions from the time the vaccine is made until it is used is important since the effectiveness of the vaccine decreases each time it is exposed to the wrong conditions. This includes being too hot, too cold, or too bright at any point in the chain. It is impossible to get potency back once it has been lost. Any refrigerated vaccine can lose its effectiveness if it is exposed to bad conditions. Freezing temperatures (0°C or 32°F or below) can damage vaccines permanently, especially those that contain adjuvants (Figure 4).^41,42

The need for cold chain storage and distribution was another big problem with logistics. This was especially true for mRNA vaccines like Pfizer-BioNTech and Moderna. Many other vaccines are kept in refrigerators at temperatures between 2 and 8°C, but the Pfizer-BioNTech vaccine had to be kept at −70°C, which is very cold.⁴⁴ This rule made things very hard for countries that do not have cold chain infrastructure, especially in LMICs. Keeping the vaccine safe at such low temperatures required expensive investments in special freezers and transportation systems that could keep everything very cold along the supply chain.³⁹ This meant that the Pfizer-BioNTech vaccines took longer to get to places where the infrastructure was not good enough.

The Moderna vaccine had to be stored at −20°C, which made it easier to get than the Pfizer-BioNTech vaccine. However, many LMICs still needed to buy cold storage equipment, which was expensive. But the AstraZeneca vaccine could be kept at 2–8°C, which made it work better with the cold chain systems that are already in place for regular vaccines in LMICs as depicted in Table 5. This logistical advantage made AstraZeneca an easier choice for many countries, but production delays and worries about side effects made it harder to get.

The table shows how different COVID-19 vaccines compare based on the company that makes them, the type of vaccine, the doses that are needed, and how they should be stored. Starting with the Oxford Uni-AstraZeneca vaccine uses a viral vector approach to boost the immune system presented in Figure 5. This method uses genetically modified viruses. This vaccine needs to be given twice, and it can be kept at 2–8°C for up to six months. This means it can be used in places with basic refrigeration systems. Next, the Moderna vaccine builds immunity with RNA technology. The Novavax vaccine, which is made of proteins, should also be kept between 2 and 8°C and should be given every two weeks, just like other vaccines. Last but not least, the Janssen vaccine is unique because it only needs one dose. This makes it easier for people who need it to get it. It works with viruses and can be stored between 2 and 8°C for up to three months.

Figure 6 shows the steps that need to be taken to get a new vaccine to people who need it and store it so that it can stay cold for a long time. To start, the vaccine is sent to the target country in dry ice packs that are made to hold up to 5,000 doses each. This prevents the vaccine from freezing while it’s being sent. It will stay good for a long time because the country that gets the vaccine can keep it in a freezer farm at −70°C for up to six months. Third, use dry ice packs that haven’t been opened to give the vaccine ten days to get to the places where people get vaccinated. For shipping and logistics purposes, this gives more time, but it doesn’t change the quality of the vaccine. After it gets to the center, the vaccine can be kept in a regular fridge for up to five days as long as the temperature stays between 2 and 8°C. This window makes it possible to distribute and give the vaccine before its effectiveness is lost. These problems with logistics made it clear that the world needs to spend more money to improve the systems that are used to make vaccines and keep them cold.⁴⁹ This way, vaccines can be given out more quickly and fairly during future pandemics. It would be easier for LMICs to handle the distribution of vaccines that need to be stored in a complicated way if they spent money on strong cold chain systems and regional manufacturing hubs.

Different drug companies set the prices of their vaccines in different ways. Some, like AstraZeneca, said they would sell their vaccines for as little as they cost during the pandemic.⁵⁰ This promise was specially made to make sure that people in LMICs could get vaccines since high prices could have made it impossible for many individuals to get vaccinated. AstraZeneca’s cost-based pricing strategy was better because it put public health ahead of making money. The COVAX initiative also made the vaccine available at fairly low prices, especially in poorer countries.

Figure 7 shows that different companies that make COVID-19 vaccines charge different amounts for their products. It compares the prices per dose of these vaccines. The most expensive vaccine is made by Moderna. Each dose costs between $25 and $37. There is a similar range in price for Sinovac, which is between $13.6 and $29.75. The cost of one dose from Sanofi/GSK is $10.65 to $21, and the cost of one dose from Pfizer/BioNTech is $18.34 to $19. Prices for Oxford-AstraZeneca range from $4 to $8.1 per dose, which is a lot less than other companies.

Some vaccines, like Novavax, Curevac, Johnson & Johnson, and Sputnik V, have prices that are more narrow and, on average, less expensive. Newovax costs $16, Curevac costs $11.84, and both Johnson & Johnson and Sputnik V cost $10 per dose. Price differences could be caused by differences in how goods are made, how they are distributed, or trade agreements.

One of the most controversial parts of the global response to the pandemic was how different it was for rich countries and LMICs to get vaccines.⁵² HICs, like the US, UK, and EU members, bought most of the vaccine doses early on by making deals with drug companies to buy them in advance. These deals would often lock in supplies before vaccines had even been approved by the government. This way, countries with more money would be the first to get doses when they were made. This behavior, called “vaccine nationalism,” made global inequality worse by making LMICs rely on programs like COVAX that send vaccines later than planned.⁵³

Figure 8 shows how much the prices of different vaccines are different on the UNICEF/GAVI market compared to the public market in the US. The price of a Hepatitis B (HepB) dose in the UNICEF/GAVI market is only $0.18, while it costs $9.63 in the US public market. If you want to buy the Tetravalent vaccine (DTP3-HepB), each dose costs $0.69 in the UNICEF/GAVI market but $21.50 in the US public market. In the case of the Pentavalent vaccine (DTP3-HepB-Hib), the UNICEF/GAVI market price is $2.49, which is a lot less than the $30.58 price tag in the US public market. The price difference for the Pneumococcal conjugate vaccine is also very big. In the UNICEF/GAVI market, it costs $3.50 per dose, but in the US public market, it costs $95.10 per dose. Another difference is that the Rotavirus vaccine costs $2.50 per dose on the UNICEF/GAVI market, but $88.50 per dose on the US public market. This graph shows the big difference in the prices of vaccines between these two markets. Vaccines are always much cheaper in the UNICEF/GAVI market than in the US public market.

The problems with pricing and distributing vaccines during the COVID-19 pandemic show how important it is to have future pricing models for vaccines that make them affordable and easy for everyone to get. For future pandemics, the global response to vaccine prices will need to be better coordinated, making sure that public health comes before making money. Vaccines are priced differently depending on how much a country can pay. Systems like tiered pricing could be expanded to give LMICs stronger guarantees of access. Vaccine nationalism might get in the way of efforts to immunize everyone in the world. To stop this, global health organizations might need to play a bigger role in setting prices and making sure there are enough vaccines for everyone.

One important step forward is to invest money into regional hubs for making vaccines, especially in LMICs.⁵⁹ Many of the vaccines used in the COVID-19 pandemic were made in HICs, which caused delays in getting vaccines to LMICs. By spreading out the production of vaccines and setting up regional hubs, future pandemics can be dealt with more quickly and locally.⁶⁰ Investing in these hubs will not only make sure that vaccines can be made closer to the people who need them, but it will also create jobs, help technology spread, and improve the health infrastructure around the world. Having manufacturing capabilities in LMICs will also help these areas build cold chain infrastructure, train skilled workers, and improve their ability to make vaccines in an emergency.

A strong cold chain is very important, especially in LMICs, and the pandemic made that clear.⁴⁹ Antibodies like those made by Pfizer and BioNTech need to be kept very cold, at −70°C. If there are any more pandemics, it will be very important for LMICs to spend money on better cold chain systems, training, and more advanced refrigeration technologies. Building a strong cold chain system that can handle different types of vaccines will help get vaccines to more people faster during health emergencies.

Another important thing we learnt from the pandemic is to come up with new ways to pay for vaccine development that do not put too much financial stress on governments or private companies.⁸ Traditional ways of funding things, like public sector funding or private investment, were not enough to make sure that everyone had equal access to COVID-19 vaccines. Creating global vaccine bonds is a promising way to pay for vaccines in the future. It would be possible for governments, international groups, and private investors to pool their money through these bonds and put it into a global fund for vaccine research, development, and production.⁶¹ In times of health emergencies, this fund could be used to pay right away for the work needed to make vaccines and get them to people who need them.

People from different groups can put money into a common fund that helps with making and researching vaccines.⁶² The WHO, Gavi, or the CEPI could be in charge of these systems of global health.

When people pool their money, the risks of losing money are spread out among many people. The system will not have to rely as much on market-based models that put making money ahead of people’s health. Pooled mechanisms can bring in money from several different sources to keep vaccine development going even in low-return markets.⁶³ The rules for fair distribution of pooled funds can also make sure that low-income countries get vaccines first and are not left behind by market forces.

The COVID-19 vaccine was made faster with the help of PPPs like OWS. However, these partnerships can be used in the future to make things more affordable and fair. For better partnerships in the future, there is a need to make sure that PPPs have clear rules for fair pricing and access for everyone around the world. This will help stop vaccine nationalism and monopolistic practices. Governments, international groups, and private companies must work together to make financing deals that balance making money with meeting public health needs.

The COVID-19 pandemic also showed that the global governance systems that control the distribution of vaccines are not as strong as they should be. Even though programs like COVAX tried to make things more fair, the international response was disorganized, and richer countries beat out LMICs for early vaccine supplies. During the COVID-19 pandemic, one of the biggest problems was vaccine nationalism, which is when richer countries put their people ahead of fairness for everyone else.⁶⁴

As a possible solution, global distribution frameworks could be set up so that vaccines and other important medical supplies are given out based on clear criteria like the number of diseases, the size of the population, and the vulnerability of the population. By setting up ways to give priority to vulnerable groups, regardless of how wealthy their country is, global health governance can make sure that everyone has equal access during pandemics. Also, we need to think about intellectual property (IP) again in terms of how vaccines are made.⁶⁵ IP rules made it hard for LMICs to make vaccines locally during the pandemic, even though the technology was out there. If IP laws are changed to allow temporary exemptions during global health emergencies, vaccines could be made faster and for more people.⁶⁶ Such changes would allow LMICs to make generic versions of vaccines without being limited by patent laws. This would make sure that a few companies or countries cannot regulate the supply of vaccines.

The COVID-19 pandemic has taught us a lot about health policy and economics that will last for a long time. First, it is clear that putting money into health infrastructure, especially in LMICs, is not only the right thing to do but also the smart thing. If there is not a global response to health emergencies, the economy will continue to be severely and widely affected. Not only will strengthening health systems and supply chains save lives, but also lessen the damage that future pandemics do to the economy. Also, the pandemic has shown the importance of having economic policies that are adaptable and quick to respond to crises. To make sure that vaccines and other important supplies get to the people who need them most quickly, governments and international organizations must be ready to act quickly with finances, changes to the way things are run, and help with logistics. The world will be better prepared for the next pandemic if these lessons are used to shape future global health policies. Finally, what we learnt from the COVID-19 pandemic should be used to make future efforts to be ready even better. To make sure that vaccines are made and distributed more quickly, fairly, and effectively during future pandemics, it is important to strengthen global supply chains, look into new ways to finance them, and change the way governments work.

COVID-19 vaccines could be made so quickly because of PPPs, which had never been seen before. They sped up research, clinical trials, and manufacturing. Many governments, international groups, and private businesses worked together and shared their resources to make the process of making vaccines go faster. More than $10 billion in government funds were given to help develop, make, and distribute vaccines at unheard-of speeds in the US through OWS.⁶⁷ Additionally, worldwide plans like CEPI made it easier for early vaccine research, especially in LMICs.⁶⁸ There were concerns about the costs, the agreements for distribution, and the fact that richer countries got early vaccine supplies because they bid more.

Since mRNA vaccines like Moderna and Pfizer-BioNTech need to be kept at Ultra-cold storage (−70°C for Pfizer-BioNTech), this was needed for these vaccines, which was a big problem for many countries, especially LMICs that did not have the right infrastructure.⁶⁹ Many LMICs had to wait longer to get these vaccines because they needed specialized tools, reliable electricity, and advanced transportation systems. Vaccines like AstraZeneca were easier to get to people because they could be kept at normal fridge temperatures. However, their production was often delayed because of problems in the supply chain and limits on exports.⁷⁰ These problems with logistics showed the world’s uneven health infrastructure.

Vaccine pricing strategies made it even harder for some people to get vaccines around the world. Some, like AstraZeneca, promised to sell their vaccines at cost during the pandemic, while others, like Moderna, raised prices even after getting a lot of money from the government for research and development.⁷¹ Because mRNA vaccines are expensive and drug companies have advance purchase agreements with HICs, these countries were able to get most of the doses early on, leaving low- and middle-income countries with limited access. This behavior, which is sometimes called “vaccine nationalism,” led to big differences in the number of people getting vaccinated around the world.⁷² The COVAX initiative, which wanted to make sure everyone had equal access to vaccines, had a hard time getting doses early in the pandemic because of competition from countries with more money and problems with production. Many LMICs had to wait longer for vaccines to be sent out, which not only made the pandemic last longer but also made health disparities worse around the world.

These results show that the release of the COVID-19 vaccine was a big step forward for science and the economy, but it was also a big problem for health systems around the world. The growing gap in vaccine access between HICs and LMICs was caused by using pricing models based on the market, not distributing vaccines equally, and the fact that it was hard to make and send more vaccines all over the world.⁷³ To make things better in the future, we will need more fair ways to pay for things, stricter rules for global governance, and more money to improve health infrastructure. This way, we can avoid repeating the same unfair patterns in how we respond to pandemics.

Long-term economic studies of how COVID-19 vaccine pricing plans will impact public health are one of the most important gaps that need to be filled. This is especially true in LMICs. Pricing plans that were used during the pandemic were only meant to work for a short time. To get the medicine to people in HICs quickly, they often let the market decide who could get it. However, these models have not been fully tested to see how they will affect long-term global public health equity, healthcare budgets, and people in LMICs’ ability to get vaccines.

Some vaccines, like mRNA vaccines, were very expensive, and some countries had to pay ahead of time to get them. This meant that there were two levels of access. LMICs had to wait longer and pay more to get doses, while rich countries could get them faster. Since some countries had trouble getting vaccines, it is important to think about how pricing strategies for vaccines affected not only the number of people who got vaccinated right away but also death rates, the length of the pandemic in different parts of the world, and the overall economic recovery of those countries.⁷⁴ There needs to be more research on how these pricing strategies have changed long-term gaps in immunity, the strength of healthcare systems, and the ability of countries with lower incomes to recover from the pandemic.

Worldwide supply chains had major flaws during the COVID-19 pandemic. These flaws were mostly found in how vaccines are made, stored, and sent out. Many LMICs did not have the right infrastructure, so it took longer for vaccines like Moderna and Pfizer-BioNTech to get there and be used there.⁷⁵ There needs to be less centralization and more resilience in the global supply chain so that it can grow quickly in times of emergency.

Also, there needs to be more study on how to use cutting-edge technologies in supply chain management, such as blockchain, AI, and data analytics. With these technologies, it would be possible to keep track of vaccine doses in real time, figure out the best ways to get them to people, and guess when supplies will run out. This would make things run more smoothly and cut down on wait times. On the other hand, these technologies should only be used after a full analysis of their possible pros, cons, and issues.

The COVID-19 pandemic has shed light on new ways to think about the economics of making and distributing vaccines. Key to these theoretical advances is the understanding that global cooperation is an important part of vaccine economics and that we urgently need inclusive financing models that make sure everyone, no matter their income, has equal access to vaccines.

In the past, vaccine development was mostly influenced by national interests and market-based incentives. This is because drug companies focus on making money in lucrative markets, and governments put their own citizens’ health needs first. The COVID-19 pandemic, on the other hand, showed how important global interdependence is for handling health crises and how everyone needs to work together to stop them. The fast spread of the virus across borders showed how nationalistic views, which are sometimes called “vaccine nationalism,” can make the pandemic last longer by not immunizing large parts of the world’s population. This allows the virus to keep changing and spreading.

This knowledge has led to the creation of new theories that put global public goods at the center of strategies for dealing with pandemics. Vaccines are now more often seen as global public goods. This means that all countries benefit from making and giving them out, regardless of who pays for or makes them. This is why the pandemic has changed the conversation from being about nationalism and the market to being about how everyone can benefit and share responsibility. The economic theory of public goods was first used to explain things like keeping the environment safe or making sure the country is safe.⁷⁶ Now it is being used to explain how to make vaccines. To stop pandemics, we need finances from everywhere and equal access to new medicines for everyone.⁷⁷

This change has big theoretical effects on how vaccines will be paid for and given out in the future. For example, COVID-19 vaccines were made available equally to both high-income and low-income countries as part of COVAX, one of the first large-scale efforts to put the ideas of global cooperation in vaccine distribution into practice.⁷⁸ Even though COVAX had some problems, it was an important step towards making the financial and operational systems for distributing vaccines more fair around the world. In the future, vaccine economics models will need to improve the ways that global resources are distributed so that vaccines and other health interventions reach the people who need them the most, rather than just being given out based on a country’s wealth or political power.

Another important theoretical contribution of the pandemic is the realization of the need for financing models that work better for everyone. The problems with the economy that came up during the rollout of the COVID-19 vaccine showed how flawed traditional ways of funding things are that depend on market-based solutions and money from the federal government. These models often make inequality worse because vaccines can be bought early by richer countries through advance purchase agreements.

Because of this, the pandemic has led to the creation of new funding systems that are meant to lower the risk of making vaccines and ensure fair distribution from the start. More theoretical models stress the importance of pooled funding systems that spread financial risk among many parties, such as governments, international organizations, and private investors. In the old way of doing things, countries or companies take on most of the risk when they research, develop, and make vaccines. This method is different. People can get more vaccines made when they pool their money, like in the CEPI program. Vaccine bonds are a new way to get money to fund the research, development, and distribution of vaccines. Long-term funding for global health initiatives could come from this model. New ideas focus on tiered pricing, also known as differential pricing, where vaccines are sold for less in poorer countries and more in richer countries.⁷⁹ This method is fair and takes into account the fact that different areas have different economic situations. This makes global health financing more in line with the bigger goals of fair resource distribution and social justice.

Along with these changes in funding, the pandemic has also caused people to think about what role IP rights should play in how much vaccines cost. During the COVID-19 crisis, there was a lot of discussion about whether or not IP waivers should be used to allow LMICs to make generic versions of vaccines without being stopped by patents. The traditional way of making vaccines gives the company that comes up with the idea full rights to control production and pricing. This system encourages new ideas, but it can also make it hard to get medical care during global health crises.

Hybrid models that balance the need for innovation incentives with the need for global access are now being explored in theory. Some people have suggested that during pandemics, temporary IP waivers or mandatory licensing should be put in place to allow more companies to make vaccines without impacting the long-term incentives for innovation. These models show that intellectual property rules should be able to change during global emergencies so that more people can get access to important medical innovations.

The pandemic taught us that we need policies and practices that put global fairness at the top of our list when it comes to making vaccines, getting them to people who need them, and setting prices. Because of these real-world effects, governments, international organizations, and drug companies need to work together to make sure that future pandemics are dealt with in a way that is fair, effective, and open to everyone, no matter their income. Another useful step could be to set up vaccine stocks just for LMICs, which would be managed by international groups like the WHO. These stockpiles would make sure that vaccines are ready to go in case of a pandemic, so there wouldn’t be any delays like there were during COVID-19. Regional distribution centers could be set up to quickly store and send vaccines to places that aren’t usually served by global supply chains.

From now on, governments, international groups, and drug companies need to work together to create pricing models that make sure all countries can afford them. One practical solution is to use tiered pricing, also known as differential pricing, to change the price of vaccines based on the income level or ability to pay each country. Also, pricing models could include LMICs’ advance purchase commitments, which are paid for by international groups like Gavi or the Global Fund, and help them get doses at a price they can afford before they are made.

Future PPPs should make it clear that they support global access and require drug companies to provide vaccines to LMICs at prices that people can afford. PPPs could also be used to build regional manufacturing hubs. In these cases, governments and private companies would invest in the infrastructure needed to make vaccines in LMICs. PPPs can help make sure that everyone in the world has equal access to vaccines by making sure that LMICs are involved in the early stages of vaccine research and production.

IP rights became a contentious issue during the COVID-19 pandemic, especially since LMICs had a hard time getting vaccine technologies made in HICs. When pharmaceutical companies get exclusive rights under the old IP system, they often have a monopoly on vaccine production, which means that only people who can afford it can get it. A useful way to make sure that more people can get vaccine technologies is through voluntary IP-sharing programs like the WHO’s COVID-19 Technology Access Pool (C-TAP). Drug companies are asked to share their IP and production know-how as part of C-TAP. This will make it easier for LMICs to make vaccines, tests, and treatments.

A lot of the delays in giving vaccines to people were caused by logistics issues, like not having enough cold chain storage, transportation issues, or healthcare workers. Groups and countries around the world need to spend money on strong health systems that can handle the difficult task of giving out vaccines during a pandemic. The COVID-19 pandemic has shown how important it is to have rules that make sure everyone can get vaccines. To make pricing models that work for everyone, pharmaceutical companies, governments, and international groups need to work together. They also need to improve PPPs, change how intellectual property is handled, and spend money to build up global health infrastructure.