The South American country, where there have been more than 3.5 million cases of the disease, offers a “golden opportunity” in the development of the formula against the coronavirus, according to the same scientists who investigate them
Brazil, one of the countries most devastated by the coronavirus pandemic, has become a testing ground for vaccines against COVID-19.
The South American country, where there have been more than 3.5 million cases of the disease, is considered by scientists who research vaccines as a “golden opportunity.”
There they are testing two of the most promising and advanced vaccines against infection: that of the University of Oxford with the pharmaceutical company AstraZeneca and that of the Chinese company Sinovac.
And two others, from the US pharmaceutical companies Johnson & Johnson and Pfizer, have just received approval from the authorities to begin their clinical trials in the country.
With this, the Brazilian authorities hope that their citizens can be among the first to be inoculated against the infection.
And they have even raised the possibility of producing these vaccines internally and exporting them to the rest of Latin America.
But why is Brazil considered an “ideal laboratory” to carry out clinical trials of vaccines?
Dr. Jon Andrus, an expert in epidemiology and immunization at George Washington University in the United States, who was deputy director of the Pan American Health Organization (PAHO), points out that high rates of community transmission of the virus it is one of the main criteria to be able to test a vaccine.
But as he explained to BBC Mundo, there are other reasons why Brazil is considered a perfect setting for vaccine research.
“You certainly need a situation where you have enough prevalence of a disease to be able to test the efficacy of a vaccine and if it is going to work.”
“But I think that in Brazil there is almost a perfect storm for trials because in addition to the high prevalence, the country has a long history of excellence in public health, with research institutions recognized worldwide such as Fiocruz (Oswaldo Cruz Foundation) in Rio de Janeiro, which for decades have been conducting research and trials, ”says the expert.
Indeed, Fiocruz is the scientific institution that is participating in the research and production of the Oxford and AstraZeneca vaccine.
Another world-renowned Brazilian institution, the Butantan Institute in Sao Paulo, is participating in the production of the Chinese Sinovac vaccine.
But there is also the experience and strength of Brazil in its national immunization programs and its long tradition in the production of vaccines.
The Bio-Manguinhos plant, which belongs to Friocruz, is one of the largest vaccine production centers in Latin America.
Millions of doses of vaccines against yellow fever, tuberculosis and measles, among other diseases, are processed there.
And the Butantan Institute is currently the leading producer of vaccines against influenza or flu from the southern hemisphere, with a capacity to produce 100 million doses.
“It should be noted that Brazil has had a strategic approach to becoming self-sufficient in vaccine production“, He tells BBC Mundo Cristiana Toscano.
The doctor is a member of the World Health Organization (WHO) group of advisory experts for vaccines against covid-19.
“For three decades the various governments have strengthened and invested in public national capacity, so almost all vaccine production laboratories are financed with public money,” he adds.
Indeed, most of the vaccines in Brazil, points out the expert, who is also a professor at the Federal University of Goiás, are produced locally or there is an attempt to establish technology transfer mechanisms with large pharmaceutical companies.
And this is precisely what is now being negotiated with the Oxford and Sinovac vaccines: transfer technology to produce both vaccines locally.
Both the AstraZeneca and Sinovac vaccines are in phase 3 of their clinical trials.
The trials of the first are carried out with some 5,000 Brazilian volunteers. 9,000 volunteers participate in the second.
As part of the preferential agreements for the vaccines being tested in Brazil, the country will initially receive the raw material to carry out the final stages of production.
Both agreements include technology transfer so that Brazil can later produce the vaccines from the start.
In the agreement with Oxford-AstraZeneca, the Brazilian government will invest $ 127 million dollars in exchange for technology and equipment so that Fiocruz can initially produce 30 million doses of the vaccine during its testing phase.
If the vaccine proves effective, Brazil will be able to produce another 70 million doses.
The agreement between Sinovac and Butantan will offer Brazilians 120 million doses of the vaccine.
Brazilian officials have indicated that they hope to begin vaccinating some of their citizens in the first half of 2021.
Some experts, however, have expressed doubts that the country really is capable of producing within six months the enormous number of doses of vaccines that it will need for its 212 million inhabitants.
In recent years, the Brazilian economy has contracted and the country’s public institutions they have suffered from lack of funding.
And as the former Minister of Health, José Gomes Temporao, told Reuters, technology transfer takes time, it can take between five and 10 years, so the country’s laboratories may not be ready to start production in 2021. of vaccines.
“It is impossible,” declared Gomes Temporao. “(The transfer) takes a long time. Maybe they can speed it up a bit, but not that much. “
Dr. Cristiana Toscano believes, however, that Brazil is capable of receiving the technology and starting the production of vaccines.
“It all depends on the technology we are talking about and if the site has the capacity,” the WHO expert tells BBC Mundo.
“There are new technologies that have not been used and I agree that transferring them can be a process of up to 10 years.”
“But Butantan, for example, really has experience in the production of many inactivated vaccines, like Sinovac. It has a safety laboratory that is capable of doing everything that is needed to produce an inactivated vaccine ”, she adds.
The challenge of immunization
But there is another huge challenge that Brazil will have to overcome: how to vaccinate its millions of inhabitants when its immunization programs have suffered setbacks due to disinformation campaigns.
In 2019, for the first time in 25 years, Brazil failed to meet vaccination targets from any of the inoculations he routinely supplied.
This is a trend that has occurred in all the countries of the region due to anti-vaccine campaigns and the growing reluctance of people to be immunized.
“I think the main challenge will be how to keep the vaccination program that was already affected even before the COVID-19 pandemic up to date and how to incorporate a new vaccine into that program now,” says Cristiana Toscano.
“They will be logistical and operational challenges that will require mobilization, training, combat reluctance to vaccination, as well as the entire organization of distribution and administration of the 35,000 vaccination units,” adds the expert.
All of the above, however, is under the assumption that there really will be a vaccine that will be effective and safe.
It is not yet known whether any of those being tested in Brazil, or in other parts of the world, will show positive results when clinical trials end.
What will happen then if the candidates that Brazil is betting on fail?
The Brazilian government is trying to diversify its options and has expressed interest in joining the WHO COVAX initiative, which seeks to ensure rapid and equal global access to covid-19 vaccines.
Experts agree that, for now, any bet on a vaccine is risky while the results of clinical trials are not known.
And to say that a vaccine will be ready in 2021 might be an overly optimistic statement.
“It is important to remember that we should not be waiting for a magic solution,” says former PAHO Deputy Director Jon Andrus.
“We must be humble and remember that we have not always been successful, that we have many diseases for which we have not been able to find a vaccine despite working with them for decades, such as HIV,” he tells BBC Mundo.
“That is why it is so important that we do what we can do now: all public health interventions such as maintaining social distancing, wearing masks, testing and tracking cases, and following hygiene practices, “he adds.
And the WHO expert agrees.
“The goal we are proposing (to have a vaccine in the first semester of 2021) seems optimistic, but it is conditional on the approval of clinical trials if they show positive results and the approval of the regulatory authorities,” Cristiana Toscano tells BBC World.
“And while that happens, it is necessary to minimize expectations and be more realistic,” adds the expert.
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