Abstract

Abstract COVID-19 has highlighted the failure of the current monopoly market system of pharmaceutical industries to efficiently and equitably distribute lifesaving health commodities in a pandemic. The pre-purchasing of COVID-19 vaccines in 2021 by high income countries (outside of the global coordinated effort called the COVAX facility) has led to inequitable access to vaccines globally. This may have contributed to the development of new COVID-19 variants of concern such as ‘Omicron’. Further, vaccine inequity has resulted in the poor suffering the worst health and economic outcomes of the pandemic. COVID-19 has deepened inequalities and increased global poverty. While high income countries are on a path to recovery with pre-pandemic growth rates forecast for 2022, low and middle income countries are still in economic recession, with growth rates forecast to remain at 5.5 percentage points below pre-pandemic levels by 2024. The Health Impact Fund approach offers an alternative, whereby pharmaceutical firms profit in proportion to their contribution to reducing the disease burden rather than through monopoly rents from product sales.

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