According to the latest report by the NUS–Lancet PRIME Commission, titled 'Transforming Pandemic Preparedness for Equity,' nearly 2.7 million additional deaths could be prevented during a future pandemic if vaccines are distributed proportionally to population rather than to the purchasing power of countries.
The Commission modeled an H1N1 influenza pandemic scenario where, without the rapid development of an effective vaccine, 58.5 million deaths were expected. With the rapid development of vaccines, the projected number of deaths would decrease to 23.9 million. However, the modeling showed that the number of victims could be reduced even further if vaccine distribution is based on population size rather than purchasing power.
In such a scenario, an additional 2.7 million deaths could be prevented, with the greatest reduction observed in middle-income countries. These results highlight one of the key lessons from the Covid-19 pandemic: access to medical countermeasures and vaccines heavily depends on a country's ability to secure necessary supplies.
Wealth and Vaccine Access
The commission's modeling demonstrated the trade-offs associated with a more equitable distribution of limited vaccine supplies. When distribution was based on population, the number of deaths in high-income countries increased from a modeled 2.4 million to 3.9 million, while the global death toll decreased.
It is important to note that the figures presented are estimates from a hypothetical pandemic model and do not predict the exact number of victims from any specific future outbreak. The Commission also examined the impact of vaccine confidence. Its modeling showed that measures capable of increasing confidence in vaccines could prevent another 1.9 million deaths within the hypothetical pandemic. This points to another challenge for future pandemic response: vaccine development is only part of the process; people must also trust them and have access to them.
Pandemic Preparedness Goes Beyond Vaccines
The report asserts that pandemic preparedness must consider the socio-economic conditions that affect people's ability to protect themselves during a public health emergency. The Commission analyzed data from 20 countries, examining issues such as healthcare access, social protection, public trust, and communities' ability to respond to health threats.
This work comes amid ongoing efforts by the United Nations, which focuses on strengthening international readiness for future pandemics. In its own report, the UN noted the need for countries to learn from Covid-19 and strengthen cooperation before the next major health crisis emerges. The Commission similarly argues that pandemic preparedness cannot rely solely on surveillance systems, laboratories, vaccines, and emergency action plans.
It calls for the principle of equity to be included in pandemic planning so that countries and communities that have historically had less access to medical resources are not left waiting for vital medicines during the next crisis.
Another Approach to the Next Pandemic
The report frames vaccine distribution as part of a much broader question of how the world prepares for future outbreaks. The modeling shows that rapid vaccine development can significantly reduce mortality, but the benefit of this partially depends on how these vaccines are distributed. The commission's findings indicate that changing vaccine distribution criteria could save millions of additional lives worldwide, and increasing vaccine confidence could prevent millions of additional deaths.
These figures are based on modeling, not pandemic observation, so the actual impact of any future outbreak will depend on factors such as the virus involved, its transmissibility and severity, the speed of vaccine development, and the effectiveness of delivery by countries.