The Scientists' Collective 10-point proposal for equitable and timeous access to COVID-19 vaccine in South Africa

Recent announcements of the efficacy of four vaccines have sparked enormous hope that the world and individual countries will rapidly be able to bring the COVID-19 pandemic under control. South Africa (SA) must crystallise this hope with a smart, ambitious and effective plan to deliver the vaccine to the population in the shortest possible time frame, as suggested in Table 1. The development of COVID-19 vaccines has been a spectacular scientific achievement, culminating in vaccines being authorised for use within 11 months of discovery of the SARS-CoV-2 virus (cause of COVID-19). In contrast, it has taken an average of 10.5 years for most other vaccines to be licensed from the time of discovery in the laboratory. The success in development of a COVID-19 vaccine has been fuelled by use of novel technology that is adaptable to quick modification to target new pathogens, hence shortening the timespan between pathogen discovery and vaccine development. Furthermore, the traditional approach of undertaking clinical development of the vaccine in series has been short-circuited by undertaking different phases of studies in parallel. Notably, this has been done under stringent regulatory authority and independent scientific oversight to ensure data integrity on both safety and efficacy. Regulatory authorities set thresholds for vaccine efficacy to qualify for licensure. The recent announcement that four COVID-19 vaccines have achieved the efficacy threshold against COVID-19 illness, generally beyond expectations, represents a potential sustainable turning point in the pandemic. However, this will only materialise with timely, equitable and substantial access to vaccines that are suitable to being deployed globally, including in resource-constrained low- and middle-income country (LMIC) settings at an affordable price.