[New Wave] Is Vaccine Sovereignty Possible?

Published 02 Sep.2020 16:41(KST)

The novel coronavirus infection (COVID-19) is spreading as a great disaster for all humanity. What is even more concerning is that the COVID-19 virus is expanding its spread through mutations over time. The only way to return to life as it was in the past is the development of breakthrough treatments and the supply of vaccines.

In particular, securing COVID-19 vaccines is being named like the Russian vaccine case, as if showcasing the superiority of national science and technology during the Cold War era, naming it 'Sputnik V' after the artificial satellite launched by the former Soviet Union, the first in human history to orbit space. Additionally, global pharmaceutical companies, mainly in advanced countries, are showing overheated competition to secure vaccines.

Through experiencing COVID-19, the importance of vaccine development is increasingly emphasized as it is directly linked to national security. So far, despite efforts to establish vaccine sovereignty in our country, what are the problems and what are the countermeasures?

Although Korea recognizes the importance of vaccine sovereignty, according to vaccine experts, the vaccines needed for domestic vaccine self-sufficiency include 28 types: 19 types of national (regular) immunization vaccines, 5 types of other immunizations, and 4 types of vaccines for pandemics and bioterrorism preparedness, excluding new viruses. Among these, only 14 types are currently domestically self-sufficient.

The current problems in securing Korea’s vaccine sovereignty are, first, a fragile ecosystem caused by lack of participation from venture companies, manufacturing and clinical trial outsourcing agencies, and the fact that a few companies perform the entire process. Second, compared to global companies, there is a severe shortage of R&D funding and a lack of shared research infrastructure and research support centers that can be jointly utilized. Lastly, due to the low domestic market prices leading to poor profitability, a decrease in newborns, and high dependence on overseas supply causing supply instability, companies avoid investing in research and development.

To secure vaccine sovereignty, fundamental measures should seek to reduce medical expenses through treatment and prevention. There seems to be a limitation in institutional governance that can link national health insurance with preventive measures such as nationwide health checkups within a national system.

The Korea Disease Control and Prevention Agency (KDCA) plays a central role in the domestic vaccine sector. The KDCA is responsible for vaccine research and development, selecting targets for essential vaccinations, securing budgets, and managing these operations. There is no disagreement about the KDCA’s role as a professional government agency in disease prevention, cause analysis, and related research and development. However, regarding insurance coverage for vaccine immunizations, the dual system with the National Health Insurance Service’s (NHIS) health insurance finances means that the limited annual budget and the preventive purpose of diseases make expanding insurance coverage very restricted.

Treatments for target diseases are covered by insurance through the NHIS, but most vaccines aimed at disease prevention, primarily for adults, are not covered. Like nationwide health checkups, which represent the future paradigm of medicine through prevention, there is a need to consider improving the system and operational framework to extend healthy life expectancy and reduce medical costs.

It may be time to consider including vaccines for national essential immunizations and disease prevention in the NHIS insurance coverage, just like general treatments, to rebalance the healthcare delivery system between treatment and prevention. This is seen as a mid- to long-term alternative to securing more competitive vaccine sovereignty, responding to the post-COVID-19 era, and operating a universal healthcare delivery system more effectively for all citizens of Korea.