The leaders of the European Union are on the defensive.
More than a year into the pandemic, only 3% of people living in the EU have received a dose of Covid-19 vaccine, compared to more than 15% in the UK and 10% in the US. And as pharmaceutical firms increasingly face production delays that are leading to shortages around the world, critics are blaming the 27-country bloc‘s experiment in collective bargaining for its slow and controversial vaccine rollout.
Five weeks ago, when vaccinations began in the EU, European Commission president Ursula von der Leyen called this crisis “Europe’s moment.” This week, she had to defend the EU-wide effort to jointly negotiate and procure vaccines before an unhappy European Parliament. She’s not alone: French president Emmanuel Macron said his country’s rollout “is going at the pace that was planned,” even though it “may seem too slow,” and German chancellor Angela Merkel was asked to apologize to Germans who have been clamoring for more vaccines.
Officials say a surge in production and deliveries down the line will make up for the initial delay; Macron has promised a vaccine for any adult who wants one by the end of summer, and Merkel by the end of September. But how did one of the largest and richest markets in the world, and a leader in healthcare, fall behind in the first place?
The EU’s vaccine procurement mechanism
When Europe locked down because of the coronavirus in March 2020, EU member states panicked. Some unilaterally closed their borders and negotiated with companies—or China—to buy personal protective equipment, ventilators, and drugs. EU institutions wagged their fingers but appeared unable to coordinate effectively.
By the spring, it looked like vaccine procurement would also be a free-for-all; France, Germany, the Netherlands, and Italy formed the “Inclusive Vaccine Alliance” and secured up to 400 million doses of the Oxford/AstraZeneca shot, to be distributed across the EU on a population basis. Politico reports that France and Spain were negotiating separately with Moderna.
The European Commission decided in June to step in and buy vaccines on behalf of all member states, absorbing the Inclusive Vaccine Alliance and its contract. While big countries would always be able to buy vaccines on their own, the Commission argued it made sense to negotiate together to obtain better prices and help smaller countries get vaccines too. It was also about optics: With the UK leaving the EU by the end of the year, it was a chance for the bloc to illustrate the benefits of membership. (The EU offered the UK a chance to be part of its vaccine scheme, but Brits said no.)
While the aim may have been laudable, experts say the EU’s attempts to negotiate as a bloc, meet the needs of 27 countries, and play hardball with the pharmaceutical industry led to months of delay that are costing Europeans dearly today.
The UK signed a contract with AstraZeneca for 100 million doses in May 2020, while the EU signed its contract with the Anglo-Swedish firm on Aug. 27—reportedly, at a price of €1.78 ($2.13) per jab, compared to about £3 ($4.07) for the UK. As a result, the UK was the first country in the world to receive AstraZeneca shots, and the extra time allowed AstraZeneca to “fix glitches,” as CEO Pascal Soriot told La Repubblica.
The British vaccine rollout began on Dec. 8, and Europe’s on Dec. 27. And in those 3 weeks, the UK was able to troubleshoot its vaccination infrastructure and innoculate 1.47% of its population.
The EU delayed approval of vaccines
The EU wasn’t just slow in signing contracts with vaccine manufacturers; it was also slow in approving vaccine candidates in the first place. The UK was the first country in the world to give the green light to a clinically-approved Covid-19 vaccine, on Dec. 2, while the EU approved the Pfizer/BioNTech jab a few weeks later, on Dec. 21. The UK was also far ahead in approving the AstraZeneca/Oxford vaccine, although the EU approved the Moderna shot two days ahead of the UK, on Jan. 6.
As well as bureaucracy, there is a substantial amount of misinformation and vaccine skepticism across Europe, and officials worry about appearing to rush the process. In France, for example, healthcare staff had to give elderly patients time to reflect on whether they wanted the jab, and the patients could ask to have family present, which caused delays because most nursing homes restricted visitors due to the pandemic.
The fear of widespread vaccine hesitancy is also connected to another kind of delay in the EU’s vaccine procurement, this time around the issue of legal liability. While the US amended a 15-year-old law shielding manufacturers from liability in a public health emergency to cover companies that make treatments for Covid-19, the EU wanted to do things differently. This extended negotiations further as the Commission wrestled with Big Pharma to decide what percentage of fees and damages the EU might cover if something went wrong.
As Sandra Gallina, director general for health at the European Commission, told the European Parliament in a hearing, “nobody can trust the vaccines when you have cut the corners.”
The EU-AstraZeneca row and vaccine politics
The EU’s vaccine rollout hasn’t just been slower than its neighbors’, it’s also been politically chaotic.
For one, after a slower-than-expected rollout in January, AstraZeneca said it would only be able to provide the EU with about a quarter of the vaccine doses it promised by the first quarter of this year because of unforeseen problems at a Belgian factory.
The EU complained that AstraZeneca was sticking to its delivery schedule for the UK, and called the delays unacceptable. Just weeks after Brexit was finalized, this issue seemed to reignite the tortuous process when news leaked that the Commission was threatening to trigger a provision of the Brexit withdrawal agreement to prevent vaccines made in EU facilities from being exported to the UK, potentially affecting the border between Ireland (an EU member) and Northern Ireland (part of the UK). The EU had to backtrack and guarantee that exports could go on, but all parties involved are still fighting over the terms of their agreements.
That’s not all. There have been scandals over contracts negotiated by the German government outside the joint EU framework; some countries started their vaccine rollouts a day before they were supposed to; and Macron claimed that the Oxford/AstraZeneca jab was “quasi-ineffective” for people over 65, on the same day as the European Medicines Agency approved it for all adults in the EU.
In short, it’s a bit of a mess. But it’s worth remembering that no one country has got this process entirely right—though some have done better than others. Manufacturing vaccines for 7 billion human beings, reviewing them carefully, and distributing them equitably, all while countries deal with lockdown fatigue, rising case numbers, and crumbling economies, is far from straightforward. As von der Leyen recently said, “in politics there are always ups and downs and even more so in times of crisis, but what matters is the final assessment.”