WHO and the letter of nonsense

The response of Dr Tedros Adhanom to the statements, a week before, by the President of Mexico about the validation processes of vaccines against covid-19 by the WHO, was overwhelming: There are scientific methods for review and recognition of vaccines and not Political statements and harangues add nothing to the information these committees require. By the way, far from the statements in “the morning”, the director of the WHO had not received a formal letter through diplomatic channels.

The story must have ended there. However, for a strange reason, the president wanted to insist on his point: The WHO has “bureaucratic” and slow procedures for the approval processes of vaccines … that López Obrador is interested in; so, annoyed by Dr. Tedros’s quasi-scolding, he replied “you shouldn’t get angry but hurry up” and then sent a letter to the World Health Organization which, he said, would have already been received.

What made the president think he could influence the WHO vaccine approval committee… with a letter? It will be very interesting to read the document that Hugo López Gatell finally sent to the WHO on the orders of the president. Particularly interesting, reviewing the bibliographic support with which you intend to tell the experts in that office how to do their job.

And it is that if there is something worse than ignoring the regulatory processes or wanting to ignore them (as is already done in the case of drug imports in Mexico), it is to believe that the world moves through political statements, harangues, “agreements” and letters. In the case of vaccines, it doesn’t work that way.

To make a long story short, the list of vaccines against covid-19 that began an evaluation process in the WHO, adds 24 compounds, although some of them are versions of the same vaccine, but developed in a different place. Some vaccines finished their validation process favorably. Others, such as the one developed by the German Curevac, were stopped at the request of the manufacturer, due to its results.

Of the seven that we have in Mexico, two of them are pending: Sputnik V and CanSino. The reasons for not completing the process yet are unknown in detail, but it is clear that, in both cases, the WHO requested missing information somewhere in the “dossiere”. They are two of seven vaccines with which 16 million Mexicans were vaccinated and that represent 16% of the total doses received by Mexico.

Having seven brands of vaccines or boasting that we have “the largest portfolio of vaccines” in the world has become a logistical nightmare. From the apparent triviality of not being able to choose which vaccine we will receive or not knowing in advance which vaccine will be applied or where, to the detail of not having foreseen what some analysts predict: The eventual adoption of “Vaccine Passports” and with it the homologation with the United States.

And whether we like it or not, that country, in addition to being our neighbor, is our main trading partner and with whom we share the busiest border with the greatest exchange rate in the world. How come we don’t think (like Canada) to mimic their vaccine portfolio? Surely due to lack of resources and wanting to save as much as possible. Unfortunately we cannot affirm it or the government contradict it, since the information on the negotiations, terms, amounts and payments is reserved.

The rush to implement a low-cost, almost artisanal vaccination system (just look at the current catastrophe with the certificates), led Mexico to use two controversial vaccines, to say the least. I will not stop to analyze the details of the formulations, since there are experts who spoke from the beginning of the type of adenovirus used in the manufacture. Nor do I intend to question their efficacy or safety, since the evidence available so far speaks of biologics that comply, at least, with producing sufficient antibodies without putting patients at risk.

The problem with the two brands has been from the beginning the poor handling and the way in which they have published (or not published) their clinical information. That is precisely what the WHO argues: That information was lacking and that they will take the time necessary to analyze it.

Faced with this, the pressure for the president and the health team is clear: 16 million Mexicans would not be accepted in the next few days in the United States, Europe or the United Kingdom, if they are not vaccinated with the biologicals recognized by the WHO.

The consequences for the Mexican government will not be catastrophic, but they will be very expensive. And the question is: Should Mexico apply new vaccines to all these people?

The government could simply do nothing. In the end, you can argue that you have already complied. He was vaccinated with what was available and the fact that 16 million Mexicans cannot travel to other countries is a responsibility that does not correspond to him.

We are only just beginning to see the results of bad decisions and things will get worse. While in other countries there is already talk of reinforcements, in Mexico there is no plan to continue or extend vaccination. The official position is not to vaccinate adolescents and children (without comorbidities), but what will we do when, sometime next year, these countries begin to require a vaccination certificate to allow them to enter their territory?

The government of Mexico got into a predicament that is getting bigger and bigger; And telling WHO not to be bureaucratic will not get us out of trouble. Reviewing, acknowledging mistakes, and correcting is the only way out.

* The author is a surgeon and health policy analyst.


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