The results of an independent review of Australia’s COVID vaccine and treatment procurements have been released.
On 27 September 2022, Professor Jane Halton AO handed over the findings from her independent review of Australia’s procurement and distribution of COVID vaccines and relevant therapeutic goods, making eight recommendations to help reach a national state of ‘COVID-stable.’
The rapid review was commissioned by the Government in June 2022 to ensure that Australia has access to sufficient supplies of vaccines and treatments to meet immediate and prospective needs for the next 12 – 18 months.
Professor Halton, who also undertook the previous Government’s Review of Hotel Quarantine, is a well-respected leader in the health sector and the current chair of the Coalition for Epidemic Preparedness Innovations and co-chair of the COVAX initiative.
“Australia and the world are not yet ‘COVID-stable’, and we are unable to confidently predict the timing or impact of new waves and variants,” Professor Halton said.
“This uncertainty presents particular challenges [and] the availability of efficacious vaccines and treatments will continue to play a key role in ensuring ongoing protection for lives and livelihoods.
“The next two years are critical to supporting our economy, health, and education systems to recover. Australia’s approach to the procurement of vaccines and treatments needs to be responsive to the changing environment and should be guided by clear policy and understanding of risk appetite.”
Her recommendations cover the need for public health campaigns around vaccine uptake, an updated COVID policy framework, the streamlining of advisory structures, a review of vaccine distribution arrangements, and the need to ensure adequate supplies of therapeutics and vaccines across 2023 and 2024:
- Public health campaigns designed to encourage sustained booster uptake for those that will benefit should be developed and delivered during 2023 and 2024 to improve coverage.
- A clear, updated, policy framework including objectives for the management of COVID should be developed to inform decision-making, purchasing, clinical decision-making and resource allocation. A statement of risk appetite should form a part of this framework.
- Advisory structures should be streamlined, and advice should be integrated to enable decision-makers to undertake their role. The role of decision-makers and advisors should be clarified. Reasons for decisions should be evidenced including indicating where they are based on judgment. Care should be taken to prevent confusion at the clinical level about who is eligible to receive vaccines/treatments and recommendations for use including in respect of target populations.
- Procurement decisions should be made in the context of agreed policy objectives, risk appetite (the acceptability of failure to supply), knowledge/predictions in respect of the evolution of the virus, and supply constraints including knowledge of market behaviour.
- Vaccine distribution arrangements should be reviewed to test value for money and reduce wastage while ensuring timely access.
- New mechanisms to manage stock held by the NMS for use in an ongoing pandemic or epidemic should be developed as a matter of urgency to enable greater transparency about and access to stock held.
- The Department of Health and Aged Care should work with sponsors to ensure that adequate supplies of therapeutics are available to meet reasonably anticipated demand for the next two years. Mechanisms such as guarantees for minimum supply should be explored to ensure availability and access.
- Steps should be taken, consistent with an agreed policy and risk appetite, to ensure adequate supplies of vaccines and treatments are available across 2023 and 2024 including in the event of spikes in demand. This should include additional Moderna vaccines in 2023 and, as a minimum and based on an assessment of ‘COVID stability’, doses necessary to meet baseline demand in 2024.
Professor Halton also highlighted that Australia would probably have an oversupply of Novavax, which arrived after most of the population had already received a primary two-dose course and was not recommended as a preferred booster by Atagi.
“Even though wastage is expected in an oversupply environment, Australia will likely have an over-supply of Novavax in 2023,” she said.
“Australia could implement more permissive eligibility settings for Novavax to increase uptake and reduce the need for additional mRNA vaccines; and/or work with the manufacturer to defer delivery of doses into 2024.
“Additional procurement of Moderna vaccines should be undertaken for 2023 to meet any anticipated shortfall in the number of mRNA vaccines required and to ensure access to vaccines for children under five years.”
The Government has thanked Professor Halton and will now carefully consider the eight recommendations contained in the report.