Equity and Pandemic Influenza Vaccine Response: The PIP Framework as a Model for an Efficient Pandemic Influenza Response Through Equitable Vaccine Access

Equity is fundamental to an effective pandemic vaccination response, yet the COVID-19 pandemic demonstrated how inequitable access, driven by purchasing power and delayed supply for low- and middle-income countries (LMICs), prolonged transmission and enabled viral evolution. The Pandemic Influenza Preparedness (PIP) Framework offers a model for providing timely and equitable access to pandemic influenza vaccines. Through legally binding advance supply agreements, the PIP Framework secures real-time access by the WHO to a proportion of global vaccine production and mandates allocation based on public health risk and need. In doing so, it addresses the two axes of inequity observed in previous pandemics—distribution and timeliness—by ensuring that affected populations that do not have access, irrespective of income status, are not at the back of the queue.