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.