NEW DELHI: With Americans, British and Canadians rolling up their sleeves for coronavirus vaccines, the route out of the pandemic now seems clear to many in the West, even if implementation will take many months. But for the poorest countries, the road will be much longer and bumpier.
The ambitious initiative known as COVAX created to ensure that everyone has access to Covid-19 vaccines has secured only a fraction of the 2 billion doses it hopes to buy over the next year, it has yet to confirm any actual deals to ship. vaccines and has little cash.
The virus that has killed more than 1.6 million people has exposed huge inequalities between countries, as fragile health systems and smaller economies were often hit the hardest. COVAX was created by the World Health Organization, the GAVI vaccine alliance, and CEPI, a global coalition to fight epidemics, to prevent the international vaccine stampede that has accompanied past outbreaks and would reinforce those imbalances.
But now some experts say the chances of coronavirus vaccines being shared fairly between rich nations and the rest are fading fast. With vaccine supplies currently limited, developed countries, some of which helped fund research with taxpayer money, are under tremendous pressure to protect their own populations and are buying vaccines. Meanwhile, some poorer countries that joined the initiative are looking for alternatives for fear that it will not work.
“ It’s simple math, ” he said Arnaud Bernaert, chief of global health at the World Economic Forum. Of the roughly 12 billion doses the pharmaceutical industry is expected to produce next year, rich countries have already reserved about 9 billion doses. “ COVAX haven’t gotten enough doses, and the way the situation can develop is that they will probably only get these doses quite late. ”
To date, COVAX’s only legally binding and confirmed deal is for up to 200 million doses, although that includes the option to order multiple times that many additional doses, GAVI spokesman James Fulker said. It has agreements for another 500 million vaccines, but those are not legally binding.
The 200 million doses will come from the Serum Institute of India, the company that will likely make a large chunk of coronavirus injections destined for the developing world. CEO Adar Poonawalla says he has a confirmed order for 100 million doses each of a vaccine developed by Oxford University and AstraZeneca and one from Novovax.
“ We have nothing else in writing, ” he told The Associated Press. “ If they want more, they will have to order more. ”
He said the lack of commitment from COVAX will mean a much longer wait for people in developing countries. Poonawalla also noted that his company’s first priority would be to make vaccines for India, which has suggested it wants at least 300 million vaccines. India may not be able to take all of them at once, but a large order could delay the distribution of vaccines to other parts of the developing world, Poonawalla said.
When asked Tuesday why the Serum Institute was only hired to produce 200 million vaccines for COVAX, WHO’s Dr Bruce Aylward said they would return to the company “ to make sure they have the guarantees they need. ” . Said the serum. Institute was “ absolutely crucial to the supply of many vaccines. ”
Possibly slowing down the process further is that neither the AstraZeneca nor the Novovax vaccine has been licensed by any regulatory agency yet, and any injections distributed by COVAX will likely need WHO approval. COVAX does not have supplies of the two vaccines that appear to be most effective so far: the Pfizer-BioNTech injection and the Moderna injection. The UK has already started administering the Pfizer vaccine and the United States and Canada we are implementing it this week. Some Gulf countries have also authorized it.
Still, GAVI said they “ aim to begin implementing safe and effective vaccines for COVAX (member countries) at scale within the first and second quarters of the New Year. ”
Even with vaccines in hand, implementation will take many months in rich countries, and many developing countries face serious logistical challenges that will add to the delays, said Dr. Gagandeep Kang, an infectious disease expert at the Christian Medical College. in Vellore in the south. India.
Senior WHO officials have privately acknowledged that attempts to distribute the vaccine fairly through the initiative are flawed, despite publicly praising its success.
“ The entire call for global solidarity has been lost for the most part, ” Dr. Katherine O’Brien, WHO’s chief of vaccines, said during a recent internal discussion, the recording of which was obtained by the AP.
When asked to clarify his comments, O’Brien said in an email that “ all countries should have access to Covid-19 vaccines, as soon as possible. ”
In addition to COVAX’s difficulties, O’Brien pointed out at a press conference this month that $ 5 billion was still missing to buy the doses he plans to get next year.
According to a report GAVI issued before a meeting this week, the alliance itself concluded that the risk of COVAX failing is “ very high, ” saying that it was “ established in record time and has to navigate unknown territory. ”
John Nkengasong, director of the African Centers for Disease Control and Prevention, criticized Western countries for buying the global supply of vaccines ‘above their needs while we in Africa are still struggling with the COVAX (effort)’ ‘.
Unsure about which injections would work, governments rushed in recent months to sign multiple agreements to ensure their citizens had at least some Covid-19 injections. Canada, for example, purchased nearly 200 million vaccines, enough to cover its population of 38 million roughly five times.
Nkengasong called the idea that people in rich countries would be immunized while Africans would be left without “ a moral problem. ”
Beyond ethics, experts note that failing to protect people in the developing world will leave a reservoir of coronavirus that could lead to new outbreaks at any time.
Amid fears that COVAX may not be able to deliver, some developing countries are pulling out entirely or seeking their own private deals. Earlier this month, the small Pacific island nation of Palau announced that it was abandoning the initiative and would instead receive vaccines donated by the United States. Other low- and middle-income countries, including Malaysia, Peru, and Bangladesh, have stuck with the initiative, but have also recently signed their own agreements with drug makers like Plan B.
Anban Pillay from the South African Ministry of Health said joining COVAX was only an interim measure before signing bilateral agreements with pharmaceutical companies.
Kate Elder, a vaccine policy adviser at Doctors Without Borders, said that “ it seems more and more that the ship is sailing towards equitable distribution of vaccines, ” and GAVI, WHO and others should discuss how to increase vaccine manufacturing.
To that end, South Africa and India have requested the World Trade Organization Give up some provisions that regulate intellectual property rights to make it easier for manufacturers in poor countries to manufacture Covid-19 drugs and vaccines. But many rich countries are reluctant to do that.
As more Western countries authorize the vaccine, “ the difference between people in wealthy countries getting vaccinated and the lack of vaccines in the developing world will become quite stark, ” said Anna Marriott, policy manager for the Oxfam health. “ And it will only prolong the pandemic. ”
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