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Difficult months are ahead, but the launch of the first vaccine in record time and the likely imminent approvals of others is a turning point for rich countries that can afford the vaccines.
But for public health officials in the developing world, it’s a stark reminder that the race to end this deadly pandemic will separate the haves and the have-nots from the world.
Several countries and regional blocs have reserved vaccines that could cover much more than their entire population. The People’s Vaccine Alliance, an international vaccine watchdog that includes Amnesty International and Oxfam, said last week that rich countries bought enough doses of the Covid-19 vaccine to immunize their populations three times.
Only the Canadian government has secured enough vaccines to vaccinate its citizens five or even six times more, although not all the candidate vaccines it pre-ordered may be approved for use.
Alliance data shows that while the world’s richest nations are closing deals, nearly 70 poor countries will only be able to vaccinate one in 10 people at best during 2021.
“It is disappointing that despite the intent to achieve fairness around the world, vaccine nationalism rules supreme,” said Professor Gregory Hussey of the University of Cape Town, who sits on the ministerial committee to advise the government. African on access to a Covid-19 vaccine.
Speaking to CNN on Thursday, the director of the African Centers for Disease Control and Prevention, John Nkengasong, said the inability of the poorest countries to access vaccines would be “catastrophic.”
“The moment we’ve all talked about, for global solidarity and global cooperation, is now. The litmus test is now. It makes absolutely no moral sense to have excessive doses of vaccines in certain countries and absolutely no doses of vaccines in others.” areas of the world, “he said.
Solidarity, in theory
As the new coronavirus swept through countries and filled hospitals earlier this year, a global effort emerged to roll out eventual vaccines for everyone.
So far, 189 countries and territories have joined the two facilities. Notably absent are the United States and Russia.
Equitable access to vaccines is not necessarily just a question of money. A Gavi spokesperson said the alliance has raised more than $ 2 billion to buy vaccines for the poorest countries and needs to raise more than $ 5 billion by the end of next year.
“Our priority remains to secure the necessary funding to ensure that these countries receive prompt access to Covid-19 vaccine candidates through the COVAX facility,” the spokesperson told CNN.
But money cannot buy vaccines that have already been sold.
And COVAX’s key contributors, such as the EU, UK and Canada, have made some of the most important bilateral deals with pharmaceutical companies. The People’s Vaccine Alliance argues that these deals could undermine the COVAX pact they have been funding.
In fact, Canada is one of the largest donors to the COVAX program to allow equitable access to the poorest countries.
In an interview on Friday, Canada’s Minister for International Development Karina Gould said her country needed to hedge its bets because most vaccines are still in development and therefore only theoretical.
“We have entered into agreements with several different vaccine companies, much like the COVAX facility is doing, recognizing that not all of these vaccines could be successful,” he said, adding that the government is committed to equitable and affordable access to vaccine.
“We are not a country isolated from the world. We have friends, family and business partners in all regions of the world. We could just vaccinate Canadians and make them safe, but we don’t want to be disconnected from the world.” “Gould said.
Dr Richard Mihingo, World Health Organization (WHO) Africa Region Coordinator for Immunization and Vaccine Development, said he understands that countries must ensure that their own citizens get vaccinated. He called the bilateral agreements a “sad reality.”
“One thing is to raise money, another is to have access to the product. The financing is not enough if there is no supply. This complicates the situation,” he said.
The WHO’s goal is to vaccinate 20% of the population in the Africa region by the end of 2020, but more significant coverage could take two to three years.
Mihingo believes that the public health impacts could be severe if the virus becomes infected in regions that do not get a vaccine.
Bitter memories
African scientists and public health officials still remember the years and nails struggle to access life-saving drugs to combat HIV / AIDS long after they became available in the West. More recently, despite similar talks of solidarity, the H1N1 flu vaccine reached the continent months after the peak of the epidemic in 2009.
Hussey believes that the debate over the Covid-19 vaccine will relive these painful memories. “This is not a new phenomenon. It has manifested itself many times in the past,” he said.
There are many other historical and contemporary examples of life-saving drugs available to the rich but not the poor.
If the moral argument cannot beat solidarity, officials across the continent hope the public health argument will. Eradicating Covid-19 everywhere is an epidemiological necessity.
“Until everyone is protected, no one can be safe. We live in an interconnected world and even if those countries can protect themselves, they will live on an island. We need a world where we can interact. Not just socially, but economically,” Mihingo said .
The long-term impact of any delay in vaccination in poor countries will widen global inequalities, he believes.
It would be just one of the ways that developing countries could be left out while the rest of the world opens up. “It reminds me of the old days of apartheid, when a black African needed a pass to get out of his ghetto and into the city. The notion of no one being left behind is silly at the end of the day.” Hussey, a professor at the University of Cape Town, said.
A window to get it right
Despite extreme pressure on vaccine supply, COVAX’s goal is to deliver nearly 1 billion doses of vaccines to low-income countries by the end of 2021.
Public health officials who spoke to CNN hope that rich countries will move their unused orders to COVAX.
Gould said it is too early to make those guarantees, but that the Canadian government is in active discussions with COVAX about what a donation mechanism would look like.
Even if vaccines are shared, not all are suitable for low-income countries. The Pfizer / BioNTech and Moderna vaccines are expensive and require extreme cold storage, a challenge for countries with limited health infrastructure.
And while Johnson and Johnson has reached an agreement with South African pharmaceutical company Aspen Pharmacare to manufacture its vaccine, there is no guarantee that those doses will reach the continent.
The vaccine can be transported by basic refrigeration and the Serum Institute of India will manufacture 1 billion doses of the vaccine, which should be provided to the poorest countries at a manufacturing cost through COVAX.
Despite these commitments, billions of more doses of Oxford vaccine have already been committed elsewhere through bilateral agreements.
Mihingo says the next few months will be critical in ensuring that the majority of the world’s population is not left behind in the largest vaccination campaign of our time, for the good of all.
“We must provide the minimum supply to low-income countries to ensure that they can not only protect the lives of the most vulnerable, but also open up trade opportunities and help lift themselves out of poverty,” he said.
