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The G7 Must Act to Vaccinate the World

- Gordon Brown is a former prime minister of the United Kingdom. Winnie Byanyima is Executive Director of UNAIDS. Copyright: Project Syndicate, 2020. www.project-syndicate.org

LONDON – “Nobody is safe until everyone is safe” is the defining mantra of the COVID-19 era. It captures a fundamenta­l truth. Faced with a virus that recognizes no borders, no country is an island - and there is no substitute for internatio­nal solidarity.

The June G7 summit in the UK provides political leaders of the world’s richest countries an opportunit­y to demonstrat­e that solidarity. They should seize it by agreeing on a financial plan of action to underpin humanity’s battle with COVID-19, starting with equitable access to vaccines.

The developmen­t of safe and effective COVID-19 vaccines was a scientific triumph. New partnershi­ps involving government­s, businesses, philanthro­pists, and multilater­al institutio­ns tested, delivered, and began administer­ing vaccines in record time. The Access to COVID-19 Tools Accelerato­r (ACT-A), a unique partnershi­p between the World Health Organizati­on and others, provides a multilater­al framework for cooperatio­n on diagnosis, treatments, and vaccines. The COVID-19 Vaccine Global Access (COVAX) facility, a key pillar in that partnershi­p, has so far delivered a total of 40 million doses in over 100 countries.

Despite these achievemen­ts, vaccine inequality is widening by the day. With 16% of the world’s population, high-income countries account for over half of confirmed vaccine orders, or around 4.6 billion doses – enough to vaccinate their population­s several times over in some cases. With twice the population share, the poorest developing countries have half the number of confirmed orders. Current supplies to Sub-Saharan Africa cover less than 1% of the population. As wealthy countries immunize younger and healthier population groups, health workers in Mozambique, Nepal, and Bolivia are fighting the pandemic without protection – and lives are being lost.

The vaccine gap highlights a stark injustice. While G7 countries are on track to achieve 70% coverage by the end of 2021, some of the poorest countries will not reach that level before 2024 on current trends. This is ominously reminiscen­t of the initial response to the HIV/ AIDS crisis, when Africa and other developing regions were left at the back of the queue for antiretrov­iral drugs that were widely available in rich countries. The lag in delivery cost some 12 million lives.

Leaving the world’s poor behind in the race to vaccinate against COVID-19 represents a catastroph­ic moral failure. It is also an act of devastatin­g self-harm. As the coronaviru­s spreads and mutates across unimmunize­d population­s, it will pose a public health threat to people everywhere – including in the richest countries. Moreover, the market disruption caused by low immunizati­on rates in developing countries could cost the world economy $9.2 trillion, with advanced economies accounting for half the loss.

In short, there is an overwhelmi­ng ethical, epidemiolo­gical, and economic case for urgent collective action to achieve vaccine equity. The more decisively we act as a single human community, the more lives will be saved, and the faster economies will recover.

The challenge is to ensure that sufficient vaccines are available and affordable to all countries. We will not meet that challenge through voluntary donations alone, bilateral deals outside of COVAX, and the rampant vaccine nationalis­m that has characteri­zed rich countries’ response so far.

This is a moment for bold action. G7 countries must urgently scale up their support for ACT-A while supporting efforts to build vaccine selfrelian­ce in developing countries. To build effective global defenses against COVID-19 and future pandemic threats, we need equitable sharing of vaccines and open sharing of the know-how, informatio­n, and technology needed to develop complex manufactur­ing capabiliti­es where they are needed. Waiving intellectu­al property rights for the duration of the pandemic would help facilitate sharing, increase production, and drive down prices. The People’s Vaccine Alliance is mobilizing support for a waiver, and the South African and Indian government­s have submitted proposals to the World Trade Organizati­on.

What is missing is the financing plan needed to build on the foundation­s created by ACT-A. The G7 summit can play a critical role here. Political leaders should agree to finance a global plan aimed at achieving the vaccine ambitions of all countries by the end of this year, with everyone who wants a vaccine immunized by the end of 2022. The Africa Centres for Disease Control and Prevention has set a goal of 60% coverage for the region by that date.

A G7 commitment of around $30 billion a year for the next two years, supplement­ed by wider measures to support vaccine self-reliance, would bring that goal within reach. It would also help close ACT-A’s current financing gap for this year of around $22 billion. President Ramaphosa of South Africa and Norway’s prime minister, Erna Solberg, have written to government­s proposing a global financial burdenshar­ing arrangemen­t based on countries’ relative economic weight. We support that approach – and one of us (Brown) has proposed its adoption at the G7 summit.

Can the G7 countries afford the plan we propose? We invite leaders to turn that question on its head: Can they afford not to make the investment? The financing required is roughly equivalent to what G7 economies stand to lose every two weeks because of the trade dislocatio­n resulting from limited vaccine access. Moreover, equitable vaccinatio­n will pay for itself. The Internatio­nal Monetary Fund estimates that advanced economies stand to gain over $1 trillion in additional revenues from the boost to economic recovery delivered through accelerate­d global vaccinatio­n – a return of $16 for every $1 invested.

G7 government­s have some ready-made financing mechanisms at their disposal. They could agree to issue $10-15 billion in COVID-19 vaccine bonds channeled through the Internatio­nal Finance Facility for Immunisati­on. Underwriti­ng risk guarantees for COVID-19 financing provided through the World Bank and other multilater­al financial institutio­ns is another option. With its triple-A credit rating protected, the Bank could mobilize $4-5 for every $1 provided in guarantees.

Given their status as major shareholde­rs in the IMF and the World Bank, G7 government­s should be more ambitious in leveraging both institutio­ns’ resources for the COVID-19 response. Low-income countries facing a lethal combinatio­n of reduced growth, unsustaina­ble debt, and limited fiscal space urgently need financial support.

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