Spreading the jab for all

Three ways to vaccinate the world and make sure everyone benefits, rich and poor

AS OF February 25, a total of 221.7 million doses of Covid-19 vaccine had been administered around the world. Well over one-third of these doses were in just two countries – the US and the UK.

A study in mid-November analysed commitments to buy 7.48 billion doses of Covid-19 vaccines. Just over half will go to the 14% of the world’s population who live in high-income countries.

It’s estimated most high-income countries will achieve widespread vaccination coverage by the end ofthis year. Most middle-income countries will not achieve this until mid- to late 2022, while the world’s poorest countries, including almost every country in Africa and some in our own Asia-Pacific region, will have to wait until 2023.

This inequality is clearly a moral outrage. But it is also a surefire way to perpetuate the pandemic’s devastating health, social and economic impacts on the whole world.

There are many reasons why rich countries should do all they can to ensure global vaccine equity – in which Covid-19 vaccines are distributed fairly to different populations, including people of different means and backgrounds.

First, there is the moral argument. Given the vaccines already exist, every day that goes on results in deaths we could have prevented.

Second, the longer it takes to eradicate the virus globally, the more it will mutate, possibly reducing the effectiveness of the vaccines. That would affect us all.

Third, as long as the virus is here, trade flows and global supply chains will be severely disrupted. Avoiding this is also in our own interests if we want to see foreign tourists and students return to our shores.

A recent study found high-income countries may bear 13-49% of global losses – which could be up to $9 trillion (about R135 trillion) – arising from an inequitable distribution of vaccines in 2021.

Finally, a prolonged pandemic might result in even more poverty, destabilising the already fragile livelihoods of millions of poor people in low- and middle-income countries. This, in turn, could result in conflict, undermining global political stability, which would affect us all. Three ways to ensure global vaccine equity

1. The Covax facility – but there are issues.

A number of large middle-income countries have begun to roll out their vaccination programmes, including India, Brazil, Mexico, Chile, Egypt, South Africa and Indonesia. Only a few African countries have begun their vaccination programmes, of which just one, Zimbabwe, is a low-income country.

Some middle-income countries and most low-income countries will be relying on the World Health Organization-led Covax facility, to which Australia contributes funding. This aims to administer 2 billion doses of vaccine, starting with healthcare workers, in poorer countries by the end of this year.

However, Covax doses will cover only up to 20% of the population of each country. And Covax supplies may be slow to arrive, especially if delays in the production and delivery to richer countries push back delivery dates for poorer ones.

Tedros Adhanom Ghebreyesus, director-general of the WHO, has said that rich countries’ approaches to manufacturers to secure more vaccine doses are undermining Covax’s effort to achieve its goal of purchasing 2 billion doses of vaccines to administer during this year.

2. Countries can produce their own vaccines.

Low- and middle-income countries can also produce Covic-19 vaccines themselves.

The Serum Institute of India is one of the world’s largest manufacturers of vaccines and has a licence to produce the AstraZeneca vaccine, which the WHO has approved for emergency use.

India is also developing its own vaccine, from Bharat Biotech, which has been approved in India.

Cuba has four vaccines under development. The most promising in early trials is Soberana 2, which will start phase three clinical trials shortly. If successful, Cuba’s Finlay Institute plans to produce up to 100 million doses by the end of this year.

In Thailand, two vaccines are under development by Chulalongkorn and Mahidol universities. Both are about to start human trials.

In Vietnam, Nanogen Pharmaceutical has received government go-ahead to start clinical trials of its vaccine Nanocovax.

3. Rich countries can donate vaccines to poorer countries.

France’s President Emmanuel Macron said richer countries should send up to 5% of their vaccine supplies to poorer nations. There is little evidence other countries have followed France’s lead. However, Russia and China have provided their own vaccines – Sputnik V and Sinopharm, respectively – to a number of low-income countries in Africa, the Middle East and Latin America.

This is no time for short-sighted vaccine nationalism. The projected two-year delay between vaccinating the world’s rich and the poor is morally unacceptable and the biggest impediment to the world’s health and economic recovery.