‘No one is safe until everyone is safe’
Variants obstruct global protection amid slow rollout
CAPE TOWN, South Africa — As a dangerous variant of the coronavirus first discovered in South Africa sickens and kills thousands across the country, Jan Matsena has shown up every day to stock the shelves at a Cape Town supermarket, terrified that he too will catch it.
A neighbor died in December, then a co-worker this month. Now Matsena is waiting for a vaccine so he can return home to his township and hold his baby daughter again. But in South Africa, the country hit hardest so far by the variant, inoculations have not yet started.
“The wait for this vaccine has been long, long now,” said Matsena, a firsttime father who has been living away from his family for fear of exposing them. “People are passing away. People are losing jobs. It’s trauma.”
While more than 90 million people worldwide have been vaccinated, only 25 in all of sub-Saharan Africa, a region of about 1 billion people, have been given doses outside of drug trials, according to the World Health Organization.
But as new variants such as the one discovered in South Africa migrate to more countries — including the United States — it is becoming ever clearer that the tragedy for poorer countries could become a tragedy for every country. The more the virus spreads and the longer it takes to vaccinate people, the greater chance it has to continue to mutate in ways that put the whole world at risk.
Recent studies suggest that at least four vaccines that are effective at preventing infection with the original virus did not perform as well against the variant found in South Africa.
That variant is also more infectious — as is another one, discovered in Britain — and it is now estimated to make up 90 percent of all cases in South Africa, according to data compiled by researchers. It has turned up in dozens of other countries.
Inoculation prompts the immune system to make antibodies to the virus, but as mutations change its shape, the virus can become more resistant to those antibodies. In the worst case, failing to stop the spread of the virus globally would allow more mutations that could make existing vaccines less effective, leaving even inoculated populations vulnerable.
“This idea that no one is safe until everyone is safe is not just an adage; it is really true,” said Andrea Taylor, assistant director at Duke Global Health Innovation Center.
Even in the most optimistic scenarios, Taylor said, at the current pace of production, there will not be enough vaccines for true global coverage until 2023. The current rollout plans across Africa are expected to vaccinate only 20 percent to 35 percent of the population this year if everything goes right.
And while some wealthy countries have secured enough vaccine to cover their populations multiple times, South Africa has secured just 22.5 million doses for its 60 million people, and many nations lag further behind.
South Africa’s first million doses, made by AstraZeneca, are set to arrive there Monday, and officials say it will take as long as two weeks to start giving the shots.
The burden of supplying vaccines to low- and middle-income nations hangs heavily on a nonprofit group, Covax, formed by a coalition of international organizations.
Although more than 190 countries have pledged to obtain vaccines through Covax, many of them are also striking deals directly with drug companies or belong to multinational groups that are doing so. That threatens to drive up prices and delay delivery of doses through Covax.
Covax has announced that it has secured 2.1 billion doses for 2021, but it is unclear how many of those will actually be delivered in 2021.
The hope is that rollouts to poorer countries can begin in earnest in the next month or two.
“Covax is necessary but not sufficient,” Taylor said. “It is the only mechanism we have for global equity. We need it, and we need it to succeed. But even if they are successful, it does not get countries close to herd immunity.”