Covid vaccine inequity: in the fierce race to secure doses


No one disputes that the world is unfair. But no one expected a vaccination gap between rich and poor around the world to be so severe, so far into the pandemic.

Inequity is everywhere: Vaccines are begging in the United States while Haiti, a short flight away, received its first delivery on July 15 after months of promises of 500,000 doses for a population of over 11 million inhabitants.

Canada procured more than 10 doses for each resident; Sierra Leone’s vaccination rate just crossed 1% on June 20.

It’s like a famine in which the richest guys take over the baker, said Strive Masiyiwa, the African Union envoy for vaccine procurement.

In fact, European and American officials deeply involved in funding and distributing coronavirus vaccines have told The Associated Press they have no idea how to handle the situation around the world. Instead, they hustled each other for their own home use.

But there are more specific reasons why vaccines have and haven’t reached the haves and have-nots.

COVID-19 first unexpectedly devastated rich countries and some of them were among the few places that make vaccines. Export restrictions kept doses within their borders.

There was a global purchasing plan to provide vaccines to the poorest countries, but it was so flawed and underfunded that it couldn’t compete in the fierce competition to buy. Intellectual property rights rivaled global public health for priority.

Rich countries extended vaccinations to increasingly younger people, ignored repeated calls from health officials to give their doses instead, and debated booster shots – even though poor countries could not immunize them. more sensitive.

The disparity was in some ways inevitable; wealthy nations expected a return on the investment of taxpayer dollars. But the scale of the inequity, the stockpiling of unused vaccines, the lack of a viable global plan to solve a global problem have shocked health officials, even if it wasn’t the first time.

It was a deliberate global architecture of injustice, Masiyiwa said at a Milkin Institute lecture.

We do not have access to vaccines either in the form of donations or available for purchase. Am I surprised? No, because that’s where we were with the HIV pandemic.

Eight years after the therapies became available in the West, we haven’t received them and we’ve lost 10 million people.

It’s a simple calculation, he says. We don’t have access. We don’t have a miracle vaccine.

The World Health Organization has duly updated its epidemic playbook after each outbreak, most recently with Ebola in mind.

Then, as so often in previous decades, an emerging disease was largely contained in countries lacking robust public health services, with poor sanitation and overcrowded living conditions and limited travel links.

For years, the WHO has assessed countries’ preparedness for an influenza pandemic: the United States, European countries and even India ranked among the first. The readiness of the United States was 96 percent and that of Britain 93 percent.

On January 30, 2020, the WHO declared the coronavirus outbreak in China a global emergency. It will be months before the word pandemic becomes official.

But that same day, the Coalition for Epidemic Preparedness and Innovations, or CEPI, predicted the worst. CEPI has announced a call for proven vaccine technologies applicable to large-scale manufacturing, according to minutes from its scientific advisory group.

CEPI said it would be essential to support the global access strategy from the start of the match.

CEPI quickly invested in two promising vaccines against the coronavirus under development by Moderna and CureVac.

We said early on that it would be important to have a platform from which all countries could draw vaccines, where there is accountability and transparency, said Christian Happi, professor at Redeemer University in Nigeria and member of the CEPI scientific advisory committee.

But the general idea was that we thought the rich countries would fund it for the developing world.

Happi said officials did not expect the pandemic to strike first and harder in Europe and the United States or that their assessment of preparedness in the world’s most advanced economies would turn out horribly. optimistic.

World health experts would quickly realize that rich countries could sign a paper saying they believe in fairness, but as soon as the chips are down they will do whatever they want, he said. .

On March 16, five days after the declaration of the global pandemic, the new mRNA vaccine developed by Moderna was injected for the first time into a trial participant.

At that time, the disease was ravaging the elderly populations of Europe and the United States.

Moderna and Pfizer / BioNTech were the first companies to come up with an mRNA vaccine, devising near-on-the-fly mass production methods. Scientists at the UK University of Oxford have also developed a vaccine with a more traditional platform, and Bill Gates negotiated a deal for them to partner with AstraZeneca, a pharmaceutical company with global reach but without experience in vaccine production.

On April 30, the deal was confirmed: AstraZeneca took sole responsibility for the global production and distribution of the Oxford vaccine and pledged to sell it for a few dollars a dose.

Over the next few weeks, the United States and Britain reached agreements totaling 400 million doses of AstraZeneca.

The race for vaccine manufacture and safety was on, and the United States and Britain were leagues ahead of the rest of the world, a lead they would not lose. Yet both countries would see their life expectancies drop by at least a year in 2020, the biggest drop since World War II.

In the European Union, 22 countries have seen their average lifespans shortened, with Italy at the top of the list.

But as grim as the situation was, all of these countries had one major advantage: They were home to drug companies with the most promising vaccine candidates, the world’s most advanced production facilities, and the money to fund both.

On May 15, 2020, President Donald Trump announced Operation Warp Speed ​​and promised to deliver coronavirus vaccines by the New Year. With unprecedented money and ambition behind the project, the director of Warp Speed, Moncef Slaoui, was more confident than his counterparts in Europe that a vaccine was in sight. He signed contracts almost without regard to price or conditions.

We were frankly focused on getting this as quickly as humanly possible. If I had to do it again, I probably should have expressed a more global dimension, said Slaoui. The operation had focused, which frankly was also part of its success, on staying out of politics and making the vaccines.

The idea of ​​including clauses ensuring that vaccines would be distributed to anyone besides Americans was not even considered.

At the same time, the United States has repeatedly invoked the Defense Production Act 18 times under the Trump administration and at least once under Biden.

The measures prevented exports of crucial raw materials, as factories increased production of vaccines not yet approved and, ultimately, of the vaccines themselves.

But it also meant that these materials would be depleted in much of the rest of the world. The American vice would not be lifted until spring 2021, and only partially.

Operation Warp Speed ​​has spurred the global race to secure vaccines, but it would take another two weeks before COVAX, the COVID-19 Vaccines Global Access Facility, was officially announced as the entity to ensure fairness, with the Serum Institute of India as the main supplier to the developing world.

(Only the title and image of this report may have been reworked by Business Standard staff; the rest of the content is automatically generated from a syndicated feed.)


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