A global approach to the pandemic would require global vaccination

When there is a global vaccine shortage, should it be Europe and America first?

Thanks to rising vaccination rates, death rates and hospitalization have significantly declined in the US and other affluent countries, but people are dying in many countries, especially India.. The easiest way to slow down the pandemic and prevent new variants from developing and spreading would be through global vaccination.

However, global vaccination has been very slow so far. When we look at Africa, South Asia, South East Asia, and Latin America, the disparities are glaring. While 85 % of shots have gone to high and upper-middle income countries, low-income countries has only received 0.1 % of doses. The fate of the low-income countries was sealed from the start of the pandemic as the rich nations rushed to hijack vaccine supplies.

Efforts to distribute the vaccine globally had actually begun in June 2020-spearheaded by a coalition called COVAX comprised of Coalition for Epidemic Preparedness Innovations (CEPI), Gavi,The Vaccine Alliance, and the World Health Organization(WHO). The three above-mentioned organizations are working with UNICEF, the World Bank, and vaccine manufactures to make Covid-19 vaccines available across both affluent and the not-so affluent countries (https://www.who.int/news/item/01-03-2021-first-covid-19-covax-vaccine-doses-administered-in-africa).

There are political, socioeconomic, and logistical reasons behind the slow roll out. Luckily, vaccine production capacity isn’t much of an issue. The new single dose Johnson and Johnson vaccines can be a game changer since it doesn’t require storage at very cold temperatures. And, the US is sitting on 40 m doses of the Astra-Zeneca vaccine-unlikely to be used anytime soon(https://economictimes.indiatimes.com/news/economy/foreign-trade/bidens-america-isnt-back-it-has-turned-its-back/articleshow/82237602.cms). 

The real issue is a set of Trade Related Intellectual Property (TRIPS) formulated by the World Trade Organization (WTO) that favor pharmaceutical companies. While there have been calls to at least temporarily waive these rules, the US and some rich countries are yet to acquiesce. This approach allows profits over human lives and flies in the face of claims by some world leaders that “we are in this together”.

The COVAX program inked its first vaccine procurement agreement with the British-Swedish pharmaceutical giant Atra-Zeneca to supply vaccines to 142 countries. In turn, Astra-Zeneca partnered with the Serum Institute of India to produce the vaccines, and early in March the first doses started to be sent out. The Astra-Zeneca and Johson and Johnson vaccines both obviate the cold chain issue and can be stored, moved, and handled under normal refrigeration temperatures for 6 months(https://www.prevention.com/health/a35118263/astrazeneca-vs-pfizer-vs-moderna-covid-19-vaccine(https://www.prevention.com/health/a35118263/astrazeneca-vs-pfizer-vs-moderna-covid-19-vaccine/) Covax also signed a deal to procure 220 m doses from Johnson and Johnson for the 55 African Union states with delivery slated to begin in the third quarter of 2021, and an additional 180 m doses through 2022..

So far, COVAX has shipped 39 m doses of Covid-19 vaccines to 34 countries-still a very slow process (https://www.gavi.org/covax-vaccine-roll-out) At this rate, COVAX’s goals to supply 2 b doses of vaccines seem overly ambitious (https://www.who.int/news/item/08-04-2021-covax-reaches-over-100-economies-42-days-after-first-international-delivery) what with the blood clotting cases that have been reported after administration of both the Astra-Zeneca and the Johnson and Johnson vaccines.

Unsurprisingly, in spite of laudable efforts by Covax, a North-South divide is obvious, with developing countries desperately needing more vaccines. Among countries with populations in excess of 50 million, the UK and US have fully vaccinated 28 and 14 %, with rates increasing steadily (https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html). In Europe, it’s a mixed story with the exception of the UK. Sadly, the disparities are glaring in Africa, South and South East Asia, and Latin America,. Among Latin American countries, with the exception of Chile, which has fully vaccinated nearly 28 percent of its folks, barely 1 % of the population has been vaccinated. In Africa, cases are rising again in Kenya at an alarming rate(https://www.health.go.ke/wp-content/uploads/2021/04/MARCH-31-2021-MOH-CS-COVID-RELEASE.pdf). In Asia, Vietnam is poised to receive about 4 m doses from COVAX by May of this year, and plans to vaccinate about 20% of its nearly 100m population by this year’s end (https://www.reuters.com/article/health-coronavirus-vietnam-vaccination/vietnam-to-vaccinate-20-of-population-against-covid-19-by-end-of-year-idUSL4N2LV1DQ). More seriously, India is teetering on the brink of a collapsing healthcare system as record-breaking cases continue to rise amid a woeful shortage of oxygen

As we can see, many countries in the developing world lack vaccines while rich nations have grabbed nearly all available doses of the vaccine for their citizens. For instance, the US alone has contracted for 300 m doses each from Pfizer and Moderna, and another 100 m doses from Johnson and Johnson.(https://www.medpagetoday.com/special-reports/exclusives/91489?xid=nl_covidupdate_2021-03-25&eun=g1522510d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=DailyUpdate_032521&utm_term=NL_Gen_Int_Daily_News_Update_active). News has come that the EU is already in talks with companies to secure hundreds of millions of doses for booster shots. Clearly, the rich nations have set a terrible example by having rushed to only vaccinate their own people.

As countries prioritize vaccinating their own citizens, the truth is that we don’t live in islands that are closed off to others. We need to remember that viruses mutate and people travel. A good example would be how the UK, South Africa, and Brazil variants have moved to the US.

In summary, a coordinated global response is needed. A self-centered approach can result in surges and more frequent lock-downs across the world. Instead of just making a financial commitment to COVAX, the Biden-Harris administration should start sending some of the Astra-Zeneca nd the J and J vaccines to India and other nations, at the least. It should waive patent rights on Covid-19 vaccines manufactured in the US so as to spur global manufacturing. Inaction at this critical time can squander much of the respect and goodwill that the US enjoys in India and the rest of South Asia.