Forgotten in the scramble to secure vaccine supplies for high income countries such as the UK, Germany and the US are the low-income nations of the Global South. They rarely figure if at all in public discourse around the pandemic – including in Scotland.
All the fine talk about “nobody will be left behind” from governments and international bodies like the EU as well as Big Pharma has virtually melted away like the first snow of this winter. Many of these rich nation governments are willing to pay high prices while some (not all) companies are set to make billions.
On January 8 Dr Tedros Adhanom Ghebreyesus, World Health Organisation director-general, said that, of the 42 countries now rolling out vaccines, 36 are high-income, six middle-income and none low-income.
India and South Africa, the two middle-income countries that sought a patent ban on new vaccines so they could be manufactured anywhere, are now sourcing supplies outside the Covax facility. South African President, Cyril Ramaphosa, who chairs the African Union, says the continent has few options to secure supplies. The talk is of 2022 before substantial volumes can be obtained; complete coverage may not be achieved until 2024. This puts the rest of the world at risk as we have seen with the spread of the South African variant so it’s a matter of self-interest as well as solidarity to ensure that we’re all vaccinated but the omens are not good.
Covax, the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level, says it can access 2 billion doses on behalf of 190 participating countries, especially 92 low-income countries. it said in mid-December. But, in truth, these are often options rather than firm orders and candidate vaccines rather than approved ones.
The People’s Vaccine Alliance says 70 low-income countries will only be able to vaccinate 10% of their population this year because of rich nation hoarding. It’s claimed Canada can vaccinate each citizen five times and high income countries almost three times. If each one of the world’s 7.6bn humans need two doses that means over 15bn are required but maybe a third of that total will be “available” this year.
What’s more, the facility – to which the UK has offered £500m and the EU €850m – has not raised the required sums; pledges have not been kept. Dr Tedros says it needs $4bn this year alone to buy vaccines for LMICs. He’s urging WHO member countries to stop doing bilateral deals on the side – and calling for genuine global solidarity.
“The governments and health systems are on standby for global vaccine rollout. We are ready, COVAX is ready, countries are ready. The time to deliver vaccines equitably is now,” Dr Tedros said.”
“This potentially bumps up the price for everyone and means high risk people in the poorest and most marginalized countries don’t get the vaccine,” he added. “I want to see manufacturers prioritize supply and rollout through COVAX.” This is not least because governments have contributed £6.5bn to vaccine development.
A key – and unanswered – related question is whether pharma companies, which have collaborated on an unprecedented scale to produce safe and efficacious vaccines within ten months rather than the typical ten years, should now help enable a system where all vaccines are manufactured and distributed free of charge everywhere as the People’s Vaccines Alliance urges. Or at least allow free or ultra-cheap licensing for low-income countries as some are. The industry claims some of this is already being achieved, with four big companies – including AstraZeneca (64% of its doses) – signed up to “eventually” produce “at least” 3bn doses for LMICs. But it insists Intellectual Property Rights (IPR) cannot be suspended.
Elsewhere on this site James Urquhart urges complete transparency about the roll-out of the vaccination programme at home. We need such data and free flow of info globally too. More critically, richer nations such as Scotland need to live up to their oft-repeated, much-vaunted proclamations in favour of global solidarity. So far, we’re not even talking about it in the pandemic.