LONDON – Lost amid the cheers of the introduction of vaccines in America this week is an uncomfortable reality: The world’s poorest countries will have to wait months and possibly years to see a dose at all.
The US, Canada, Britain and the European Union have pre-ordered enough Covid-19 injections to inoculate their populations several times, subject to regulatory approvals.
In this pivotal game of drug logistics – where supply is small but immediate and universally required – campaigners and some officials are accusing these wealthy nations of taking orders and gathering more than they need.
The People’s Vaccine Alliance, a collaboration between several aid organizations, including Oxfam and Amnesty International, has said that unless drastic measures are taken, nearly 70 poor countries will not be able to vaccinate 90 percent of their populations next year.
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“Higher-income countries like the US and the UK are putting themselves in the front row – that’s clear what’s happening,” said Philip Clarke, professor of health economics at the University of Oxford. “The obvious failure here is that there are no stronger international institutions and more financial resources to pay for a vaccine worldwide.”
One of these institutions is COVAX, led by the World Health Organization, whose goal is to prevent exactly this from happening. It has raised $ 2 billion from dozens of countries and international organizations, and aims to provide 1 billion shots to poor countries next year.
It was undermined from the start, supporters say, after President Donald Trump refused to give the plan any support. Russia is the only other major economy to retreat.
COVAX says it is still $ 4.3 billion short of the money needed. And many experts are now skeptical that it will one day provide the necessary protection for developing countries.
There are plenty who saw this coming. In April, keen observers predicted a sad recurrence of the 2009 swine flu pandemic, with rich countries pushing past poor countries to the front of the vaccine line. Today, vaccination nationalism is once again moving “at full speed,” United Nations Secretary-General Antonio Guterres warned at a news conference last week.
COVAX has signed advanced purchase orders for 700 million doses, but no deals to ship them to their destinations. According to research from Duke University, this modest supply remains overshadowed by the nearly 4 billion doses that the rich countries secure.
Data collected by Airfinity, a scientific analysis company, shows that almost half of COVAX pre-orders come from AstraZeneca and Oxford University, whose vaccine is awaiting regulatory approval. Most of the rest are from Sanofi and GlaxoSmithKline, whose candidate has been delayed until the end of 2021 after trials showed a weak response in older people.
COVAX is in talks with Pfizer-BioNTech. But these recordings are much more expensive, and experts say they are not suitable for developing countries because they must be stored at extremely low temperatures.
Even if the program succeeds in its ultimate goal of vaccinating 20 percent of people in poor countries, it is far from giving them immunity. Duke researchers believe that enough vaccines for the entire world won’t be produced until 2024.
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When asked about these challenges, a spokesman for Gavi, the Vaccine Alliance, another organization coordinating COVAX, remained optimistic about its outlook.
“With the strong commitment of vaccine manufacturers and the right support from donor governments, we can ensure that all countries have timely access to doses, not just those who can afford their own way,” a spokesman said via email.
But WHO Director General Tedros Adhanom Ghebreyesus hit a much less confident tone on Monday. “High-income countries are now starting to roll out vaccines, while those in low-income countries can only stand by and hope,” he told a meeting to discuss the issue, warning that COVAX was already “at risk of not realizing its potential. . “
Some experts say it is not surprising that these altruistic efforts have been surpassed by the medical-industrial complex that supports rich countries’ relationships with major pharmaceutical companies.
The US has a world-class medical regulator who works closely with drug manufacturers to efficiently approve vaccines. It is the home of Pfizer and its manufacturing facilities, and it has the economic and infrastructure resources to carry out massive rollouts.
“COVAX doesn’t have the power it needs, it doesn’t have the money it needs, and it’s too slow because governments like the US are quick to close their deals,” said Dr. Natalie Roberts, Doctors director of studies. Without Borders, a humanitarian organization. “The vaccines are simply not available because they have already been bought by others – it is too late.”
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Few argue that this is an easy-to-find balance. Only a brave politician would tell their constituents that they are diverting vaccines from their own hospitals and sending them to a faraway land. Some bioethicists say it’s only good that the US and others get the vaccines first because they’ve invested billions to produce them in such record time.
But there may be a selfish reason to vaccinate the world. Even if the US achieves herd immunity, the minority of Americans who have not been vaccinated could still become infected if the disease is rampant elsewhere in the world.
“No one is safe until we are all safe,” German President Frank-Walter Steinmeier said at the World Health Summit this month. “Even those who overcome the virus within their own borders will remain trapped within those borders until it is conquered everywhere.”