There is a wild fight front-line for COVID-19 vaccines, with the EU discussing export bans and legal action to ensure delivery accelerates in the coming months.
The downside: The back of the line is likely to extend to 2023 and beyond. Almost no low-income countries have managed to start distributing them seriously, and the total number of vaccinations across continental sub-Saharan Africa currently stands at tens.
Driving the news: The EU is expected to approve a third vaccine tomorrow, from AstraZeneca. But European leaders are outraged that initial stocks will be much lower than expected.
- The EU is now putting pressure on the Anglo-Swedish company to supply it with doses produced in the UK – which had previously struck a deal – to fill the shortage.
- The EU has so far managed to vaccinate only 2% of the total population, compared to 11% in the UK. Shortages have forced Madrid to suspend distribution, and Paris will follow suit.
- Brussels is considering export bans on doses produced in the EU, including the Pfizer / BioNTech vaccine.
The state of affairs: The fact that rich countries are not only buying up most of the supply of approved vaccines but also struggling to roll them out efficiently bodes badly for those countries that are waiting further.
- Some pay a premium on smaller bilateral deals, often for vaccines from China and Russia.
- The Economist Intelligence Unit (EIU) predicts that vaccines will only be widely available in the world’s richest countries this year, while many others (Brazil, India, Egypt) will achieve widespread vaccination next year, and most low-income countries will wait until 2023. or further.
What they say: “What we are seeing worldwide now is not what we hoped for,” said Matshidiso Moeti, WHO Africa Regional Director.
- “It would be very unjust for the most vulnerable Africans to wait for vaccines while lower-risk subgroups in wealthier countries are brought to safety,” she said.
- Barry Bloom, a professor of public health at Harvard, puts it more bluntly: “Right now, it’s the law of the jungle.”
African health authorities hope Vaccine distribution will begin across the continent in March, initially with the roughly 3 million doses needed to cover medical workers.
- The urgency is only increasing as the number of cases on the continent rises and new variants spread. “The second wave is here with vengeance and our systems are overwhelmed,” said John Nkengasong, director of the African CDC.
- The global COVAX initiative hopes to cover 20% of each country’s population by the end of 2021, and the African Union is seeking to supplement that with additional orders.
- If all those pieces fall into place, the WHO says that by the end of the year, 30-35% of Africans could have been vaccinated.
What to watch: “To be successful, we need to meet a 60% target within two years. If we don’t, COVID will be endemic to the continent,” Nkengasong told reporters on Wednesday.
- The other side: NIAID director Anthony Fauci has set a target of 70-85% in the US for this summer.
- In numbers: The US, EU, UK and Canada have jointly purchased at least 2.5 billion doses, enough to vaccinate all of their residents (with two doses where needed) and still have about 1 billion left.
The big picture: The outlook in rich countries depends in part on what is happening in poorer countries, as new variants of the virus emerging around the world could eventually cause new international outbreaks.
- “We are in an arms race, except it’s not an arms race, it’s a race between vaccination and mutation,” Israeli Prime Minister Benjamin Netanyahu said at the virtual Davos Agenda conference this week.
Israel, which sprinted ahead of the rest of the world in terms of vaccinations, is also on track to over-dose millions.
- The government plans to cover Israeli citizens and then “see what we can do for our immediate neighbors,” the health minister told the FT.
- Israel has been criticized for refusing to provide vaccines to Palestinians living in the occupied territories, even though it has vaccinated Jewish settlers there.
Countries on the edge of the EU also hope to access leftover doses.
- For example, Ukraine has so far only managed to negotiate a relatively small deal for a Chinese vaccine with questionable efficacy.
- The country is otherwise dependent on COVAX and any arrangements it can make with European manufacturers and governments.
- The EIU places Ukraine among the countries likely to wait for wide coverage until 2023, along with parts of South Asia, Central and South America and almost all of sub-Saharan Africa.
Canada has received more doses in relation to its population than any other country, and it has pledged to donate to COVAX those who don’t need it.
- But Prime Minister Justin Trudeau – even though he insists on “fair distribution” – has refused to say whether donations will be made before Canada vaccinates its entire population.
Meanwhile, President Biden has piqued the hope of global health experts and the WHO by reviewing Donald Trump’s decision to reject COVAX.
- Bloom calls this an “important new factor,” although Biden has yet to make specific commitments in terms of doses or funding.
- He hopes world leaders will see the current bickering in Europe as an indication that a centralized, equitable structure is needed for global distribution. But, he adds, “I’m not optimistic.”
Go deeper: The Israeli COVID crisis is getting worse even as vaccination coverage soars