NEW DELHI (AP) – With coronavirus cases still on the rise, Honduras grew tired of waiting for vaccines through a United Nations program, so the small Central American country struck out on its own, securing the admissions through a private agreement .
Honduras “cannot wait for bureaucratic processes or wrong decisions” to give citizens “the peace of mind” afforded by the COVID-19 vaccine, said Juan Carlos Sikaffy, president of the Honduran Private Business Council, who helped the purchase through a bank to provide guarantee.
Other countries are also getting impatient. Unlike previous outbreaks of disease, where less wealthy countries have generally waited for vaccines to be delivered by the UN and other organizations, many are now taking matters into their own hands. Experts are increasingly concerned that these go-it-alone efforts could undermine a UN-backed program to get COVID-19 shots in the neediest people worldwide.
Countries like Serbia, Bangladesh, and Mexico have recently begun to vaccinate citizens through donations or commercial deals – an approach that could leave even fewer vaccines for the program known as COVAX, as rich countries make up most of the supply from this year have already picked up.
Led by the World Health Organization, a coalition for epidemic preparedness known as CEPI, and a vaccine alliance called GAVI, COVAX was formed to distribute COVID-19 vaccines fairly. Countries can join to buy vaccines or receive donated injections.
Mustaqeem De Gama, a diplomat with the South African mission in Geneva, called “a level of despair” fueled by the spread of virus variants and “the uncertainty of when COVAX vaccines might arrive.” He doubted that countries that have signed up for COVAX “get even 10% of what they need.”
Even if the effort succeeds, COVAX’s stated goal is to vaccinate less than 30% of people in poor countries, meaning governments must seek other sources to obtain enough shots to achieve immunity to the herd.
Serbian President Aleksandar Vucic said his country had been forced to make its own deals after seeing rich countries fighting over the scarce shots. He criticized nations who, he said, were buying more doses than they needed.
“It’s as if they plan to vaccinate all of their cats and dogs,” he said.
Although Serbia paid 4 million euros to COVAX last year, it has not yet received injections and started its vaccination campaign with vaccines from Pfizer, China’s Sinopharm and Russia last month.
Recent production delays in Europe are raising concerns about whether drug manufacturers will be able to meet the multiplying orders.
“So many deals are being signed that I think it’s hard to see how the numbers could add up for all the ordered doses to actually be produced in the near future,” said Amanda Glassman, a public health expert and executive vice president of the US. Center for Global Development.
Last week, the African Union signed a deal for 400 million doses of the AstraZeneca vaccine, to be produced by the Serum Institute of India. That’s in addition to a previously negotiated deal by the African Union for 270 million doses from various pharmaceutical companies and on top of the 600 million doses Africa expects to receive from COVAX.
Some experts warn that these new deals could take COVAX further to the back of the line, especially if some countries are willing to pay a premium for speed.
To ensure that South Africans got doses of the AstraZeneca vaccine quickly, government officials reluctantly agreed to pay a higher price per shot than in Europe or North America. The first shipments arrived this week.
COVAX hopes to send its first batches of vaccines to Africa later this month, but those plans are subject to change depending on the manufacturers ‘manufacturing capabilities and countries’ vaccination plans.
Mexico began vaccinating health workers in December because of a direct purchase deal with Pfizer. In recent weeks, the country has been forced to turn to Russia’s Sputnik V vaccine, expected to arrive next week, although it hasn’t been approved by Mexican regulators.
Kate Elder, senior vaccines policy adviser at Doctors Without Borders, said developing countries should not be criticized for having private vaccine deals, as that’s exactly what the rich countries did last year.
“Every country is just doing what it needs to do to protect its people,” she said, but the ability of poor countries and regions to get vaccines faster than COVAX could hurt future UN efforts.
“If countries get vaccines themselves, how will the WHO and GAVI deliver them?” she asked.
Although India has signed a contract to supply COVAX with hundreds of million doses of vaccine, the injections have not yet been approved by the WHO, meaning India cannot release them to the UN program. India has now donated more than 5 million doses to neighbors, including Sri Lanka, Bangladesh and Nepal.
Dr. Haritha Aluthge of the Association of Medical Officers of the Government of Sri Lanka called on WHO to intervene amid intense competition for vaccines and the failure of COVAX to deliver.
“Not a single dose (of COVAX) has been received,” said Aluthge.
WHO chief Tedros Adhanom Ghebreyesus recently warned that the world is on the brink of a “catastrophic moral failure” if the COVID-19 vaccines are not distributed fairly, but the agency has no authority to force rich countries to share.
His pleas for countries to act in solidarity have been largely ignored.
Norway is the only country to say it would send vaccines to developing countries because its own citizens were vaccinated, but it did not specify how many would be donated. Britain said it would not divert vaccines until it completes its own immunization program. Australia, which has largely eradicated COVID-19, has no timeline for when it could share vaccines with its poorer neighbors in Southeast Asia and the Pacific Islands.
The relentless pressure on the world’s vaccine supplies could only increase if more shots prove successful, said Krishna Udayakumar, director of the Duke Global Health Institute.
“COVAX is the only global, multilateral platform that allows for something close to global access and equality, yet has access to a relatively small amount of vaccines,” he said. “The only way out is to have more vaccines.”
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Cheng reported from Toronto. Associated Press writers Dusan Stojanovic in Belgrade, Christopher Sherman in Mexico City, Marlon González in Tegucigalpa, Honduras and Krishan Francis in Colombo, Sri Lanka contributed to this report.