Rich countries hog Covid-19 vaccines. Is there a solution?

Wealthy countries have hog­ged Covid-19 vaccines, providing a glaring illustration of how unfair the world can be. While 57 per cent of people in high-income countries had received at least one dose of vaccine by August 30, the figure in low-income countries was just 2 per cent, according to the United Nations. Health advocates wo­rry that the imbalance will be aggravated by plans in wealthy countries to provide booster shots to fully inoculated people to combat the super-contagious delta variant of the coronavirus. The uneven distribution — which many scientists say will likely prolong the global health crisis — has prompted proposals to expand production of Covid shots, re­allocate rich countries’ excess doses, and ensure vaccines are deployed more equitably in future pandemics.

First in line

As inoculations were being de­veloped, a number of affluent countries signed advance contracts with a variety of companies, securing the lion’s share of initial doses. The US, as part of its multibillion-dollar programme hastening the development of vaccines, also used wartime powers to req­u­ire ma­n­ufacturers to fill mass­ive US government orders first. The US, UK and European co­un­t­ries had the added advantage that firms with local manufacturing plants were the first to deliver vaccines with proven efficacy; China and Russia also rolled out vaccines early, be­fore final trial results were in.

Others in queue

A number of middle-income countries, such as Turkey, Mal­aysia, Serbia and El Salvador, have now managed to procure supply to inoculate sig­nificant portions of their po­pulations. But the poorest na­tions are still waiting for anything beyond a trickle of the life-saving doses. Because many lack the financial clout to secure contracts for Covid vaccines on their own, they depend for supplies largely on Covax, an initiative backed by groups including the World Health Organization that was designed to provide fair access to the shots for every country. And Covax has fallen short of its goals.

Covax shortfall

Covax uses funding provided by governments and donors such as the Bill & Melinda Gat­es Foundation to make its own contracts with vaccine manufacturers. But it has stru­ggled to get hold of doses, especially after India — home to the Serum Institute, the world’s biggest vaccine manufacturer — pared back exports to supply the domestic market following a new wave of infect­ions in March. The original aim of Covax was to distribute at least 2 billion doses, two-thirds of them to lower-income nations, by the end of 2021. By August 30, it had shipped just 11 per cent of that.

Vaccine diplomacy

China and Russia were early to export vaccines as a tool of diplomacy, and in August China pledged to dramatically expand exports to 2 billion doses this year. In June, leaders of the Group of Seven nations upped their commitments so that in all they’ve promised to provide 2.3 billion shots to developing nations by next year. So far the actual contribu­tions have been paltry. Health advocates say that billions more doses are needed and stressed that the speed of do­nations is as important as the quantity. They also worried that the flow of supply to the neediest countries would be interrupted by decisions in high-income nations to offer booster shots to people who’ve already been fully inoculated and to younger children.

What’s at stake?

The coronavirus has flourished in some places where vaccines have been scarce. In addition to causing misery locally, that increases the risk of the emergence of additional, worrisome variants, which will inevitably make their way elsewhere and may not be neutralised by exis­ting shots. Many countries short of vaccines are relying on continued lockdowns to supp­ress the virus, stifling economic activity, while wealthier nat­i­ons have been opening up. It’s possible that sub-Saharan Af­rica, where doses are in short­est supply, will be spared the worst effects. Researchers noted in a paper published in July that Covid’s impact has been significantly lower in the reg­ion than elsewhere and argued that the main factors are the re­lative youth of the populat­ion and the low numbers of el­d­erly living in long-term care fa­cilities. Still, many African co­untries are struggling to co­m­bat Covid on top of other health threats.