Covid-19: vaccines for a few in Latin America | Society

Latin America and the Caribbean do not have the amount of covid-19 vaccine they need. As of Friday, the region had received 37 million doses, which are expected to be distributed to 630 million people. The figure is enough to administer less than 6 doses per 100 inhabitants: by maintaining a criterion of two per person, the region can now vaccinate 2.8% of its population. In the United States, meanwhile, nearly one in four citizens has already received the vaccine. Inequalities in the global distribution map the differences between rich and poor countries, as denounced in January by the World Health Organization.

“Two-thirds of the vaccines have been allocated to the 50 most powerful countries and 0.1% to the 50 poorest countries,” warns Diego Tipping, president of the Argentine Red Cross. Mexico presented the demand for greater fairness in distribution two weeks ago to the UN Security Council. And he added the support of Argentina, a country with which he agreed to manufacture 250 million doses before July in partnership with Oxford-AstraZeneca. Production, however, is delayed due to lack of inputs. Faced with the emergency, for himself who may have grown up, as can also happen in Europe.

The result is that the total dose figure may mislead Latin America and the Caribbean’s ability to serve its population, as 87% of doses are in the hands of just four countries: Brazil (15 million). , Chile (8.6 million), Mexico and Argentina (4 million). This coincides with the fact that the four countries constitute the group of the five largest economies in the region, with the sole absence of Colombia. While countries like Cuba (which prepares its own formula) and Honduras have not received a single dose. Others have only a few thousand, such as Paraguay (4,000), Ecuador (73,000) or El Salvador (20,000). The differences between rich and poor are obvious.

Internal pressures on governments to outdo their neighbors, added to the current restriction of supply, have made the idea of ​​solidarity-based distribution of vaccines between countries a pipe dream. And the purchasing model did the rest. Based on the logic of the free market and not on a global health strategy, countries with oily trade ties have done better than others. Chile was the best example of this: 30 trade agreements in force and a mature culture of negotiation have enabled the Andean country to conclude contracts for 60 million doses in three years, of which it has already received nearly 9 million to be distributed among 16 million population. “Internal discussions around the vaccine are centered on the local area, on the comparison of our relationship with the neighbor. And we must understand that access to the vaccine is not just a humanitarian issue, it is linked to a successful strategy against the pandemic. It is useless for some countries to vaccinate their entire population if others have not been able to start, because the virus will continue to circulate, ”explains Tipping.

Most countries in Latin America and the Caribbean today depend on Covax, the joint mechanism of WHO and the Global Vaccines and Immunization Initiative (GAVI) to distribute 281 million doses equitably. The first 117,000 arrived last Monday in Colombia, a country which, like so many others, was excluded from the first round of deliveries by private laboratories. The vacuum has given wings to Russia and China to introduce their own vaccines to the region.

While the American laboratory Pfizer has fulfilled 1.6% of its contracts with the region and the British AstraZéneca only 0.26%, the deliveries of Russian Sputnik V and China Sinopharm represent around 5% of what had been agreed. “Laboratories like Pfizer or AstraZeneca also had large commitments in Europe and the United States, but vaccines from Russia or China did not have these commitments. Latin American countries that bought from Russia or China received the vaccines first, as it is easier to be at the top of the list of these laboratories than in those that have commitments with the United States. United and Europe, ”explains Colombian Johnattan García Ruiz, researcher at Dejusticia Reflection Center and professor of law and global health at the University of Los Andes. “One thing is the closing of the negotiations and another that the laboratory respects the deliveries”, he warns.

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Brazil is a good example of delivery problems. The region’s largest economy reserved 415 million doses (more than half with AstraZéneca), but only received 15 million for a population of 210 million. “Brazil did not buy the right quantities on time,” says Marcio Sommer Bittencourt, doctor and researcher at the University of São Paulo. Bittencourt attributes the delay to the inexperience of the government of Jair Bolsonaro, which “did not accept the offer of the companies which had been made before the completion of the clinical studies, created legal obstacles, did not facilitate the ‘acquisition of vaccines by the States and he did not seek alliances ”.

At first glance, Brazil has reserved more vaccines than it needs, but today it has only managed to vaccinate 4% of its population. “It is obviously more difficult for a poor country to buy vaccines, but Brazil is an intermediate country, like Chile, Morocco and Turkey, which are in the lead in terms of vaccination,” he warns. Brazil, like Argentina and Mexico, has relied on local vaccine production, in partnership with international laboratories. But Bittencourt regrets that his country does not develop its own vaccine against covid, despite the necessary technology. Gonzalo Vecina, former president of the National Agency for Sanitary Surveillance (Anvisa), recalls that Brazil “exports the vaccine against yellow fever”.

On December 23, Mexico was the first country in Latin America to receive the covid-19 vaccine and, like Brazil, it is also far behind due to shortage concerns. The government of Andrés Manuel López Obrador agreed to purchase more than 234 million doses of five different vaccines, but only received 1.7%. “Mexico has done what it can,” says Mauricio Meschoulam, professor at Universidad Iberoamericana. Meschoulam explains that for low- and middle-income countries the scope is very limited, as the determining factor in negotiations with pharmaceutical companies is funding for the development of their vaccines. In this way, rich countries have demanded more vaccines than they need and laboratories have offered more than they can produce, leaving the rest of the states in limbo.

“We are facing a brutal inequality in the distribution of vaccines around the world,” says Meschoulam, a reality that has served as an alibi for governments to justify delays in local campaigns. The Mexican protest before the UN goes in this direction. “The government tries to explain that ‘we are slow to vaccinate and we would like to have more vaccines, but look at what is happening in the international context,” says Meschoulam. Problems get worse when national purchasing power decreases or that the political situation is more fragile, such as Peru, in the hands of a transitional government, after the early departure of President Martín Vizcarra by parliament.

Peru received one million vials from Chinese pharmaceutical company Sinopharm in February, a purchase that was marred by the so-called to get vaccinated, a scandal that concerns more than 450 people who – between September last year and January this year – were irregularly immunized with doses the company offered to the Peruvian government in August. The director of the Bartolomé de las Casas Center in Cusco, Carlos Herz, draws attention to these additional problems, a product of the “fragile institutional framework of the state and limited management capacity”: “Inefficient public apparatus means that we quantity of vaccines, but also particular political interests add a factor of delay. It goes against the ability to identify with buying, ”says Herz.

Latin American and Caribbean countries, without exception, need to resolve the bottleneck in the supply chain as quickly as possible. They have little to no firepower to do so with the greatest savings. Tipping told the Argentine Red Cross that the situation is very serious, but also an opportunity. “All presidents have an unprecedented responsibility, which is to think of a comprehensive strategy against the pandemic, without the countries looking to themselves and comparing themselves with the neighbor”.

With the collaboration of Elie Camhaji (Mexico), Beatriz Jucá (São Paulo), Regiane Oliveira (São Paulo), Santiago Torrado (Bogotá) and Jacqueline Fowks (Lima).

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