Low-income countries fall behind in vaccine race

Insufficient supplies of Covid-19 vaccines for low-income countries mean that inoculation of parts of the world could take years, undermining global efforts to end the pandemic.

Desperate to vaccinate their populations against Covid-19, high-income countries, which are home to around 1 billion people, have obtained 4.2 billion doses, or about 74% of total government orders, according to the latest weekly data compiled by the Global Health Innovation Center at Duke University of North Carolina. In contrast, lower-middle-income and low-income countries got orders for just 675 million doses.

The shortfall means that if the UK aims to offer coronavirus vaccinations to all adults in Britain by September, in many parts of the world it could take up to three years to inoculate the population during which the virus will continue to circulate, experts have warned.

“We have a catastrophic supply problem [in low-income countries]Said Anna Marriott, Health Policy Manager at Oxfam GB. “The more the virus is able to travel around the world, the greater the risk of mutations and the greater the risk that the vaccines we have will become ineffective.”

Many low- and lower-middle-income countries had planned to build on the WHO-backed Covax center, set up last year with Gavi, an alliance of vaccine partners, and the Coalition for Epidemic Preparedness Innovations, a foundation that takes donations to fund vaccine research.

The program aimed to ensure the equitable and global distribution of 2 billion doses of the Covid-19 vaccine by the end of 2021. The poorest countries would receive doses for free and no country would vaccinate more than 20% of its population before. that each country received the same opportunity.

But Covax has struggled to mobilize the necessary support from rich countries to subsidize the initiative. So far, it has only secured orders for 1.07 billion doses, while rich countries have preferred to sign bilateral supply agreements.

“It is not normal that younger and healthier adults in rich countries are vaccinated before health workers and older people in poorer countries,” said Tedros Adhanom Ghebreyesus, head of the organization this week. world health, in a fierce criticism of rich countries and their response to the Coronavirus pandemic.

Aurélia Nguyen of Gavi told the Financial Times that Covax has a “line of fire” on 1.97 billion doses of immunization and is on track to meet its goal of fair and equitable access to vaccines for developing countries. However, she declined to say how many doses would be delivered this year. This will depend on production volumes and regulatory approval in each country where the vaccines will be used, she said.

Uncertainty over Covax has forced developing economies and regional blocs such as the African Union to enter the commercial market to compete for their own supplies.

“The global situation we find ourselves in is that we have to do what the rich countries did earlier, by hedging our bets with multiple [deals]Said Fatima Hassan, founder of Health Justice Initiative, a South African group that seeks equitable access to vaccines.

“The company is playing God,” Ms. Hassan said of vaccine makers and the nondisclosure agreements that govern sales and mean information on prices and supply volumes have remained closely watched. “They fuel a lack of transparency. . . this clearly shows where the power lies in this pandemic. “

Kate Elder, senior immunization policy advisor at Médecins Sans Frontières, said low-income countries faced “an artificially-induced supply constraint”, explaining that a more collaborative approach to intellectual property could have facilitated increasing the supply of effective vaccines. by other manufacturers.

“[Rich governments] helped shortages by pouring funds into drug companies without conditionality, ”Ms. Elder said. “We should force the sharing of technology and know-how on the right manufacturers, but we didn’t.”

One exception is the production of AstraZeneca’s Covid-19 vaccine by the Serum Institute of India, which is expected to provide significant supplies to many developing economies. The agreement is a consequence of the partnership between AstraZeneca and the University of Oxford, in which Oxford sought to ensure that “the countries most vulnerable to the worst effects of this global pandemic have early access to a vaccine”.

Carlos Felipe Jaramillo, World Bank vice president for Latin America, said he feared the region would end up in the worst of both worlds: behind high-income countries with the purchasing power to secure large quantities of vaccine, but not eligible for systems such as Covax.

In Peru, one of the countries hardest hit by the virus where more than one in 1,000 people has died from Covid-19, the government this month reached deals for 38 million doses of Sinopharm in China and 14 million doses of AstraZeneca. Discussions with Pfizer, however, are blocked by the drugmaker’s request for a liability waiver that would absolve it of any liability for any side effects. Pfizer did not immediately respond to a request for comment.

“A number of presidents have told me how difficult it is,” Jaramillo said. “These pharmaceutical products require very difficult conditions which could require a change in the legislation in the countries. . . I don’t think it will be quick or easy.

Additional reporting by Joseph Cotterill in Johannesburg, Michael Stott in London, Michael Peel in Brussels, Gideon Long in Bogotá and Andres Schipani in Nairobi