How ‘vaccine nationalism’ could prolong the Covid-19 pandemic



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At the end of December, the West African nation of Guinea injected 25 of its senior officials with doses of the Russian Sputnik V COVID-19 vaccine. Steadfast by security concerns, national leaders took to state television to celebrate.

“We are the guinea pigs,” said one.

Almost a month later, there has still not been a single dose of an authorized Western vaccine given on the African continent – even though around 60 million doses have been administered worldwide.

This drastic disparity represents a result long feared by public health experts. It also highlights the colossal challenge that awaits the global coalition, known as COVAX, which is striving to secure doses of vaccine for the world’s poorest countries.

“The price to pay for not solving the problem of international vaccine distribution will be measured in lives,” said Thomas Bollyky, director of the global health program at the Council on Foreign Relations.

Even before the vaccines arrived, the spread of the coronavirus laid bare the benefits wealthy countries have for obtaining such critical resources as hospital ventilators and personal protective equipment for medical workers.

The same dynamic has played out in the global race to accumulate vaccine doses.

A vendor sells protective masks on the street in Bamako, Mali, January 9, 2021.Annie Risemberg / AFP – Getty Images File

A small group of wealthy countries – comprising barely 16% of the world’s population – have blocked 60% of the world’s vaccine supply, according to the Global Health Institute at Duke University.

Canada has already pre-ordered enough potential doses to vaccinate its entire population nearly six times, and the United States has enough purchasing options to vaccinate every American nearly five times, according to the institute.

The hoarding of vaccine doses has left the rest of the world scrambling.

Australia, Canada and Japan account for 1% of the world’s coronavirus cases, Bollyky said, but they have amassed more doses than all of Latin America and the Caribbean, which has nearly 20% cases. Africa’s coronavirus death rate rose to 2.5% this week, officials said, beating the US rate by 1.7%.

“What has happened here is that nations have decided to worry more about the reactions of their populations at home than what needs to be done to bring this pandemic under control,” said Bollyky, author of the book. “The plagues and the paradox of progress. “

Medical workers wait for passengers inside a South African Department of Health’s mobile coronavirus testing unit at OR Tambo International Airport in Johannesburg, South Africa, January 5, 2020.Guillem Sartorio / Bloomberg via Getty Images file

This “vaccine nationalism” has serious consequences, according to public health experts like Dr. Larry Brilliant.

Brilliant, a leading epidemiologist who helped eradicate smallpox, said rich countries’ hoarding of vaccines could trigger a tragic boomerang effect.

“Being at the forefront doesn’t help you as much as making sure everyone crosses the line,” said Brilliant, founder and CEO of Pandefense Advisory, a group of experts fighting the Covid-19 pandemic .

“Until everyone is safe in the world, no one is safe,” Brilliant added. “It’s a pandemic. If a country is not vaccinated, this disease will rebound. And we will all be under constant siege.

COVAX was formed precisely for this reason.

The initial goal of the coalition, which includes global health groups like the World Health Organization and more than 190 countries, is to purchase 2 billion doses by the end of 2021 to inoculate 20% of the population in the hundred or so poorest countries.

“This is the biggest logistical challenge on a scale we have never seen before in global public health,” said Gian Gandhi, COVAX coordinator for UNICEF, who is leading the group’s efforts to purchase and deliver vaccines. .

Gian Gandhi is the COVAX coordinator for UNICEF, the United Nations agency that provides humanitarian aid to children and which is generally the biggest buyer of vaccines in the world.NBC News

The total cost is expected to reach $ 17 billion, Gandhi said, but the coalition has only $ 2 billion and has yet to receive a single dose of the coronavirus vaccine despite agreements in place to secure 1.97 million doses.

COVAX has made further progress this week, however.

The coalition announced on Friday that it had signed an early purchase agreement with Pfizer for up to 40 million doses of its vaccine. COVAX has also said it will exercise an option to receive its first 100 million doses of the AstraZeneca vaccine.

And earlier in the week, newly elected President Joe Biden announced that the United States would re-establish ties with the WHO and join the COVAX coalition, in a reversal of Trump administration policy.

But the coalition still lacks several billion dollars to reach its ambitious goal.

“He doesn’t have the funding and the resources that he needs,” Brilliant said.

The COVAX initiative was born in part from a history lesson – an attempt by the global community to stop rich countries from monopolizing vaccines in bilateral deals, as they did with swine flu vaccines in 2009.

The concept resembles a fundraising pool, where members pay into a central fund in exchange for enough vaccines to immunize 20% of their population.

For wealthy countries that can afford to negotiate their own supplies, it’s insurance in the event that a vaccine candidate they have pre-ordered is not approved by regulators. But for the world’s poorest countries, COVAX is a lifeline – the only viable route to receive vaccine doses.

The distribution of COVAX will be from the world’s largest humanitarian warehouse, a donation to UNICEF from the Danish government. The space spans three football fields, stacked higher than a mid-rise building with items ranging from syringes to therapeutic food, soccer balls to water drilling rigs.

Etleva Kadilli, Director of UNICEF Supply Division, in the world’s largest humanitarian warehouse in Copenhagen, Denmark.Unicef

A box of supplies can travel from the Copenhagen hub to anywhere in the world in 72 hours. The vaccines – once secured – will be shipped directly from the manufacturers.

As the rich countries of the world pile up vaccines, COVAX has resorted to appeals for donations of viable doses from rich countries – the sooner the better.

“If there are vaccines that are not being used and are stored for a rainy day, these should be donated, because more can be produced,” said Gandhi, head of market development. and supplier funding to UNICEF.

Canada and the European Union have both said they are ready to donate surplus vaccines, but nothing has been cemented. According to UNICEF, COVAX has not received any donated vaccines.

Meanwhile, some countries struggling to gain access to vaccines are doing what Guinea has done, turning to less regulated vaccines from China and Russia.

The state-backed doses already have takers in more than a dozen different middle-income countries, including Argentina, Mexico, Turkey, Brazil and Egypt.

Auto-disable syringes and safety boxes that are used in the Covid-19 response at the UNICEF warehouse in Copenhagen, Denmark, December 7, 2020.Unicef

“The challenge we have with COVAX is that right now it’s a charitable endeavor,” Bollyky said. “In the end, charity is going to seem like a side issue to many politicians and national leaders.”

“Until we recognize that making this initiative successful is in our own best interests…. we are not going to see the types of investment and the types of behaviors of national leaders that we need to see to move forward, ”added Bollyky.

One of these arguments is purely economic. According to RAND, global GDP would fall by nearly $ 300 billion each year if only high-income countries could get vaccinated, with $ 30 billion in losses specifically for the United States. But if high-income countries paid for the provision of vaccines, they would get back $ 4.8 for every dollar spent, the nonprofit policy research organization estimated.

There are also many secondary consequences if developing countries are not protected. If COVAX cannot immunize frontline health workers in developing countries, it could disrupt long-standing immunization programs, Gandhi said, leading to a resurgence of diseases like measles and polio, which the world is about to eradicate.

But the biggest consequence of an uneven global vaccination is a prolonged pandemic. A vaccine failure in Mali or Mozambique could mean a resurgence of the virus in America, endangering large numbers of people who are unwilling or unable to get vaccinated, such as children and those with immunocompromise.

“No child or person is safe,” Gandhi said, “until everyone is safe.

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