Wednesday, May 12, 2021

Unequal access to vaccines will come back to haunt the rich

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As rich countries rush to distribute Covid-19 vaccines, poorer countries are afraid of missing out. The UK has inoculated more than 4 million people while South Africa, which has also been severely affected, has yet to administer a single non-test dose.

Guinea has virtually no vaccine: as of Jan. 18, only 25 injections – enough for two dozen “senior officials” and the president. So much for equality.

This uneven start causes an alarm. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, has called it is a “catastrophic moral failure”. It was wrong, he said, that “younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries.”

It surpasses him. In the UK, which has got off to a good start, nearly half of people over 80 have yet to receive their first blow. In a controversial policy, the government is withholding the second dose for up to three months in an effort to provide at least one vaccine to as many people as possible. Few young and healthy Britons other than healthcare workers have yet received a dose.

So, in his moral indignation, Mr. Tedros exaggerates the matter. But it highlights a real problem. If the rich countries take care of themselves, eliminating the poor from the world in their struggle for vaccines, they will not only be guilty of selfishness. They will also be damaged.

If the virus is allowed to rage unchecked in one part of the world, it will kill more people. It will also be likely to mutate faster, possibly in strains against which existing vaccines offer no protection. Ultimately – as it should be obvious by now – we are all in the same boat.

Both morality and self-interest therefore dictate that vaccines – along with diagnostics and therapies – should be treated as global public goods. With this in mind, led in part by the European Commission, the world has developed Covax, a sort of buyer’s club and insurance plan united. New US President Joe Biden said his country would join him on Wednesday.

By ordering in bulk, Covax encourages companies to invent new vaccines. Under its rules, around 90 poor and middle-income countries eligible for free jabs. The wealthier nations, from Azerbaijan to South Africa, will pay. Although they are not prohibited from entering into bilateral deals, Azerbaijan has with Chinese Sinovac, they could do better in the Covax club than alone.

If Covax ruled the world, it would distribute vaccines around the world, starting with the highest priority groups no matter where they lived. But this is not the case. No one voted for Covax and the world in which it operates is divided into nation states. Plus, the pandemic struck at a time when nationalism prevailed too. If it is America first, then it must also be Brazil first, India first, Germany first, Israel first, Djibouti first and so on.

Inevitably the richer countries make the biggest deals. There is also competition among developing countries. Adar Poonawalla, Managing Director of the Serum Institute of India, the world’s largest vaccine manufacturer, Told The New York Times: “India has priority because it’s my home country.” SII also plans to sell vaccines to private facilities, meaning some people will receive vaccines based on their ability to pay, not their need.

As some enter the queue, Covax has come under fire for falling behind. Peter Piot, director of the London School of Hygiene and Tropical Medicine, says the next five months will be crucial. In Africa, where Covid-19 is declining, at least 2.5 million healthcare workers should be protected immediately, he says. “We are not asking for the moon.”

To circulate the doses, companies would have to give up intellectual property rights and share their know-how so that manufacturers in India, Brazil and elsewhere can increase production. They must also provide regulators with timely data. WHO accused some dragging its feet by prioritizing regulators in lucrative markets.

Richard Hatchett, head of the Coalition for Epidemic Preparedness Innovations, which funds vaccine developers, says Covax can get 3 billion doses. It will, he said, start deliveries next month. Africa is expected to receive 150 million doses in the first half of the year and nearly 600 million by the end of the year. If he’s right, it’s a promising start.

Eventually there will be plentiful supplies, especially if Johnson & Johnson single dose vaccine proves effective and, even more tempting, if the $ 1 per injection vaccine developed by Organic E, a Hyderabad-based company, is doing well.

“We have a short window to get there,” says Benjamin Schreiber, UNICEF coordinator for Covid-19 vaccines. For an interconnected world – or one that longs to be interconnected again – the sharp end of the problem comes now.

david.pilling@ft.com

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