Globally, the COVID-19 pandemic has resulted in 400 million infections and more than five million deaths. Although the virus does not discriminate, the crisis has shed light on the sharp inequalities between the world’s garden and garden-nots. While about two-thirds of the world’s population has received at least one dose of a COVID-19 vaccine, less than 2 out of 10 people in low-income countries have received at least one dose.
We must treat COVID-19 diagnostics, treatments, and vaccines as common goods for the benefit of all, not profit-making instruments for large corporations or supplies for high-income countries to gather, and leave others without.
Now in the third year of the pandemic, vaccine inequality continues to prolong this health crisis, leading to more deaths and potentially allowing the virus to mutate dangerously in hotspots. The world will not succeed in controlling COVID-19 everywhere until vaccines, as well as diagnostics and treatments, are affordable and widely available to all people everywhere. While so much of the attention of the world’s richest countries is now focused on Ukraine, it is vital that we are not distracted from the fight to curb and eradicate this pandemic.
Why do millions in parts of the world remain unvaccinated?
When the vaccines were developed in 2020, governments across high-income countries entered into agreements directly with pharmaceutical companies and contributed billions of dollars in public funds to support their development, testing, manufacturing and distribution. In return, these countries were guaranteed access to a certain number of doses. When vaccines came on the market in early 2021, many of these countries were also committed to vaccine nationalism — stored so many excess doses that millions expired and were discarded before they could be used.
This meant that the rest of the world was at the back of the queue for supplies to vaccinate their own population. Many low-income countries had to wait for pooled vaccine procurement and distribution mechanisms such as COVAX or rely on the willingness of high-resource countries to redistribute excess doses. This happened even though many lower income countries had cash in hand to buy their own vaccines. For example, the African Union could not obtain the vaccines it wanted, even with the $ 2 billion it had available. This inequality has been exacerbated by Africa’s imports 99 percent of his vaccines — makes it impossible to be self-reliant.
Meanwhile, major pharmaceutical companies have refused to share the vaccine recipe and know-how that would allow other manufacturers to start producing them. The European Union and countries, including Germany, France and the United Kingdom, have stood by the interests of the pharmaceutical industry and blocked a proposed waiver by the World Trade Organization of intellectual property rights to COVID-19 vaccines, an initiative proposed by India and South Africa.
How does this account for access to diagnostic tests and therapy?
The catastrophic global gap in vaccine access risks being repeated when it comes to diagnostics and treatments. Access to a PCR test in countries such as Ghana, Kenya or South Africa can cost half a teacher’s monthly salary. Alone in Africa six out of seven COVID-19 infections go undetected.
High-income countries are also stockpiling new therapies. For example, they have already purchased the first 30 million courses of the new oral antiviral therapy Paxlovid, which is shown to reduce the hospitalization of high-risk patients by up to 89 percent and is expected to be available in July 2022. This means that this drug is likely remain out of reach for most people in low- and middle-income countries for at least a year.
What does pandemic justice look like?
The pandemic has highlighted the flaws in the charity-driven global health response that has today led to non-existent or fragile health systems in many low-resource countries and a medicine and health technology industry that puts many countries at a brutal disadvantage. for essential things.
Undoing this means supporting more capacity in the global South to produce its own vaccines, diagnostics and therapeutic agents and ensuring that scientific breakthroughs everywhere can alleviate public health emergencies everywhere. This can only be done through patent exemptions and technology transfer for vaccines and other tools.
Manufacturers in low- and middle-income countries should not only be released from legal obligations if they copy essential vaccines and other tools to combat COVID-19, but should also be supported with the technology transfer and know-how they need to participate in production. Meanwhile, governments in countries where pharmaceutical giants are based need to step up to use all the tools at their disposal to pressure these companies to share vaccine technology and know-how.
A solidarity-based response to the pandemic also means that high-income countries should help fund efforts to get vaccines into arms, including support for the costs of health workers, outreach programs and public awareness campaigns. Addressing the challenges of adequate vaccine supply does not matter if countries do not have systems in place to convert doses into administered vaccinations. In addition, high-income countries should not use the COVID-19 crisis as an excuse to cut foreign aid by, for example, counting the cost of redistributed vaccines — including those that were too close to expire to be used – against their overseas development budgets.
In addition, domestic deployments of vaccines, diagnostics, or therapeutic agents must be designed and implemented to include marginalized populations. So far, the rollout of the COVID-19 vaccine has highlighted how inequalities continue to leave the most marginalized populations in the world under-protected, including groups exposed to discrimination due to. race and class, persons in detention and those who have been forcibly displaced. Vaccination programs in the country must include clear protection of such groups, and decision-makers should engage in consultations with civil society to ensure that their response strategies are inclusive, well-designed and explicitly protect the interests of the most vulnerable.