The Global Inequality of COVID-19 Vaccines

A global pandemic needs a unified vaccine solution. However, at the current rate, it may take until mid-2022 to achieve the high level of global immunity required to bring the pandemic under control. This is according to Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations (CEPI). [1]

Why is global immunisation important?

The current death toll from the pandemic sits at over 4 million confirmed deaths, [2] with a further 80,000 deaths still happening each week – and billions of lives disrupted. [3, 4] Economically, $375 billion are lost from the global economy every month without vaccination. [4] However, rich countries have been buying up nearly all available vaccines and leaving little for anyone else, as illustrated by figures 1 and 2, with nearly 85% of vaccine doses administered in developed countries. [3]

Figure 1, Progress on vaccinations by GDP per capita, Financial Times COVID-19 vaccine tracker, accessed 26^th July 2021. Circle size represents population. [5]

Figure 2, COVID-19 vaccine doses administered per 100 people, Our World in Data, accessed 26^th July 2021. [6]

Why is global inequality a problem?

While some high-income countries such as the United States are already vaccinating children as young as 12, who are at low risk of hospitalisation and death from COVID-19, many developing countries lack the supply required to vaccinate their frontline health workers and the most vulnerable – drawing vaccine doses away from where they could most effectively save lives. [3, 7] Moreover, while the pandemic continues anywhere in the world, there is a risk that viral variants may evolve and be resistant to the currently available vaccines. The introduction of vaccine-resistant viral variants could set the world back by months of progress. The world therefore needs a united, global strategy for vaccination.

COVAX

COVAX, or COVID-19 Vaccines Global Access, is a global initiative for equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance, CEPI, and the WHO. COVAX coordinates international resources to provide vaccines to developing countries, as well as tests and therapies. [3, 4]

COVAX aims to provide doses for at least 20% of countries’ populations via a diverse portfolio of vaccines that are delivered as soon as they become available. [4] Once the WHO has approved vaccines for Emergency Use Listing (EUL), they can be distributed as part of COVAX. Many countries lack regulatory capacity and depend on WHO authorisations for EUL. At time of writing, these vaccines include Oxford-AstraZeneca, Pfizer-BioNTech, Moderna, Sinopharm, Sinovac, and Johnson & Johnson vaccines. [8]

Where are we now?

COVAX began delivering its first doses on 24th February 2021, just 2 months after vaccinations started in Europe. At time of writing, COVAX has so far shipped over 138 million COVID-19 vaccines to 136 participant countries. [4] However, COVAX is not meeting its goals. [1]

COVAX’s main supplier, the Serum Institute of India, reneged on its promises as India was overcome by a surge in infections. If the Serum Institute of India does not resume shipments earlier than December, COVAX planned deliveries could be short by 1 billion doses. [3]

Many rich countries will soon have hundreds of millions of excess vaccines that they could donate to developing countries – potentially as many as 1 billion by September. The biggest pledge comes from the US, which aimed to donate 80 million doses by the end of June, including 60 million doses of the Oxford-AstraZeneca vaccine. However, logistical hurdles have delayed delivery of vaccines into July and beyond. [9] Similarly, after restricting their use to older age groups, many European countries are ready to donate their Oxford-AstraZeneca doses. Moreover, the G7 recently pledged to share at least 870 million doses, with the aim of delivering at least half by the end of 2021. [10] Finally, vaccine manufacturing capacity also continues to increase. [3]

Unfortunately, for the time being, the world has a two-track recovery from the COVID-19 pandemic. Vaccinating the world against COVID-19 is a great challenge, but no one wins until everyone is vaccinated.

References