Perhaps no other moment in the pandemic has lent more truth to the often ignored mantra that “no one is safe until we are all safe.” Variants, experts say, are one deadly side effect of vaccine inequality — and a global system that has allowed wealthy nations, and large developing ones, to corral jabs for themselves, leaving poorer and less powerful countries to subsist on vaccine crumbs.
Low vaccination rates have also made those nations potential breeding grounds for viral mutations that can then quickly spread in a globalized world. Full vaccination rates in the United States, France and China stand at 60 percent, 70 percent and 77 percent, respectively. Compare that to only 6 percent for Africa’s 1.2 billion people.
“Our achievements in our own country are at high risk because of the failures outside of our country, because of vaccine nationalism, not just in the United States and Europe, but also India and China,” J. Stephen Morrison, director of the global health policy center at the Center for Strategic and International Studies, told me over the weekend. “If you have uncontrolled transmission in large populations, that is the optimum environment for generating new variants. In Africa, you have a 6 percent vaccination rate. You’re going to get mutations.”
Early indications suggest omicron may spread with relative ease, but it’s too early to tell how virulent it may be. Over the weekend, African leaders forcefully pushed back against the flurry of economy-crimping travel bans imposed by a host of nations including the United States, arguing they had no basis in science and were unjustly punishing nations with low access to vaccines. Experts told my colleagues that the travel bans being imposed now may already be too late.
“The prohibition of travel is not informed by science, nor will it be effective in preventing the spread of this variant,” South Africa President Cyril Ramaphosa said in a televised address. “The only thing the prohibition on travel will do is to further damage the economies of the affected countries and undermine their ability to respond to, and recover from, the pandemic.”
The rising alarm over omicron, however, is raising the prospect of a significant new global threat that could have been avoided.
“Despite the repeated warnings of health leaders, our failure to put vaccines into the arms of people in the developing world is now coming back to haunt us,” Gordon Brown, the former British prime minister and an ambassador with the World Health Organization, wrote in the Guardian.
The answer, experts say, lies in more radical solutions than rich and powerful nations appear able or willing to agree on.
Wafaa El-Sadr, director of ICAP, a global health center at Columbia University, is calling for a two-tiered approach. First, “wealthy countries, including the US, must provide resources to companies that produce vaccines now to increase vaccine production,” she wrote to me this weekend. “What we are doing [so far] is donating the excess supply we have, essentially what we can spare.”
“For a longer term strategy, suspending intellectual [property rights] and investing in regional vaccine production capacity is critical,” she wrote.
Those types of bold solutions, however, face major obstacles at a time when developing nations are still far behind the West on vaccines.
The World Health Organization-backed program to share vaccine doses around the world — known as Covax — had initially pledged to distribute 2 billion doses by year’s end, reducing that target to 1.425 billion in September. As we lurch into December, only about 537 million have shipped. The reasons are myriad. As Vidya Krishnan wrote in Foreign Policy, India — intended to be Covax’s primary supplier — stopped exporting vaccines in March to focus “instead on protecting its own population” amid a devastating coronavirus surge. Some exports restarted this month.
At the same time, pledges from rich countries haven’t come through fast enough. Some that did shipped too close to their expiration dates for use. Perhaps the biggest problem: Rich nations are still outcompeting poorer ones, giving booster shots widely and vaccines to children before the most vulnerable groups in many African countries have received their first doses.
“Countries with the highest vaccine coverage continue to stockpile more vaccines, while low-income countries continue to wait,” WHO Director General Tedros Adhanom Ghebreyesus said this month. “Every day, there are six times more boosters administered globally than primary doses in low-income countries. This is a scandal that must stop now.”
Some good news: A fast ramp up of doses to the developing world is set for the coming weeks and months, and in some countries, has already started. Last month, Covax shipped 111 million doses, more than in any other month this year. An extra 900 million doses are expected to be in the “pipeline” by December, the Wall Street Journal reported.
But that expansion faces major hurdles to translate rapidly into shots in arms. Some vaccine makers are still not giving Covax enough notice on how many doses will be available and when. Some developing nations are also still not prepared for an onslaught of doses, needing more assistance for cold storage, distribution and heath-care staffing. Fueled by public skepticism and misinformation, many poorer countries are also confronting the same vaccine hesitancy and resistance seen in richer ones, the Wall Street Journal reported.
Citing two sources, Politico reported last week that the White House was working on two deals to get more doses to developing countries. One would facilitate delivery of hundreds of millions of Moderna doses to Covax and another would expand manufacturing capacity for Moderna and Pfizer to supply the rest of the world. Neither, however, would generate significant new doses until the second half of 2022. A partnership between Johnson & Johnson and Merck to ramp up vaccine production, Politico added, is not expected to “generate any usable shots until the spring.”
Meanwhile, hope for another radical solution — a temporary suspension of intellectual property rights, supported by President Biden and opposed by big pharmaceutical firms, to allow vaccines to be produced rapidly and cheaply abroad — is fading, the Wall Street Journal reported. The White House, according to the Journal, has not advanced proposals to close the gap between countries that favor the move — including India and South Africa — and those that oppose it, including European countries such as Germany. In South Africa, Lesley Wroughton reported for The Post, an attempt to replicate Moderna’s vaccine could be done within a year if the company shared its formula — a request it has thus far denied, citing intellectual property. Without it, the number of years it takes to recreate the vaccine balloons to three.
On Friday, officials announced a postponement to the World Trade Organization meeting in Switzerland originally slated for this week and where the intellectual property issue was set to be discussed.
The reason: the new outbreak of omicron.