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The good news about the global vaccine supply

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This week, a cargo plane arrived at the international airport in Ghana carrying a global message: 600,000 doses of coronavirus vaccine developed in Britain and manufactured in India, with needles sourced from Dubai. The delivery was part of an international initiative backed by 165 countries, but the lives it would save were Ghanaian.

The Oxford-AstraZeneca doses that arrived in Accra on Wednesday mean that Ghana, a lower-middle-income country with a population of 31 million, can begin vaccinations next week. It’s only one step, but a big one. As Juliette M. Tuakli, a public health physician and pediatrician in Accra, described it to The Washington Post, the doses mean “there is hope in sight.”

And that hope is not just for Ghana, but for many other nations that hope to receive vaccines through the Covax Facility.

Covax, an international effort backed by the World Health Organization, was formed last year in a bid to ensure equitable vaccine distribution globally. But its multilateral approach had initially struggled against the vaccine nationalism of wealthy states, some of which either refused to back it, outbid it for guaranteed orders early in the pandemic, or both.

Now, there are tentative signs that things are changing. Last week, new pledges of funding from the United States and the European Union, among others, pushed Covax’s funding to $6 billion. The Biden administration alone has pledged a total of $4 billion in funding to the effort, reversing the policy under President Donald Trump.

Separately, French President Emmanuel Macron has asked wealthy nations to donate 13 million coronavirus vaccine doses to African governments. Macron argued at last week’s virtual Munich Security Conference that this process would be quicker than donating money to Covax, which, rather than having to negotiate new orders, would effectively jump the line.

Though few other countries have signed up to the idea yet, as the pace of vaccinations grows in wealthy nations it is likely that these calls will gather momentum. The British government said last week that it will “share the majority of any future surplus coronavirus vaccines from our supply” with Covax, without giving a time frame.

The past week’s successes for Covax provide some badly needed good news about the global vaccine supply. After a disastrous winter that saw cases and deaths surge in many wealthy nations, governments had focused on rolling out vaccines to their own people. But experts warned that without a global plan of action, the pandemic may not truly end for anyone.

According to tracking from Duke University’s Global Health Innovation Center, by Feb. 15 wealthy nations had secured more than 4.6 billion doses of vaccines — more than all middle- and lower-income nations combined and roughly four times the number procured by Covax, which had secured 1.1 billion by that point.

Separate research from the Council on Foreign Relations’ Think Global Health project found that while 84 percent of high-income countries had started their vaccination programs as of Feb. 18, just 7 percent of low-income countries had vaccinated anyone.

Scientists have argued that such unequal vaccine supply raises the risks of prolonging the pandemic, with the possibility that unmitigated spread across the world could lead to hardier vaccine variants. Notably, South Africa, where one particularly dangerous variant was first found, had initially relied on Covax. It only began vaccinations last week.

The announcements from Covax about increased distribution and funding are positive, but they are only one part of the puzzle. There has also been good news from studies of available vaccines, with recent data about the effectiveness of vaccines after a single dose, their successes against variants and even their storage that could affect global vaccine efforts.

According to research from Scotland this week, for example, the first doses of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines reduced hospital admissions for covid-19 among the elderly by up to 85 percent and 94 percent, respectively. Arne Akbar, president of the British Society for Immunology, called the initial data “extremely promising.”

In the United States, a Food and Drug Administration review released Wednesday of a vaccine made by Johnson & Johnson found the single-shot vaccine was safe and appeared to be effective against variants. Francois Balloux, who directs the Genetics Institute at University College London, called the data “absolutely wonderful” on Twitter.

Pfizer-BioNTech recently announced that their vaccine did not need the ultracold storage that had made it prohibitive in poorer nations. Rival vaccine manufacturers have been teaming up to increase supplies by summer. Vaccines produced by Russian and Chinese companies are releasing positive data, which should further increase supplies.

There’s a trend toward cautious optimism right now. Certainly, in the United States the numbers look positive — as the Atlantic’s James Hamblin put it last week, many are already looking forward to a “quite possibly wonderful summer.” On the global stage, the picture is less rosy but clearly better than in recent weeks.

At the same time, the optimism shouldn’t overshadow the caution. Covax is still underfunded, despite the latest round of cash injections, while Macron’s proposal to donate doses remains just that: a proposal. At a WHO briefing on Monday, top U.S. infectious-disease doctor Anthony S, Fauci declined to comment on whether Washington would support it, but suggested it had been discussed.

The vaccine rollouts remains staggeringly unequal, with doses often distributed not by need but along geopolitical fault lines.

The shipment that arrived in Ghana on Wednesday is enough to cover 1 percent of Ghana’s population. Like some other middle- and low-income nations, Ghana has not been hit as hard by the virus as wealthier nations — it has so far had about 80,700 coronavirus cases and 580 deaths — but there is little understanding of why that is or how it might change.

That’s not the only mystery. Though case numbers have dropped dramatically in some countries since winter highs, the exact reason behind those declines is uncertain. In some countries, case numbers are edging back up — in some, such as Denmark, this is happening despite a lockdown. A recent survey of experts by the journal Nature found that 90 percent of experts thought the virus was likely to become endemic, but there was no consensus on how that would effect humans.

But even so, the current outlook is more positive than it has been in months. The vaccines are working against the virus, their rollout appears likely to severely slow its spread and these vaccines are shipping out to more parts of the world. It could be a lot better, but also a lot worse, and at least it’s a start.

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