NEW DELHI: With Americans, Brits and Canadians rolling up their sleeves to get coronavirus vaccines, it seems that many in the west are clear on the way out of the pandemic, even if it will take many months to get there. But for poorer countries the road will be much longer and rougher.
The ambitious COVAX initiative, launched to ensure the whole world has access to Covid-19 vaccines, has only secured a fraction of the 2 billion doses it plans to buy in the next year and has none yet Offers confirmed for the shipping of vaccines is short of cash.
The virus, which killed more than 1.6 million people, exposed huge inequalities between countries as fragile health systems and smaller economies were often harder hit. COVAX was founded by the World Health Organization, the GAVI Vaccine Alliance and CEPI, a global coalition to fight epidemics, to avoid the international vaccine rush that accompanied previous outbreaks and exacerbate these imbalances.
But now some experts say the chances that coronavirus shots will be shared fairly between rich nations and the rest of the world are rapidly dwindling. With current limited vaccine supplies, developed countries, some of which have contributed taxpayers’ money to fund research, are under tremendous pressure to protect their own people and are buying up shots. In the meantime, some poorer countries that have joined the initiative are looking for alternatives because they fear that they will not be implemented.
“It’s simple math,” said Arnaud Bernaert, Head of Global Health at the World Economic Forum. Of the roughly 12 billion doses that the pharmaceutical industry is expected to produce in the next year, around 9 billion shots have already been reserved by rich countries. “COVAX did not secure enough doses and the situation may develop where they are likely to receive those doses quite late.”
To date, COVAX’s only confirmed, legally binding agreement applies to up to 200 million cans. However, this includes the option to order a multiple of this number of additional cans, said GAVI spokesman James Fulker. Agreements have been made for an additional 500 million vaccines, but they are not legally binding.
The 200 million doses will come from the Serum Institute of India, the company that will likely take a large portion of the coronavirus shots destined for developing countries. CEO Adar Poonawalla says it has a confirmed order for every 100 million cans of one of Oxford University and AstraZeneca and one from Novovax.
“We have nothing beyond that in writing,” he told The Associated Press. “If you want more, you have to place more orders.”
He said COVAX’s lack of engagement will mean a much longer wait for people in developing countries. Poonawalla also noted that his company’s first priority would be to capture footage for India, suggesting that at least 300 million vaccines are needed. It’s likely India won’t be able to take them all at once, but a large order could delay vaccine distribution to other parts of developing countries, Poonawalla said.
When asked why the Serum Institute was only hired to make 200 million vaccines for COVAX, Dr. Bruce Aylward of WHO that they would return to the company to make sure they had the necessary reassurances. He said the serum was “absolutely critical to the institute’s supply of many vaccines”.
The process may be slowed down even further as neither the AstraZeneca nor the Novovax vaccine have been approved by any regulatory agency and any injection marketed by COVAX will likely need to be approved by the WHO. COVAX doesn’t have the two vaccines that appear to be the most effective so far – the Pfizer BioNTech shot and the Moderna vaccine. The UK has already started giving the Pfizer vaccine, and The United States and Canada roll it out this week. Some Gulf states have also approved it.
Still, GAVI said they are “trying to get safe and effective vaccines for COVAX (member countries) on a large scale within the first and second quarters of the new year.”
Even with vaccines in hand, rollouts in rich countries will take many months, and many developing countries face serious logistical challenges that will create delays, noted Dr. Gagandeep Kang, an infectious disease expert at Christian Medical College in Vellore in southern India.
Senior WHO officials have privately acknowledged that attempts to fairly assign the vaccine through the initiative are flawed, despite publicly praising its success.
“The entire call for global solidarity has largely been lost,” said Dr. Katherine O’Brien, WHO vaccines chief, during a recent internal discussion, the tap of which was received from the AP.
To clarify her remarks, O’Brien said in an email that “every country should have access to Covid-19 vaccines as early as possible”
In addition to COVAX’s troubles, O’Brien noted at a news conference earlier this month that it was still $ 5 billion missing to buy the cans that are slated for next year.
According to a report published by GAVI ahead of a meeting this week, the alliance itself concluded that the risk of COVAX failure is “very high”. It was “founded in record time and has to break new ground”.
John Nkengasong, director of the African Centers for Disease Control and Prevention, criticized western countries for “buying up global vaccine supplies beyond their needs while we in Africa are still struggling with the COVAX”.
With no certainty as to which shots would work, governments have signed several contracts in the past few months to ensure their citizens receive at least some Covid-19 injections. Canada, for example, bought nearly 200 million vaccines – enough to supply its 38 million people about five times as well.
Nkengasong mentioned the idea that people in rich countries would be vaccinated, while Africans could get by without “moral problems”.
Beyond ethics, experts note that failure to protect people in developing countries leaves a reservoir of coronavirus that can trigger new outbreaks at any time.
Amid fears that COVAX will not be able to deliver, some developing countries are pulling out completely or starting their own private businesses. Earlier this month, the tiny Pacific island nation of Palau announced it would be giving up the initiative and receiving donated vaccines from the United States instead. Other low- and middle-income countries, including Malaysia, Peru, and Bangladesh, have stayed in the initiative but recently signed their own drug-making contracts as a Plan B.
Anban Pillay of the South African Ministry of Health said joining COVAX was just an interim solution before signing bilateral deals with pharmaceutical companies.
Kate Elder, Vaccine Policy Advisor for Doctors Without Borders, said, “It is increasingly looking like the ship has sailed on a fair vaccine distribution.” GAVI, WHO and others need to discuss how vaccine production can be increased.
To this end, South Africa and India asked the World Trade Organization to waive some provisions regulating intellectual property rights in order to make it easier for manufacturers in poor countries to manufacture Covid-19 drugs and vaccines. But many rich countries are reluctant to do so.
As more countries in the West approve the vaccine, “the difference between people being vaccinated in rich countries and the lack of vaccines for developing countries becomes quite large,” said Anna Marriott, health policy manager at Oxfam. “And it will only prolong the pandemic.”