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On December 4, 2020, a 90-year-old grandmother in the UK became the first person in the world to receive a highly effective vaccine against COVID-19, initiating the spread of inoculants developed at an unprecedented rate. situation in high-income countries around the world.
Two and a half months later, on February 24, the first vaccines were to coordinate the simultaneous distribution of the two rich people under the COVAX initiative, the World Health Organization (WHO), the GAVI vaccine alliance and the Coalition for Epidemic Training Innovation Coalition (CEPI) mechanism. and poor countries arrived in Accra, Ghana.
Public health officials warned at the time that the widespread spread of the vaccine — through COVAX, regional agencies, and bilateral donations — was essential to prevent and prevent mutations in dangerous variants that would prolong the pandemic.
As 2022 approaches, with nearly nine billion vaccine doses administered worldwide, public health experts say vaccine equity targets have fallen. terribly short. Vaccine production has increased not only in the face of shortages in low-income countries, but there is a long way to go to address the various challenges of vaccinating low-income countries into vaccines in the arms of residents.
Meanwhile, the emergence of the Omicron variant, which seems to be ineffective in some widely used vaccines, could lead to even greater fluctuations in global supply and delivery.
“In almost every measure, vaccine distribution and global equity have been a huge failure and a deep moral crisis,” said Lawrence Gostin, director of the National and Global Institute of Global Health Law at Georgetown Law, Al Jazeera. “I think that’s unquestionable.”
The COVAX scheme initially aimed to achieve a 20 percent vaccination rate in all countries of the world by the end of 2021. The World Health Organization then set a 40 percent vaccination rate in all countries.
But there are only five nations in Africa was expected to reach the 40 per cent target, with most countries on the continent falling well below 20 per cent.
In November, the median vaccination rate of the population of the 92 countries most in need of COVAX (only the majority in sub-Saharan Africa) was only 11%. data collected A follow-up initiative launched by COVID GAP, Duke University and COVID Collaborative, a team of public health experts.
In contrast, most high-income countries have fully integrated it more than 50 percent among their populations, and many have given booster doses to more than 20 percent of the population, according to Our world in data.
Although vaccine production has risen to the level of global demand in recent years, the situation remains precarious, largely due to limitations. technology sharing, supply chains and uncertainty about The Omicron variant, experts and advocates say.
In a November report, COVID GAP saw that G7 countries, informal groups of the world’s most advanced economies, and European Union countries are projected to have more than 834 million high-quality vaccine doses by the end of the year, even accounting. for promoting 20% of the population and providing outreach to children.
Meanwhile, given the projected shipments, it was estimated that the world would need about 650 million doses to reach the 40 percent target by the end of the year.
The COVID Gap report was published in South Africa a day before the Omicron variant was first identified. Its rapid spread around the world has prompted governments to push for a faster and more widespread promotional campaign, with initial research showing that some owners, especially Pfizer and Moderna mRNA vaccines, appear to provide high protection against Omicron infection after administering a booster.
“We are now producing more than a billion doses of vaccines a month, but reaching very low-income and low-income countries is very slow,” said Dr. Krishna Udayakumar, founding director. The Duke Global Health Innovation Center told Al Jazeera. “So we have not solved the supply challenge in any way, but we are closer than ever to solving it.”
But he added that supply is only part of the problem.
“Looking ahead to 2022, I think the whole game will be vaccinated. So how do we get from airports to weapons? How do we convert vaccines to vaccines?” He said.
“I think we have limited resources and we are prepared for that…
‘We’re not there yet’
Vaccine collection rich countries stop the development and approval of promising vaccines and other production interruptions, especially one month stop In India’s Serum Institute exports, a major COVAX supplier pushed the initiative to halve the goal of delivering two billion doses by 2021, of which 1.3 billion had to go to the 92 countries most in need.
As of December 17, COVAX has delivered 610 million vaccines out of 800 million.
Although the WHO has encouraged donations to move through COVAX, several countries have donated directly and indirectly to countries. asking questions whether geopolitics has taken precedence over need.
China, which has been opaque in vaccine shipments, has generally favored donations and sales to Latin American and Asian countries. Beijing Bridge, Which tracks Chinese donations. Countries on the African continent have received 113 million of China’s 1.2 billion vaccines distributed internationally, of which 50 million have gone to Morocco.
Benjamin Schreiber, who leads UNICEF, which organizes international transportation for COVAX to prepare and deliver vaccines in the country, said he expects the supply of vaccines to low-income countries to be limited for at least the first months of 2022. countries will be essential.
“People say the offer is fixed. And now demand is an issue. But it is not. We’re not there yet, “he told Al Jazeera.
“We still have countries that vaccinate only a small part of their health care facilities … We are still a long way from vaccinating every person who needs a vaccine.”
Beyond the shortage of supplies, Schreiber said the distribution in low-income countries – which is hampered by poor health systems, lack of equipment, political constraints and social inequality – remains a challenge.
In the midst of the year-end rise in COVAX shipments, Schreiber said many low-income countries are struggling to find a cold to keep vaccines, and stressed the need to increase support by 2022.
As of Nov. 10, COVID GAP data showed that 92 countries in greatest need in the world managed about 75 percent of their total supply, a phenomenon attributed to a mix of factors, including low warning before shipments, receiving vaccines donated at nearby donations. until the expiration date, the difficulty of vaccinating in areas of high need and the hesitation among some populations.
Health officials have also warned next syringe shortage.
Schreiber said that UNICEF has identified about 20 countries that require a “hands-on” approach next year, adding that the main funding needs are money to buy the “cold chain” equipment needed to store and transport many vaccines, as well as training funds. and hiring staff, developing infrastructure, and supporting public information campaigns.
In October, the World Health Organization said should $ 23.4 billion by next September in a wide-ranging campaign to tackle vaccine inequality, support testing and treatment, and achieve a 43 percent vaccination rate in countries in greatest need.
That money should also be used to address vaccination concerns in low-income countries, similar to what has been seen in the U.S. and Europe, said Dr. William Moss, executive director of the Johns Hopkins Bloomberg School Internal Vaccine Access Center.
“Certainly there is misinformation in childhood in sub-Saharan Africa that we have never seen with childhood vaccines, I would say,” I would say, “Al Jazeera said.
However, he noted that raising funds to support health infrastructure and public information campaigns has historically led to special challenges.
“That’s a long-standing problem in these settings, where products are very easy to deliver, be it bed nets or vaccine doses. You can count them. You can tell we donated them all,” he told Al Jazeera.
“It’s much harder to make a donation to invest in the primary health care system, the vaccine chain, or the transportation industry. All of them are less attractive to outside lenders and financiers, but they are very important. ”
‘Inequity 2.0’
There is an Omicron variant on issues related to the supply and delivery of vaccines, a better understanding of which could be a “turning point” in driving global vaccine equity, said Dr. Udayakumar of Duke.
If vaccines need to be redesigned, “then we will return to a very limited supply scenario,” he said. Meanwhile, the growing need for promoters comes with its own complications.
“We are seeing more doses of strength per day in high-income countries than in the first doses in low-income countries,” he said.
In a recent interview with the Associated Press, Seth Berkley Gavi, director of the vaccine alliance, said that the growth of people receiving boosters in rich countries and the shortening of recommended booster times, “means we can see that in the future. These vaccines are not available to developing countries. ”
“We’re also seeing donors not giving up their doses as quickly as they would like, because of the uncertainty of where we are,” he said.
Concerns have renewed calls from rights groups for vaccine manufacturers to share broader technology.
Human Rights Watch recently highlighted A list that identifies more than 100 companies in Africa, Asia and Latin America, according to health experts, has the ability to make mRNA vaccines produced by Pfizer and Moderna, and has shown promising results – when boosters are administered – to protect against Omicron infection. These vaccines are only manufactured in Europe and North America.
Gostin of Georgetown said that the promotion of global manufacturing outside the current centers should be given priority next year.
“Low-income countries always know that donations come too late,” he said. “And they are disgusted with charitable donations hand in hand begging. They want the power to vaccinate themselves. ”
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