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COVAX, and the race to inoculate the world’s poorest citizens

A ratio of 90 to 10 best describes the state of global health: 90% of the worlds pharmaceutical products serve 10% of the world’s population – such a shocking statistic is shown to be true now more than ever. 

Wealthier countries like the US and much of Western Europe are swiftly progressing with their vaccine rollout – the UK has already provided 14 million people with their first inoculation, and 530,000 with their second. By comparison, only 25 doses have been given to one of the lowest income countries. The difference is astronomical – millions, and just double digits. The US, Australia, Canada and most Western European countries are some of the few who have begun their COVID vaccine rollout.   

It is no secret the world is unequal, especially when over wealth and health inequality. However in the face of a global pandemic this is unsustainable. Vaccines may be the solution to ending the pandemic, but only if they are used on a global scale. 

Advanced countries can afford to pre-order large bulks of vaccine doses, whilst emerging developing countries, like India, were able to provide doses to their population by being manufacturing centres for the vaccine. Countries like Brazil have negotiated deals to provide vaccines through hosting clinical trials.

Low-income developing countries do not have the money, manufacturing or clinical trial-hosting opportunities to negotiate vaccine supply. In a contagious global pandemic, herd immunity needs to be achieved globally, which will be impossible if one half of the world is left behind in the race to normality. 

During the World Health Organisation (WHO) executive board meeting, Director-General Dr Tedros Adhanum emphasised the clear inequality present, with low risk, healthy individuals in rich countries being vaccinated before the vulnerable and healthcare workers in poorer countries, describing the world as being near a “catastrophic moral failure.” The price of this failure, Dr Tedros claimed, “will be paid with lives and livelihoods in the world’s poorest countries”.

In an effort to prevent this “moral failure”, the WHO and Gavi, the Vaccine Alliance, launched COVAX last year to ensure that poorer countries will not be left behind in the race to global immunity. 

COVAX will raise money through donations from wealthier countries, which will be pooled together to buy vaccines to the poorest countries. 172 countries have joined this vaccine fund, of which 92 are the world’s poorest, and will be prioritised in the vaccines being handed out. 

COVAX has already raised $2 billion to purchase the vaccines, with the target to raise a further $6 bn in delivering more than 1.8 billion vaccinations to the planet’s poorest citizens by 2021.

Yet, the scheme is far from foolproof. COVAX relies on donations and state aid to fund its operations, while richer countries in the West had pre-ordered vaccinations far in advance – their wealth pushing them to the front of the queue in the global rush to procure vaccinations.

They also donated generously to COVAX whilst negotiating personal vaccine deals with manufactures, and as demand is much higher than supply, their donations were essentially useless in the face of the race. 

Furthermore, COVAX is governed by the WHO, thus the vaccines provided by COVAX need to be approved by the body first. By contrast, countries approve the vaccines on their accord, speeding up the whole process. This leads to further delays in negotiations with manufactures, and reduces invaluable resources – currently, the Pfizer/BioNTech vaccine is the only such type to have been approved by the WHO.

We are once again up against a global disease outbreak and it seems history is repeating itself. The AIDS epidemic tore its way through Africa, killing many more people on the continent than in the US during the 1990s. While antiretroviral treatment was developed in the US, six years had passed before it was made available in African countries; countless lives that could have been saved ultimately weren’t

History has proven that a country’s wealth directly equates to its success in fighting disease. As in the race to extinguish the coronavirus pandemic, the world’s poorest countries will always be last, and so will undoubtedly suffer more.

Image: US Secretary of Defence via Flickr