The coronavirus is a global pandemic for which the phrase “we are all in it together” is appropriate. But, while the development of Covid-19 vaccines is a global public good, rich countries’ vaccine nationalism leaves poor countries out in the cold. Sadly, Nigeria, nay Africa, is too underdeveloped to compete in this game. Thus, while the rich countries are massively inoculating their citizens, Nigeria and the rest of Africa are on the sidelines, waiting for crumbs from the rich world’s table! It wasn’t supposed to be like this!
First, the story of the vaccines. As the Covid-19 pandemic gripped the world last year, it was clear that the development of vaccines was critical to tackling it. Few were confident that an effective vaccine could be produced and licensed speedily. After all, it took several years, even decades, before vaccines were licensed for viruses such as measles and polio.
Yet, in November last year, within a year of the outbreak of the pandemic, Pfizer and BioNTech, two pharmaceutical companies, announced they’ve produced a Covid-19 vaccine with more than 90% effectiveness. In quick succession, other pharmaceutical companies, or partnerships, such as Oxford-AstraZeneca, GSK-Sanofi, Moderna, Novavax and Johnson&Johnson, announced successful trials of their own vaccines.
As these vaccines were licensed, hopes began to rise that both rich and poor countries alike would be able to vaccinate a sizeable proportion of their population, starting with the most vulnerable ones and key workers, such as medical staff and care-home workers, over the course of this year. Although there were concerns about production and supplies, few expected that vaccine nationalism, where a country secures and hoards more vaccines than it needs, would be a common practice. Yet, that’s what has happened.
While the rich countries are inoculating millions of their citizens, 9 out of 10 people in poor countries are set to miss out on Covid-19 vaccination this year
Despite earlier promises to ensure that developing countries had equitable access to supplies, the world’s richest nations pre-ordered billions of doses of vaccines – enough to protect some populations several times over. For instance, according to an analysis by the World Economic Forum, Britain and the US procured enough vaccines to inoculate their citizens four times over, while Canada procured enough to inoculate its citizens six times over. As one analyst put it, “The high-income countries have gotten to the front of the line and cleared the shelves.”
Indeed, the rich nations were fighting each other. Vaccine nationalism almost became vaccine wars when the European Union imposed a ban on the export of vaccines to Northern Ireland to stop them getting into the UK. This would undermine the Northern Ireland Protocol of the EU-UK trade deal, designed to prevent a hard border between Northern Ireland and the Republic of Ireland. The EU immediately reversed the decision following widespread outcries, but the frayed nerves were palpable.
From a rationalist perspective, the fact that rich countries hedged their bets by reserving more than enough doses is not surprising. According to Mile’s Law, “where you stand depends on where you sit”, meaning, for instance, that policymakers would pursue policies that benefit their nations rather than the world! Which was why vaccine nationalism trumped interdependence and global cooperation. But the upshot is that, while the rich countries are inoculating millions of their citizens, 9 out of 10 people in poor countries are set to miss out on Covid-19 vaccination this year, according to one analysis.
Yet, as Dr Helen Rees, a World Health Organisation expert in Immunization, Vaccines and Biologicals, told CNN, cornering most of the Covid-19 vaccines and leaving less for developing countries “is not only inequitable, but foolish in terms of stopping the pandemic.” This is because, as the mantra goes, “as long as one nation is at risk, all nations are at risk”, given that the virus and its variant easily spread across nations. Yet, that has not stopped the rich countries from spending billions of dollars in deals with Covid-19 vaccine manufacturers in pre-purchase agreements that effectively locked in most of their supplies.
Last year, Gavi Alliance, the global health partnership, launched the COVID-19 Vaccines Advance Market Commitment (COVAX AMC) to help low-and middle-income countries to negotiate and secure access to donor-funded doses of COVID-19 vaccines. But since the COVAX Facility is largely funded through Official Development Assistance (ODA), its success is partly dependent on support from donors. Experience shows that when rich countries promise financial assistance to poor countries, few of them keep that promise. Furthermore, COVAX faces another challenge: it has to compete with the rich countries, which are buying up the vaccines and, thus, raising their prices.
All of which brings us back to Africa and Nigeria, how are they coping? First, local vaccine manufacturing is critical to overcoming the production and supply challenges in Africa. Yet, while the COVID-19 vaccine manufacturers have sites in many countries, none of the vaccines are produced in Africa, although some may have been packaged there. Second, although the African Union has secured about 270m doses for the continent, it lacks the bargaining clout and resources to enter into significant pre-purchase agreements with Covid-19 vaccine manufacturers on behalf of the continent. This idea that Africa is so poor and so dysfunctional that it cannot pull its weight internationally is deeply embarrassing.
That said, the African Union can only be as strong as its individual member countries. And, in that regard, South Africa is the only country that, to some extent, has a developed-country level of sophistication in the continent. Of course, South Africa also has the highest rates of COVID-19 infection and mortality in Africa, with concerns about a South-African variant fuelling case surges in the country and may enter into some western countries. Yet, it is also true that South Africa is, according to Gavi, probably the only country in Africa with the readiness and preparedness for vaccine roll-out, in terms of planning and coordination, expedited regulatory approval, vaccine procurement and funding, prioritisation, targeting and delivering strategies, as well as communication and community engagement.
Like South Africa, Nigeria is part of the GAVI COVAX Facility. But its state of preparedness inevitably poses a challenge. While the vaccines are expected to be approved speedily by the National Agency for Food and Drug Administration and Control (NAFDAC), the domestic challenge will be with Nigeria’s preparedness and readiness to roll out the vaccines successfully. Furthermore, dealing with concerns around vaccine hesitation and resistance, which, shamefully, is led by the governor of Kogi State, Yahaya Bello, who raised doubts about the safety of the Covid-19 vaccines.
But the immediate concern is about getting vaccines. According to a report in the Punch newspaper, state governments are not making plans to procure COVID-19 vaccines, they say they are waiting for allocations from the Federal Government. Yet, there are no vaccines in the country.
Unlike South Africa, which received its first vaccines from the COVAX Facility last year, Nigeria will not receive its vaccines until the end of the first quarter of this year or the beginning of the second quarter. Furthermore, in January, the Federal Government was still blaming “politics and logistics” for delay in the arrival of 100,000 doses of free Pfizer-BioNTech vaccines. It said it is now expecting them this month. Well, fingers crossed!
Then, the Federal Government reportedly said it needed N400bn to procure coronavirus vaccines for the country, but Peter Obi, former governor of Anambra State, said he could get them for N150bn! The issue of vaccine procurement and funding, including the costing and budgeting for the roll-out, calls for total transparency and accountability, because any project that requires spending billions is open to waste and even corruption.
That apart, the challenge is whether Nigeria can get enough vaccines for a first dose, let alone a second dose, for its large population. Here, ironically, is an economic nationalist than can’t play the vaccine nationalism game!
