Across the globe, countries are locked in both the race against time and against one another as they battle over vaccine supply.
There is an international race to vaccinate as many people as possible and finally overcome the coronavirus pandemic. But vaccines are not being distributed equitably and at the current pace, there may not be enough shots to cover the world’s population until 2024.
While Canada has purchased enough shots to vaccinate their population 5 times over, low-income nations such as Nigeria, Cameroun and Ghana are struggling to get even just a small share of the supply. These nations face a lack of supplies but also huge logistical challenges with distribution.
So, what can be done to make the covid-19 vaccine roll-out more equitable?
After months of lock-down, fear and spiraling death-tolls, the world began to see the light at the end of the tunnel when pharmaceutical firms announced the success of their vaccine candidates against the covid-19 in November 2020. This paved the way for the first regulator approved covid-19 vaccinations in December. Although more vaccines have been approved since, the reality is that the shots are not being rolled out everywhere at the same pace.
Thomas Bollyky of the Council of Foreign Relations stated, “In low income nations, the vaccine roll-out has been slow. Among the dozes distributed so far, 75% has been used in just 10 nations. There are a few low/medium income countries among those, most notably, India and Nigeria, but by and large we are talking about wealthy nations”.
On the other side of the spectrum, there are 80 countries in the world, representing 1.5 billion people who are yet to administer a single doze. It thus goes to say that, the early vaccine roll-out has been characterized by gross inequity.
When looking at the vaccine roll-out so far, it is clear that many countries in Africa, South America and Asia have vaccinated only a tiny fraction of their populations. In comparison, Israel, the UK and the United States are a long way ahead in this race.
The pertinent question thus becomes; why is it so hard to see vaccinations picking up in these countries?
Thomas indicated that it was primarily an issue of supply. “Right now, we have too little of it, doses are scarce and most of that supply has been purchased in advance by a handful of nations which are now using those doses,” he added.
The US and the UK, which have had higher vaccination rates through the early months of 2021, were quick to sign deals with pharmaceutical firms even before they knew whether the scientific work was going to be successful. These 2 countries were the first to reach vaccine supply agreements back in May 2020. Japan followed suit in July 2020 while most of Europe, Canada and a few other countries struck their first deals in August. These advance agreements secured their place in line to be among the first recipients of COVID-19 vaccines. As a result, high income countries had rights to 4.6 billion doses of covid-19 vaccines by the first quarter of 2021. On the other hand, lower/middle income countries have secured 614 million doses, while low income countries are due to receive just 670 million shots.
Source: Global Health Innovation Center, March 2021.
To overcome supply issues, middle-income nations such as India and Brazil used their manufacturing capacities to negotiate lodge agreements with the pharmaceutical firms. Others such as Peru, leveraged their infrastructure to host clinical trials to negotiate purchase deals.
But low income countries are at a disadvantage here too, as they generally lack large pharmaceutical manufacturing capacity and testing infrastructure. They are therefore more reliant on multilateral agreements. The African Union (a group of more than 50 nations), has collectively bought 670 million vaccines on behalf of its members; and COVAX (a coalition of international organizations including the WHO and UNICEF) has secured another 600 million doses for the continent.
In Nigeria, the current pace of vaccinations means that it would be some time before the population is protected against the virus. Dr. Faisal Shuaib of the National Primary Health Care Development Agency stated, “Our target is to vaccinate 100% of eligible population. We plan that within the first year, we should be able to vaccinate 70% of that population and then by the second year, we should be able to vaccinate the remaining 30% of the population. So, overall we are looking at being able to vaccinate 112 million Nigerians”. He also stated that all the preparations would be predicated on the availability of vaccines, thus pacing it along the availability of the vaccines.
He went further to state that “It could be observed that low and middle income countries have had the challenge of obtaining vaccines because of the phenomenon of ‘vaccine nationalism’. Most of the developed countries have mopped up a lot of the vaccines and this is where the COVAX facilities has been very helpful as they have been able to make some vaccines available to low and middle income countries”.
But simply being able to purchase vaccines is not enough. Local networks to distribute covid-19 shots also need to be improved. Some of the most common challenges include: a lack of trained medical personnel to administer shots, insufficient facilities for disposal of bio-hazard waste and the need for some vaccines to be stored at incredibly low temperatures.
Suerie Moon, an expert at the graduate Institute, Geneva stated, “There are important differences which is the ability to get super cold freezers in a poor country is going to be far less as they cost money and there are limited supply”. “I do think that the logistical burden and the cost burden are also significant,” She added.
And there is the issue of vaccination hesitancy and the growing tide of misinformation. The challenges of vaccination hesitancy will be challenges for all countries. It’s not prominent yet because we are still in the early phases where the people who want the vaccines cannot get it. We however know that vaccine hesitancy is not fixed, it is not something that cannot be changed. It could be observed that the levels of willingness to get vaccinated go up and down and it is an encouraging thing to recognize because it means that public health authorities can take action to try to build that trust.
These challenges will be difficult to overcome especially if there is little international cooperation; but it is not an impossible task if world leaders have the will to end the global health emergency as soon as possible. If we are going to eradicate covid-19 as one global community, then it is important that every community has access to these vaccines. Since the virus knows no borders, even if developed economies eradicate it, if low and middle income economies do not have access to the vaccines, then the virus would continue its trajectory regardless. After the first reports of infections emerged in China in late 2019, European countries began imposing strict lock-downs and the US was closing its borders in March 2020.
With the emergence of new variants, some of which are more infectious or evade immunity, protecting populations against mutated forms of the virus would be crucial in moving on from the pandemic. This is also true from an economic perspective, the IMF had initially forecasted 3.4% rise in global output for 2020. But shortly after the pandemic hit early in the year, the IMF cut its projection to a contraction of 3%, predicting that it would be the worst economic shock since the 1930’s. In more recent calculations, the IMF estimated that global economic activities in fact fell by 3.3% over the year with the chances of an immediate recovery in 2021, threatened by renewed waves of infections and virus mutations. Vaccinations will be critical in enabling economic activity to pick up after this severe global recession.
Source: International Monetary Fund.
The assumption is that for advanced economies and for some emerging markets, they would receive wide spread vaccinations by third quarter (Q3) of 2021; while the rest of the world would be by the end of 2022. Thus as long as we do not see any virus variants that evade the effectiveness of vaccines, we hope that there would be a vaccine powered recovery in so many countries especially in the second half of this year.
The itching question thus becomes; what is the economic importance of vaccinating the whole world?
If we get a much faster vaccination, the cumulative effect would be $9 trillion in 4-5 years. Out of that $9 trillion, 40% would be beneficial to advanced economies while the rest would be spread across emerging and developing economies. Virus mutations have been observed, and as long as many parts of the world remain unvaccinated, we are going to see many more of these mutations and that is a big concern for the global economy. If vaccinations continue on this ‘slow pace’ trend or if new virus mutations (variants) evade the vaccines, that would subsequently have a very sharp downgrade to the outlook.
Helping low/middle income nations in their vaccination efforts is a critical test for international corporations especially among wealthier countries. If countries are unable in the midst of this global crisis to share a vaccine that is in the interest of all nations, what are the prospects of these countries cooperating on preventing future pandemics?, what are chances of cooperating on climate change?, on nuclear non-proliferation? Or anything that requires nations of the world to trust one another and work together to make the world much safer for everyone. If we cannot do it in this crisis, then we have little hope of doing it in the many other areas where we need to see that cooperation.
