Omicron Brings Inequality for COVID-19 Vaccine

The emergence of a new variant of the omicron and the world’s desperate and probably futile attempts to keep it in check are reminders of what scientists have been warning for months: the coronavirus will flourish until huge parts of the world are vaccinated.

The accumulation of limited COVID-19 vaccinations by rich countries – the creation of virtual vaccine deserts in many of the poorer – doesn’t just mean a risk to those parts of the world that are in short supply; it threatens the whole world.

This is because the more a disease spreads among unvaccinated populations, the more opportunities it has to mutate and potentially become more dangerous, prolonging the pandemic for everyone.

“The virus is a ruthless opportunist, and the injustice that characterized the global response is now evident,” said Dr. Richard Hatchett, CEO of CEPI, one of the groups behind the UN-backed COVAX shot exchange initiative.

Perhaps nowhere is inequality more pronounced than in Africa, where less than 7% of the population is vaccinated. South African scientists warned the World Health Organization about a new version of the omicron last week, although it may never be clear where it first came from. Researchers are now rushing to determine if it is more infectious or able to avoid the current vaccines.

COVAX should have avoided this inequality, but instead the initiative has extremely few shots and has already abandoned its original 2 billion dose target.

Even to meet its reduced target of 1.4 billion doses by the end of 2021, it must ship more than 25 million doses every day. Instead, it has averaged just over 4 million a day since early October and has dropped below 1 million on some days, according to an analysis of the Associated Press shipments.

Deliveries have increased in recent days, but far from the required amount.

In richer countries, meanwhile, there is often an oversupply of vaccinations, and many now offer boosters – which the WHO disapproves of because each booster dose is essentially a dose that is inappropriate for someone who didn’t even get their first shot. Despite a call from the UN health agency for countries to declare a moratorium on revaccinations by the end of the year, more than 60 countries are currently using them.

“It highlights the ongoing and fundamental risks to all of tackling inequalities that still persist around the world in tackling disease and ill health,” said Dr. Osman Dar, One Health Project Director at Chatham House. … tank.

Anna Marriott, Oxfam’s health policy manager, said COVAX was curtailed from the start after wealthy countries pushed it into the background.

“The COVAX team can deliver as quickly as possible, but they cannot deliver vaccines that they don’t have,” Marriott said.

Since mid-November, the International Monetary Fund estimates that only 13% of the vaccines contracted for COVAX and 12% of the pledged donations have been delivered. About a third of the vaccines released by COVAX have been donated, according to the vaccine alliance known as Gavi, and the initiative is now partly a clearinghouse for those donated doses – the very situation it was created to avoid.

Last week, COVAX sent out a press release praising the EU’s pledge to send 100 million vaccines to Africa by the end of the year, but only 1/20 of that amount was actually on airplanes.

When asked about the logistical challenges of distributing the remaining 94 million doses in just six weeks, Aurelia Nguyen, COVAX’s managing director, said that “steps have been taken to transfer a huge number of doses from now to the end of the year”.

In a statement, she said the challenge was to ensure that “there are suitable conditions for dosing in the field”.

In minutes released ahead of the leaders’ meeting this week, Gavi expressed concern that the notion of rich countries dumping older or smaller vaccines into poor countries could undermine the entire project. On Monday, in a joint statement with WHO and the African Union, among other things, he warned that “most donations to date have been spontaneous, with minimal notice and short shelf life.”

The rage about dumping the dose is already real. Tens of thousands of obsolete doses have been destroyed in Malawi and South Sudan.

But, according to some experts, the problem is not only with getting vaccines to poorer countries. COVAX “cannot get vaccines from the runway (airport) into the hands of the people,” said Dr. Angela Wahweia, senior director of health equity and rights at CARE.

The Congo authorities, for example, returned an entire shipment of COVAX this summer when they realized they would not be able to administer doses until they expired.

In a COVAX risk management report, Gavi warned that “poor uptake” of vaccines by developing countries could result in “wasted” doses. One of the challenges is logistics – just getting the dose in the right country at the right time. Equally important is the ability of often underfunded national health systems to distribute injections where they are needed most, along with syringes and other necessary equipment. The third problem is convincing the sometimes hesitant people to get the vaccines.

World Health Organization Director-General Tedros Adhanom Ghebreyesus, however, disputes the distribution issue, saying the only obstacle to immunization in poor countries is supply.

Most of the doses of COVAX so far circulated have been the AstraZeneca vaccine, a vaccine that has not yet been approved in the US and whose failed rollout in Europe helped rekindle anti-vaccine sentiment when the vaccine was associated with rare blood clots. The vaccines, which are mainly used in the US and most of Europe – from Pfizer-BioNTech and Moderna – were only available in small quantities through COVAX.

The US, which has blocked foreign sales of vaccines and exports of key ingredients for months, has donated a total of 275 million doses, more than any other country, but the vast majority of the Biden administration’s 1.1 billion pledges have a deadline of September 2022. of the year. Union, which has generally authorized the sale of vaccines produced in this block anywhere in the world, has actually delivered about a third of its 500 million promised doses.

Efforts to ramp up global production outside of a select group of manufacturers have stalled, which many activists and academics have accused of discouraging pharmaceutical companies from ditching their intellectual property rights to high-yield vaccines.

COVAX’s failure to deliver even a tiny bit of vaccine to enough vaccines has led some to question whether the effort to fight for vaccines is worth the effort, given that the pandemic still hasn’t devastated Africa as many initially feared, and has often been the worst in wealthier countries. … Few public health officials would approve of this strategy.

“I think Africa can really shame the world by stopping asking for vaccines,” said Christian Happi, a virologist from Nigeria who served on CEPI’s scientific advisory board. “The vaccines have not yet arrived, and in any case, it may turn out that we do not need them as much as the West.”

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