Global public health, not profits or nationalism, must be center stage in the fight against COVID-19

Global public health, not profits or nationalism, must be center stage in the fight against COVID-19

Pam Bailey
Editor, ImpACT International for Human Rights Policies

As new, more infectious variants of COVID-19 surge around the world, massive hopes are riding on the waves of vaccines now being distributed or under development. But while each government is looking carefully at how to stage vaccination on the way to herd immunity, there is much less public dialogue about the countries that are less able to afford and properly distribute, store and administer the life-saving drugs. And if there is anything we should have learned from the COVID-19 pandemic, we can no longer operate as if we live on islands. Viruses spread regardless of income; none of us will be safe until all of us are safe.

As ImpACT International for Human Rights Policies documents in its just-published review, 6.4 billion doses of vaccines have already been purchased, and another 3.2 billion have been reserved or are under negotiation—all primarily by governments of high-income countries. In fact, The New York Times has calculated that with these purchases, the European Union could inoculate all of its residents twice. The governments of Great Britain and the United States could vaccinate their populations four times and Canada six times. In contrast, says a new coalition called the People’s Vaccine Alliance, nearly 70 poor countries will only be able to vaccinate one in 10 of their residents at best during 2021.

Even if Pfizer and Moderna finally step up to the plate and commit to providing doses to low-income countries for free or at affordable prices, their requirements for ultra-cold storage make them impractical

However, the unfolding disparity in access is not just an issue of vaccine supply—or even of vaccines alone. There is an urgent need for continued attention to the equitable availability and accessibility of tests. COVID-19 infections have surged since new variants of the virus—between 10% and 60% more transmissible—were detected, first in the UK and now in more than 30 countries. Thus, the biggest factor that could determine how many more die from the virus is likely still a combination of mask wearing, social distancing—and expanded testing. While WHO Director General Tedros Adhanom Ghebreyesus said in September that Abbott ABT.N and SD Biosensor are providing 120 rapid COVID-19 tests to low- and middle-income countries, shortages remain. More are needed. For example, health authorities in the Gaza Strip announced on 6 December that the territory’s only laboratory had stopped conducting tests because it had run out of kits. Relief came on 17 December when the UAE sent in a supply of tests, but they continue to be given only a limited basis. People who are exposed, or have symptoms but are not elderly, are merely being told to self-quarantine—despite the fact that younger individuals account for many of the new infections.

Continued aggressive testing also is critical in light of the fact that even if Pfizer and Moderna finally step up to the plate and commit to providing a substantial number of their doses to low-income countries for free or at affordable prices, their requirements for ultra-cold storage make them impractical for largely rural nations. Fortunately, AstraZeneca—the latest entrant, now being reviewed by various governments (and approved in the U.K.)—has pledged two-thirds of its doses to lower-income countries at a cost of just $4 a dose. However, AstraZeneca’s production capacity isn’t expected to be sufficient to satisfy the yawning need. It could supply up to 38% of the global population if only one dose was needed; however, that is not the case.

It’s critical that businesses and governments share the same priority: maximum global public health—not maximum profits or nationalism

Some governments are considering giving only one vaccine dose to make supplies go further, but tests were not conducted on such a pared-down regimen and a perception of cutting corners could exacerbate a pervasive lack of trust among some vulnerable populations. For example, while about 80% of Africans overall said in a survey that they were willing to take a COVID-19 vaccine, acceptance was only 59% in the Democratic Republic of the Congo. Trust is even lower among American Blacks: Although 71%of Black Americans know someone who has been hospitalized or died of covid-19, a recent survey by Pew Research Center found that only 42% said they would get the vaccine. This points to another responsibility that must be shared by both business and governments: education and the enlistment of trusted messengers (ranging from entertainers to community leaders) to be the first to be vaccinated.

Before cutting corners so that everyone in the wealthier countries can be vaccinated quickly, priority should be given to rolling out the vaccines to the highest-risk individuals everywhere. As Bruce Aylward, senior adviser to the WHO’s director-general, has commented: “The worst possible outcome is offering vaccines to a whole country’s population before we’re able to offer it to the highest-risk people everywhere else.”

It’s critical that businesses and governments share the same priority: maximum global public health—not maximum profits or nationalism.

 

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