Vaccine Nationalism Reigns Supreme

Global Equitable Access to COVID-19 Vaccine is in Big Trouble Despite Promises of Solidarity
Boxes containing the Pfizer-BioNTech COVID-19 vaccine are prepared to be shipped at the Pfizer Global Supply Kalamazoo manufacturing plant on December 13, 2020 in Portage, Michigan
A person wearing a protective mask sits waiting at a rapid-antigen methodology Covid-19 test site set up in Ahmedabad, India

At this historic moment in time, the COVID-19 global pandemic has already caused the loss of hundreds of thousands of lives and disrupted the lives of billions more. Introduction of a vaccine is essential to reducing the tragic loss of life and helping to get the pandemic under control as well as prevent the loss of US$ 375 billion to the global economy every month.
 
Global equitable access to a vaccine, particularly protecting health care workers and those most-at-risk, is the only way to mitigate the public health and economic impact of the pandemic. But at a time where nationalism is gaining foot, and global cooperation is eroding, there needs to be a way we ensure rich countries don't stockpile the shots, leaving poor countries out in the cold. It's a goal that the COVID-19 Vaccine Global Access (COVAX), an international alliance established to ensure that all countries have equal access to the vaccine, believes it can achieve if governments are willing to work together. But despite commitments and talk of solidarity, it appears that vaccine nationalism, in which countries prioritise their domestic needs at the expense of others, reigns supreme.
 
AN INTERNATIONAL EFFORT
 
More than 180 countries have signed up to COVAX, which is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations ( CEPI) and The World Health Organisation (WHO), representing nearly 90% of the global population.
 
"By pooling financial and scientific resources, these participating economies will be able to insure themselves against the failure of any individual vaccine candidate and secure successful vaccines in a cost-effective, targeted way," the WHO explained in a news release.
 
The goal of COVAX is to have 2 billion doses to distribute by the end of 2021, which should be enough to help countries vaccinate 20% of their populations and end the acute phase of the pandemic. Funding needed to meet this initial target is estimated at $4.9 billion in addition to $2.1 billion already raised. So far, Britain and European Union countries are the main donors to COVAX. The European Union has announced this month it will contribute an additional €500 million in grant funding to support the COVAX Facility to secure access to the future COVID-19 vaccine in low and middle-income countries. The funds will complement the €400 million in guarantees the EU already committed for COVAX. The facility is also receiving funds from private donors, mainly the Bill and Melinda Gates Foundation.
 
WHO Director-General Tedros Adhanom Ghebreyesus stated that as the virus spreads in Europe and other parts of the world, "equitably sharing of vaccines is the fastest way to safeguard high-risk communities, stabilise health systems and drive a truly global economic recovery."
 
THE LIMITS OF SOLIDARITY
 
While participation in COVAX can be considered as an insurance plan even for the richest countries, the U.S. and Russia have both opted out of the project—a decision that, in the case of Washington, was prompted by the participation of the World Health Organization, which the U.S. withdrew from this year. China had also initially missed the deadline for joining the initiative.
 
This is far from being COVAX's only challenge. There is also the paradox that countries with greater resources who have committed to COVAX have simultaneously negotiated their own bilateral commitments with manufacturers, thus rendering their contributions as merely symbolic while also undermining the initiative's goal of equal distribution.
 
Through these direct deals with vaccine developers for advance purchases of anticipated COVID-19 vaccines, high-income countries have bought up the vast majority of the world's vaccine supply, with many countries claiming enough to inoculate their population several times over. Data collected by the People's Vaccine Alliance shows that rich nations representing just 14% of the world's population have bought up 53% of all the most promising vaccines so far, with Canada topping the chart with enough doses to vaccinate each Canadian five times.  The group said that so far all of Moderna's vaccine doses and 96% of Pfizer/BioNTech's have been bought up by rich countries.
 
The group - which includes organisations such as Oxfam and Amnesty International say that COVAX signatories including Canada, the United Kingdom and the European Union, are undermining the pact through these side deals for large vaccine shipments. As things stand - 67 poorer countries will be able to vaccinate only one in 10 people against the virus next year, with five of those - Kenya, Myanmar, Nigeria, Pakistan and Ukraine - reporting 1.5 million coronavirus cases between them.
 
WHO director-general has repeatedly warned against so-called "vaccine nationalism", saying "no-one is safe until everyone is safe". But senior officials at the organisation have acknowledged privately that the COVAX facility is flawed, despite publicly lauding its success. "The whole call for global solidarity has mostly been lost," said Dr. Katherine O'Brien, WHO's vaccines chief, during a recent internal discussion, a recording of which was obtained by the AP.
 
COVAX has also banked on cheaper and easier to transport vaccines such as the Oxford University-AstraZeneca vaccine, rather than vaccines from frontrunners Pfizer/BioNTech and Moderna that use more expensive new mRNA technology, further impeding their ability to fairly allocate the vaccine through the initiative. The People's Vaccine Alliance said that while the Oxford/AstraZeneca had "in welcome contrast" pledged to provide 64% of their doses to people in developing nations, that supply would likely still only reach 18% of the world's population next year at most.
 
Internal documents leaked to Reuters this week paint an even bleaker picture for the equitable distribution of the vaccine. Gavi says the COVAX programme is struggling from a lack of funds, supply risks and complex contractual arrangements, which could make it impossible to achieve its goals. "The risk of a failure to establish a successful COVAX facility is very high," says an internal report to the board of Gavi.  The failure of the facility could leave some people without access to vaccines until 2024, one of the documents says.