‘Moral failure’, concentration of vaccines in rich countries could delay end of pandemic – 22/05/2021 – World

In December of last year, a Briton, then aged 90, made history by receiving the dose that ushered in the vaccination against Covid-19 around the world. Six months later, more than 1.6 billion doses have been applied. Most, however, in the arms of people in rich countries.

With 15% of the world population, these countries concentrate almost half of the available vaccines. While a third of its inhabitants have received at least one dose, in poor countries the proportion is only 0.2%.

As with access to respirators and masks throughout the pandemic, the countries that had the most resources and power in global geopolitics came first and reserved most of the vaccines available to them. The first purchases were made by the United States and the United Kingdom in May 2020, while the vaccines were still in development.

“This creates a market reserve. The countries are arguing who will leave before the economic crisis, and those who position themselves strategically have taken the head of the vaccine line, which is fundamental for this recovery”, explains the medical officer of health Ulysse Panisset , from the Faculty of Medicine at UFMG (Federal University of Minas Gerais), specialist in international cooperation in health.

Therefore, the United States, for example, has enough to immunize three times its population, and Canada has purchased 10 doses per capita. Meanwhile, countries like Guatemala, Honduras and Mali haven’t even vaccinated 1% of their residents, and six African countries haven’t even started their campaigns.

The scenario is what WHO Director-General Tedros Adhanom defined last week as “vaccine apartheid”. Adhanom, who also called the situation a “catastrophic moral failure”, called on countries to donate part of their surplus to the Covax Facility, a global consortium created to distribute vaccines to low and middle income countries .

And not just out of altruism. Scientists warn that the dose reserve may backfire on the wealthy.

If the virus continues to circulate uncontrollably, it can undergo mutations that result in more dangerous variants, such as B.1.617, which has emerged in India. These variants are widespread across the world and may eventually be resistant to vaccines.

In short, so-called “vaccinationalism” can prove to be counterproductive even for countries where vaccination is effective.

“We will only be safe when everyone is safe,” says Joan Costa-i-Font, professor of health economics at the London School of Economics. “Variation can appear at any time. It cannot be a competition between winners and losers.”

Costa-i-Font, who sees excessive vaccine supply as a “short-sighted self-interest,” says these countries “will soon realize that in order for their economies to recover, their neighbors and trading partners must also be free. virus. “

“In Europe, it is a very strong concern today”, declares the doctor and lawyer of health Daniel Dourado, researcher at the USP and at the University of Paris. “In France, for example, there is a lot of exchange with French-speaking African countries. Letting the virus circulate in poor countries can upset everyone’s vaccination strategy,” he said.

For Dourado, the gap between countries in terms of access to vaccination was already expected. “The logic of the vaccine is the logic of the market. The central countries have more resources and production capacity, and the peripheral countries depend on donations.”

He makes an analogy with hunger on the planet. “There is enough food for everyone, but there is always hunger. Likewise, we will soon have enough vaccines to immunize the whole world, but that does not mean that they will be well distributed.”

By the end of 2021, it is estimated that the pharmaceutical industry will be able to produce 11 billion doses, enough for the adult population around the world, says a document released last Wednesday (19) by industry associations in Europe and to USA.

With the objective of distributing 2 billion doses by 2021, the Covax plant has only managed to deliver 70 million to date, 100 million less than expected.

The recent worsening of the pandemic in India, where more than half of the doses are believed to go to the consortium, has delayed the schedule. In March, the Serum Institute, the world’s largest vaccine factory, suspended exports to meet domestic demand. As a result, the dose gap for Covax is expected to reach 190 million by the end of June.

Asked by Folha, the Gavi Vaccine Alliance, in charge of Covax with the WHO, said it maintains the original target and seeks to achieve it by diversifying the vaccine portfolio through agreements with seven other manufacturers. . The initiative is trying to get more donations from philanthropic entities and governments and needs at least US $ 1.6 billion by June.

According to a study funded by Unicef, Covax would gain 153 million doses if the G7 countries and the European Union donated 20% of their reserves in June, July and August, without prejudice to the vaccination of their populations. The UK surplus alone could immunize 50 million people in poor countries.

The WHO has also called on these countries to abandon the vaccination of children and adolescents, less prone to severe Covid-19, to target doses to high-risk groups in poor countries.

France and Germany reacted to pressure from the WHO by announcing, Friday (21), the transfer of 60 million doses to Covax. French President Emmanuel Macron spoke of “vaccine multilateralism”.

In April, the United States announced it was sending 80 million doses abroad, but has not yet defined the countries to which the remittances will be sent.

President Joe Biden is trying to gain space in vaccine diplomacy, now led by China, which has already exported 35% of its production and has made donations especially to African countries.

However, some mayors of American cities have chosen to use their surplus to accelerate the recovery of tourism. Miami is vaccinating visitors at the airport, and New York has announced the vaccination of travelers at iconic attractions like Central Park.

It is the so-called vaccine tourism, which has been a gimmick even for Brazilians, even with the obligation to quarantine for 14 days in another country before entering the United States.
For Daniel Dourado, it is a practice which in itself does not unbalance the system, but ends up reinforcing inequalities. “From an individual perspective, of those who travel, there may even be a moral dilemma, but I don’t see any ethical issues. The biggest discussion is about governments promoting this, reinforcing the logic of having a vaccine for those who have more money, and not for those who need it most. “

In addition to the donation of doses, other solutions are discussed to reduce inequalities in access to vaccines. One of them is the suspension of patents for these products during the duration of the pandemic, proposed to the World Trade Organization by India and South Africa and supported by more than 110 countries, including states. -United.

Critics of the measure say it would end the incentive for innovation by pharmaceutical companies, cause production to drop and not solve the problem, given that vaccines are very complex and very few countries would be able to make them only with the “recipe” “in hand.

But there are those who argue that breaking patents, especially simpler technological vaccines, may be helpful in the medium term – even because the Covid-19 vaccination may have to be recurrent.

“We need a combination of actions. The donation is what will solve it now, but the breach of patents and the transfer of technology are also fundamental,” says Ulysses Panisset of UFMG.
For him, there is also a lack of investment in new vaccines, including in Brazil. “Brazil is one of the few countries to have a vaccine production fleet and was able to invest more. We should have been more strategic in the early days. [da pandemia]. “

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