In a shocking symbol of the west’s failure to honour its promise of equitable vaccine distribution, millions of Covid vaccines manufactured in Africa that should have saved the lives of Africans have been shipped to Europe in recent weeks. Indeed, this month and next, I have learned from African leaders that about 10m single-shot Johnson & Johnson (J&J) vaccines filled and finished at the Aspen factory in South Africa will be exported to Europe, at the very time that Africa is grappling with its deadliest wave of Covid-19 infections yet.
Compared with the swift development of the pathbreaking Covid vaccines, getting shots into all the world’s arms should be straightforward. But vaccine nationalism – and Europe’s neocolonial approach to global health – is dividing the world into rich and protected people, who live, and those who are poor, unprotected and at risk of dying.
Of the 4.7bn vaccines that have been distributed globally, more than 80% have gone to the richest G20 countries. The gap between rich and poor is now so wide that, while high-income countries have administered almost 100 doses for every 100 citizens, low-income countries have administered only 1.5 doses per 100.
To date, 496m vaccines have been administered across the European Union, which has a population of roughly 440 million people. Only 77.3m doses have been administered across Africa’s population, which is almost three times as large, at 1.3 billion people. And so, while 50% of European, US and UK adult populations have now been fully vaccinated, the figure for Africa is 1.8%, well behind India, which has only vaccinated 8% of its population. Due to the sluggish delivery of vaccines, the World Health Organization (WHO) now predicts that 47 of Africa’s 54 countries will miss even the very modest September target of vaccinating 10% of their citizens. In countries like Burundi, not a single vaccine has yet been administered.
At these current rates there is no hope of Africa achieving the west’s vaccination levels this year or next. Unsurprisingly, African leaders speak of “vaccine apartheid”. While governments across the west get ready to administer booster vaccines, millions of Africa’s nurses and health workers, risking their lives to save others, will go wholly unprotected. So will Africa’s vulnerable elderly population.
The vaccine programme should have been a new kind of “arms” race. In quick succession, country after country should have been able to inject its citizens. Instead, the countries with the most vaccines are failing to help those with the least, and now the damaging economic effects on jobs and livelihoods are causing a growing divergence between the fate of poor and rich countries. Low vaccination rates across the continent have led the International Monetary Fund (IMF) to mark down African economic prospects yet again, while upping those of the vaccinated west, and Africa is suffering growth rates that are half those of the rest of the world
The African Vaccine Acquisition Trust (AVAT), disappointed by the failure of the west to honour its promises of delivering funding for 700m vaccines to Africa by the end of the year (the multinational Covax facility has been able to secure only 60m so far), has now taken matters into its own hands. It has negotiated a deal with Johnson & Johnson (J&J) for 400m single-shot vaccines. In doing so, it had to overcome EU resistance. It was only after the South African president Cyril Ramaphosa intervened and threatened to ban all vaccine exports from South Africa that Europe agreed all J&J’s future African-produced vaccines could stay in Africa from October. Now 30% of Africa’s adult population are guaranteed vaccination, even though it will take until September next year.
But vaccines are not yet available to meet Africa’s vaccination target, set at 60% of adults, or to cover that other 30% people who were promised vaccines provided by the west. As a result, I am told the African Union has had no choice but to open negotiations with China to buy at least 200m Chinese-made vaccines. The hold-ups are now so serious that a vaccine “war room” has been created by the IMF, World Bank, WHO and World Trade Organization (WTO) to help track, coordinate and advance the delivery of vaccines. Despite this, only political leadership from the G7 countries, which have negotiated vaccines far in excess of their population numbers, will ensure that all continents receive an adequate supply.
The world will manufacture around 6bn more vaccine doses by December and ramp up production by many billions more next year. This supply could be sufficient for every country to meet the 60% vaccination target by next summer. Problems that will perpetuate the inequalities in vaccine distribution can only be resolved with a level of global coordination that has so far been absent among G7 and G20 leaders.
Two policy changes are urgently needed, which Joe Biden, Boris Johnson and Italy’s prime minister Mario Draghi, the G20 president, must now deliver at a special G20 vaccines summit that should be convened next month. First, a virtuous circle must be created, starting with guaranteed international funding from the richest countries, to underwrite and accelerate the development of new global manufacturing capacity in poorer countries. This would include expediting the transfer of technology through licensing agreements that would benefit from a temporary waiver on vaccine patents.
Still, Africa needs vaccines immediately. As things stand, the US has optioned 1.96bn additional doses. The European Commission has access to 1bn extra shots, while Canada has secured 191m (and at one stage had procured almost 10 vaccines per citizen). Due to over-ordering, their populations will probably not use all these vaccines, but in the process of securing preferential agreements rich countries have effectively locked out African countries from accessing the doses they urgently require. G7 leaders must now step in to ensure the supplies go where they are needed most. Countries with excess supply must end their stranglehold on available vaccines and future supplies. They must not only release them to Africa, but, as the IMF and four former American finance ministers proposed, provide at least $50bn in financial support through Covax and the logistical help needed to ensure vaccines can be administered quickly and safely.
Ensuring African populations have access to vaccines is not just an imperative for Africa. It’s in all our enlightened self-interest. As Britain’s leading vaccine scientist Sarah Gilbert has said, the biggest threat we all face is Covid spreading and mutating uninhibited in unvaccinated countries. We must keep reminding ourselves of the reason for ensuring the mass vaccination of the entire world: no one is safe anywhere until everyone is safe everywhere, and everyone will live in fear until nobody does.
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