The global rollout of coronavirus vaccines would never be easy. But it quickly degenerated into frustration at home and nationalist turmoil abroad as countries around the world faced a maelstrom of logistical and political challenges.
All 50 states in the U.S. report shortages as America’s fragmented administrative and health care systems struggle to distribute even the limited vaccine supply.
Europe has fallen into its own ugly battle over supplies. And there are few signs that the poorest countries in the world will soon have access, perhaps only in 2023.
Some experts believe that some in Africa, South America and Asia have turned to China and Russia, which use the vaccination of diplomacy to further their influence in the world.
In the US “the rollout is slow and uncomfortable and very frustrating for our population”, said dr. Tom Kenyon, a former director of the CDC’s Center for Global Health, said.
Washington should be best able to immunize its citizens, after ordering 1.2 billion doses while working with pharmaceutical giants. Yet the US lags behind Israel, the United Arab Emirates, the United Kingdom and Bahrain in shots per capita.
Its issues are generally twofold: manufacturing and distribution.
As in Europe, US supply has weakened because drugmakers struggle to keep up with demand, sometimes hindering too much before having to scale back orders.
“They probably did not do a very good job of communicating correctly, managing expectations and being transparent,” said Maria Elena Bottazzi, co-dean of the National School of Tropical Medicine, part of the Baylor College of Medicine in Houston. .
But what worries the U.S., according to experts, is that its health care system is not centralized, and that President Donald Trump’s government is not drawing up a proper national vaccination deployment plan to fill the gap.
After Trump inherited what some experts describe as one of the best pandemic preparation plans in the world, he fired his top biosecurity adviser, allowing his global health unit to disband and shrinking the coronavirus in the important early weeks of the outbreak last year. .
The result of today is a chaotic scramble when it comes to vaccines, so this criticism goes, where states, provinces and hospitals have left it alone.
Download the NBC News app for the latest coronavirus news
“We have a very divided approach,” said Kenyon, who is now chief health officer at Project HOPE, an international global health and humanitarian organization. “We actually have states competing with each other to get the vaccine. It’s in no sense optimal.”
However, these concerns need to be seen in context. Under Trump’s supervision, vaccines arrived faster and were more effective than many people expected. And the encouraging data continues to arrive.
But at the moment, it helps little to reassure officials, experts and citizens about the spread of vaccines, which are only exacerbated by new variants and the reluctance of some to be vaccinated.
This week, President Joe Biden announced measures to revamp the federal implementation strategy. Time will tell whether it will turn things around.
“When it comes to coordination during a public health emergency, you see where our system has fallen apart,” said Justin Ortiz, an associate professor at the University of Maryland School of Medicine, referring to the Trump administration’s record. “The idea that the previous federal government could wash their hands of this and rely on each state to create their own systems is a dereliction of duty.”
In Europe, the situation is equally dire.
It seems that a fierce bureaucratic infighting has stimulated the deployment of the European Union, which has been glacial and slow and dysfunctional. Doctors in Madrid and Paris had to interrupt the vaccinations because the stock was almost dry.
Amid all this, the EU and AstraZeneca disagree after the British-Swedish pharmaceutical giant said it should reduce delivery due to a production issue. The EU has insisted that the drugmaker keep its word.
In a drastic step, the EU is now trying to block the export of any vaccine from companies that have not complied with the European mandate. EU officials have also suggested that the vaccine bound by the UK be diverted to make up for the shortage on the mainland.
A dispute over logistics could now metastasize into a full-fledged diplomatic crisis.
“We reject the logic of ‘first-come, first-served’,” EU Health Commissioner Stella Kyriakides told a news conference on Wednesday. “It can work in a butcher shop, but not in contracts and not in our advanced purchase agreements.”
Even in the UK, there are concerns about its own, seemingly successful implementation, namely the decision to take up to twelve weeks between the first and second doses.
The decision was made while the country was in the teeth of the world’s deadliest Covid-19 outbreak. The delay has been defended for much longer by the expert advisers of the government and is longer than what drug manufacturers recommend, which divides the scientific community.
But the picture looks nowhere worse than in the developing world.
For all the drama in the West, the delays will be measured in weeks and months. But Africa, parts of South Africa and Central Asia, is likely to see widespread vaccine coverage in 2023, according to an article this week by the Economist Intelligence Unit, a research group in London.
In addition to trying to get his own house in order, Biden has joined a program led by the World Health Organization called COVAX, which raised $ 2 billion to buy vaccines for poor countries.
To see how the US is engaged in an altruistic effort that Trump avoided was welcomed by public health experts. But in reality, COVAX not only needs more money and kind words, but doses in hand and the ability to distribute them.
“US funds are welcome, but COVAX’s issues go beyond money,” said Mukesh Kapila, who was an adviser to the WHO’s former director general.