Poor middle-income countries, largely unable to compete in the open market, rely on a complicated vaccine-sharing scheme called Covax. A collaboration of international health organizations, Covax is designed to release the inequalities of a free market for all. But the deals come with strings, and health advocates question its transparency and accountability.
By the middle of next year, South African officials are hoping to get their first vaccine doses under Covax, even as they negotiate to buy supplementary stock from drugmakers. But in a country where luxury estates are barred from sprawling squatter villages, many expect the latest vaccines to remain a privilege for residents who can pay out of pocket or through supplementary insurance – a program that benefits white people excessively.
“You will be able to walk into your local pharmacy and pay a few hundred rand (about $ 15) and say, ‘Beat me,'” says Francois Venter, a researcher at the University of the Witwatersrand in Johannesburg.
‘Maybe we’ll get the vaccine in 2025’
The best chance that many South Africans will have to vaccinate soon is to voluntarily go for a clinical trial and test unproven vaccines on their bodies. But this arrangement raised ethical questions.
First is the question of whether countries like South Africa, which support trials by four drug manufacturers, should guarantee doses if the trials pass. The government has not yet received such a guarantee. And in any case, such an arrangement would be ethically murky, as it would punish countries participating in unsuccessful trials.
When Britain was ready to launch its vaccination campaign this month, dozens of people marched from their squatter houses in Masiphumelele township, south of Cape Town, to the gates of the Desmond Tutu Health Foundation.
They waited outside for hours, under the shade of a gum tree, for a chance to take part in a clinical study of the Johnson & Johnson vaccine.