There is a wild scurry at the forefront of COVID-19 vaccines, with the EU discussing export bans and legal action to ensure supply accelerates in the coming months.
The other side: The back of the line probably extends to 2023 and beyond. Almost no low-income countries have managed to start spreading seriously, and total vaccinations across continental sub-Saharan Africa currently number in the dozens.
Send the news: The EU is expected to approve a third AstraZeneca vaccine tomorrow. But European leaders are furious that initial stocks will be much lower than expected.
- The EU is now putting pressure on the Anglo-Swedish firm to provide doses in the UK – which previously had an agreement – to make up for the shortfall.
- To date, the EU has managed to vaccinate only 2% of its collective population, compared to 11% in the United Kingdom. Deficits forced Madrid to interrupt the distribution, and Paris will follow suit.
- Brussels is considering export bans on doses produced in the EU, including the Pfizer / BioNTech vaccine.
The state of affairs: The fact that rich countries not only buy the bulk of the supply of approved vaccines but also struggle to expand them effectively is bad for the countries that are waiting further.
- Some pay a premium in smaller-scale bilateral transactions, often for vaccines from China and Russia.
- The Economist Intelligence Unit (EIU) projects that vaccines will only be widely available this year in the richest countries in the world, while many others (Brazil, India, Egypt) will be vaccinated widely next year, and most low-income countries will wait until 2023 or further.
What they say: “What we are seeing now worldwide is not what we were hoping for,” said Matshidiso Moeti, Regional Director of WHO Africa.
- “It would be deeply unfair to force the most vulnerable Africans to wait for vaccines while making the lower-risk subgroups safe in rich countries,” she said.
- Barry Bloom, a professor of public health at Harvard, puts it more bluntly: “Right now, it’s the law of the jungle.”
African health authorities hope the distribution of vaccines will begin across the continent in March, initially with about three million doses needed to cover medical workers.
- The urgency only increases as the number of countries on the continent increases and new variants spread. “The second wave is here with revenge and our systems are overwhelmed,” said John Nkengasong, director of the African CDC.
- The global COVAX initiative hopes to cover 20% of each country’s population by 2021, and the African Union is trying to supplement this with complementary orders.
- If all these pieces fall into place, the WHO says that 30-35% of Africans could be vaccinated by the end of the year.
What to look for: “To be successful, we must reach a 60% target within two years. If we do not, COVID will become endemic on the continent,” Nkengasong told reporters on Wednesday.
- The other side: Anthony Fauci, director of the NIAID, set a target of 70–85% in the USA by the summer.
- By the numbers: The US, EU, UK and Canada have bought at least a combined dose of 2.5 billion, enough to vaccinate all their inhabitants (with two doses where needed) and still have about 1 billion left.
The whole picture: The prospects in affluent countries depend in part on what is happening in the poorer countries, as new variants of the virus emerging around the world could eventually cause international outbreaks.
- “We are engaged in an arms race, except that it is not an arms race, it is a race between vaccination and mutation,” Israeli Prime Minister Benjamin Netanyahu said at the Davos Virtual Agenda conference this week.
Israel, which jumped ahead of the rest of the world when it comes to vaccinations, it also intends to have millions of excess doses.
- The government plans to cover Israel’s citizens and then ‘see what we can do for our immediate neighbors’, the health minister told the FT.
- Israel has been criticized for refusing to supply vaccines to Palestinians living in the occupied territories, even though they vaccinated Jewish settlers there.
Countries on the edge of the EU also hope to have access to remaining doses.
- Ukraine, for example, has so far only succeeded in signing a relatively small agreement for a Chinese vaccine with questionable efficacy.
- The country is otherwise dependent on COVAX and whatever arrangements it can make with European producers and governments.
- The EIU places Ukraine among the countries likely to wait until 2023 for widespread coverage, along with parts of South Asia, Central and South America and almost all of sub-Saharan Africa.
Canada received more doses relative to its population than any other country, and it has been promised to donate to COVAX those who do not need it.
- But Prime Minister Justin Trudeau – even though he emphasizes ‘equitable distribution’ – does not want to say whether donations will be made before Canada has vaccinated its entire population.
Meanwhile, President Biden has raised hopes of global health experts and the WHO by reviewing Donald Trump’s decision to reject COVAX.
- Bloom calls this an ‘important new factor’, although Biden has not yet made any specific commitments regarding dosages or funding.
- He hopes that world leaders will see the current dispute in Europe as an indication that a centralized, equitable structure is needed for global distribution. But he adds: “I’m not optimistic.
Go deeper: Israel’s COVID crisis deepens even as vaccination rates rise