COVID-19 is undoubtedly the most significant public health crisis in recent years. As of January 6th 2022, there have been almost 5.5 million deaths related to the disease across the world. With the emergence of new variants, it is difficult to predict how many more there will be. Potentially, the most significant factor that will have an impact upon the number of deaths is the COVID-19 vaccine. A number of different vaccines have been rolled out across the globe to combat the virus. According to The New York Times, the five most widely used vaccines by number of countries are the Oxford-Astrazeneca, Pfizer-BioNTech, Moderna, Sinopharm-Beijing and Janssen vaccines. Of these vaccines, Janssen requires one dose, whereas the others require two doses. Booster doses are recommended for all five.
Based on data supplied by Our World in Data, The New York Times reported on January 6th that over 4.63 billion people across the world have received at least one vaccination dose. This represents 60.3% of the global population. However, when the data is broken down to a more granular level, significant discrepancies between different regions are visible. Across the U.S. and Canada, 75% of the population has received at least one dose, and across Europe, 66% of the population has received at least one dose. In stark contrast, however, is Africa, where only 14% of the population has received at least one dose. The New York Times further reported that high and upper middle income countries account for 72% of vaccinations that have been administered across the globe, whereas lower income countries account for only 0.9%.
With the roll out of booster programs for the fully vaccinated already well underway in some countries, these discrepancies have widened significantly. In mid December, The Financial Times reported that “wealthy countries have rolled out more COVID-19 boosters than the total number of all doses administered so far in poorer nations.”
It is clear, then, that there is an inequity in vaccination levels across the globe. When the first vaccines emerged in trial phases, there were predictions of a disparity in access, and that this would need to be addressed. As a result, COVID-19 Vaccines Global Access (COVAX) was established in April 2020. Co-led by Gavi Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organisation (WHO), the COVAX initiative aims to provide equitable access to COVID-19 vaccines. COVAX pledged to deliver 2 billion COVID-19 vaccine doses to countries in need throughout 2021. According to The Hill, COVAX fell short of this goal, distributing around 900 million doses to 144 countries throughout 2021, therefore falling significantly short of its target.
In a statement published on 30 December 2021, WHO Director General Dr. Tedros Adhanom Ghebreyesus called out “me-first approaches, vaccine hoarding and inequity” as contributors to the disparity. Ghebreyesus added that “[W]e are seeing some nations conduct blanket booster programs at a time when only half of WHO’s Member States have met the goal of immunizing 40% of their populations by the end of 2021 due to uneven global supply.” He also warned that “[t]he longer inequity continues, the greater the chance of this virus mutating into new variants that we can neither prevent nor predict.”
Conflict in several regions of the world adds another layer of complexity to the roll out of vaccines in certain countries. For instance, only 11% of the population in Afghanistan has received at least one dose, where there is ongoing conflict and instability following the reinstatement of the Taliban. Similarly, only 8.4% of the population in Ethiopia has received one dose, where there is an ongoing civil war. In both countries, mobilizing regular aid has proven to be challenging, and this has had a knock-on effect upon the mobilization of vaccines.
The disparity in vaccination levels across the globe is clearly a complex issue. The potential impact of new variants has resulted in many governments in high and upper middle income countries placing a stronger focus upon vaccinating their own citizens, rather than seeking to widen access to vaccines in lower income countries. But the current discrepancy in the number of vaccinations being administered must be addressed. COVAX and the wider international community must renew commitments to ensuring wider access to vaccines. Not only to minimize the health implications of Covid-19 and the number of deaths in lower income countries, but also to reduce the likelihood of new variants.
However, providing lower income countries and countries with low vaccination rates with vaccines alone is not enough. The delivery of vaccines to these countries does not necessarily mean that they are administered. In mid December, Reuters reported that Nigeria was set to destroy 1 million vaccines that expired. It was reported that many vaccines were donated with short shelf lives, some donated only weeks before expiration. Going into 2022, lower income countries and countries facing similar issues must therefore be supported in rolling out their vaccination programs. Not all countries have existing infrastructure such as England’s NHS that allows them to administer vaccines across the country in a relatively short timeframe. The international community must work together to combat the pandemic. Governments across the world must move away from reacting to each new development at a local level, and begin to focus upon the issue at a global level.
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