What is the similarity between toilet paper and COVID Vaccines? They are both unequally distributed.

How the WHO’s COVAX initiative failed to bridge the undermined issue of vaccine inequity due to the influence of powerful countries in resource management.

By: Maria Mian

On January 1st 2019, the world counted down to the start of the new decade, one that would hold new adventures, dreams and experiences. Little did we know that all our future endeavours would be put on hold as the entire world came to a halt by a virus. Although there have been speculations that the virus came into existence around October 2019, it was on December 31, 2019 that the World Health Organization (WHO) became aware of cases of pneumonia in Wuhan, China. The cause of the illness was identified as a novel coronavirus by Chinese authorities on January 7th, 2020 creating the temporary name “2019-nCoV”. On January 30, 2020 the highest level of alarm was declared by Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, who stated that the coronavirus outbreak is a public health emergency of international concern. This is when the situation began to escalate over the months and on March 11, 2020, the exponential increase in cases outside of China led to the announcement that the world is officially in a pandemic. The increase in cases triggered the decision for many governments to put their countries into lockdown, leaving only essential resources such as grocery stores, banks and other facilities open. This is what plunged the world into a havoc as every individual was in a race to fend for themselves, waiting in long lines to get groceries and fighting for things as simple as toilet paper. The COVID-19 pandemic not only brought to light the somewhat selfish nature of humans when it comes to times of need, but further displayed the unequal distribution of resources all across the world. More importantly, the undermined issue of unequal distribution of vaccines between wealthy and developing countries was once again displayed.

Vaccine Distribution

It was almost a year after the escalation in COVID-19 cases that the vaccine rollout began. At the end of March 2021 it was reported that more than 600 million doses of Covid-19 vaccine had been administered. However, there was a clear divide between distribution of vaccines among countries. While high income countries administered second doses to their citizens, developing countries were struggling to get a hold of first doses for their citizens. Vaccine, China. The cause of the illness was identified as a novel coronakvirus by Chinese authorities on January 7th, 2020 creating the temporary name “2019-nCoV”. On January 30, 2020 the highest level of alarm was declared by Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, whohy countries ignorantly hoarded vaccines in their race to vaccinate their populations. From data up to March 31, 2021 it was clear that the WHO’s COVAX initiative was completely ineffective in equally distributing Covid-19 vaccines to the most vulnerable countries. What is even more unfortunate is that more economically developed countries such the United States, United Kingdom and Germany were some of the countries that signed the COVAX initiative. However, their actions paint some extreme contradictions as these countries had the most shares of vaccines.

Are Health Resources Universally Distributed?

As of April 9th 2021 more than 700 million Covid-19 vaccines had been administered all around the globe. However, statistics have shown that 0.2% have gone to low-income countries while 87% have gone to high-income countries or upper middle-income countries. Even in the year of 2021 equality and equity in healthcare is directly proportional to those who have a higher income and state of living. The claim during the current pandemic that “we are all in this together”, is just a saying, the reality is countries with power are saving their people while those in developing countries are suffering in silence. The WHO Strategic Advisory Group of experts on immunization (SAGE) met on May 27, 2021 to discuss COVID-19 vaccine distribution. At that time, 15 vaccine types were actively administered with the Oxford-AstraZeneca and PfizerBioNTech products being the most widely used. By June 7, 2021, 1.9 billion doses had been administered worldwide. The SAGE reported that, “high income countries have administered 69 times more doses per inhabitant than low-income countries”. This again demonstrates the power dynamic between vaccine distribution as the wealthy countries are selfishly hoarding resources while poorer countries scramble to fight a pandemic with little to no assistance.

It is clear that the distribution of COVID-19 vaccines is completely unequal and that most of the doses have been administered in the wealthiest countries. It is time the WHO and wealthy nations’ come together with a global initiative through COVAX and bridge the gap of vaccine inequity, especially during this deadly pandemic. It is vital that vaccines are distributed to low and middle income countries and COVID-19 “hotspots” where transmission of the virus is the highest. For example, there have been heightened concerns for Africa as on June 3, 2021 the WHO reported that vaccine shipments to the continent have stopped. Many countries in Africa including Angola, Namibia, and Uganda have seen sharp rises in cases of COVID-19 which is largely due to poor vaccine distribution. Investigation by WHO found that 31.4 million doses had been administered in 50 African nations which translates to as little as 2% of the population receiving a single dose. This is in comparison to countries like the UK where more than 40 million people, equating to over 70% of the adult population, have received at least one dose of a COVID-19 vaccine. Another important statistic from the Bill and Melinda Gates Foundation found that high-income countries could share 1 billion doses of COVID-19 vaccines and still have enough to vaccinate 80% of their population above the age of 12. So far the USA and Europe have pledged to collectively donate 180 million vaccine doses, but only time will tell if these promises will be kept.

There is clearly an issue in increasing the availability of vaccine production. A total of ten countries makeup about 77% of the globally administered doses. This is because rich countries have been taking over the vaccine market. Powerful countries such as the EU, the UK and the USA have purchased an excess amount of vaccines, far than they need. An interesting analogy presented the difference in vaccine distribution as in the year of 2021 technology has significantly sped up the development of vaccines and, “there is a lake of vaccines out there, and COVAX is receiving drops. If low income and middle-income countries are not to be left behind, high-income countries will have to open the floodgates".

A Failed Attempt

The World Health Organization initiative COVAX attempted to establish a fair distribution of vaccines and negotiate affordable prices for vaccines from manufacturers. Unfortunately this initiative was unsuccessful. Powerful governments easily overpowered COVAX's attempt to purchase vaccines for the most vulnerable population. This is what led to great competition in obtaining COVID-19 vaccine supply creating a great divide between Public Health needs and a concept now known as “survival of the wealthiest”.

In the current world money does all the talking and economic division is a key player in decision-making for distribution of resources. Powerful high-income countries, multinational corporations and private philanthropy make most of the decisions leading countries with less resources and power to be silenced and conform to the decisions of the powerful. The WHO represents 193 Member States and has a 343 elected member executive board making it one of the best global platforms for nations and countries to come together to voice their opinions and concerns in a collective manner. Unfortunately, current times have definitely made it clear that the WHO is not working to its full potential, rather it is being overpowered by wealthier countries who are undermining the WHO’s mission of providing equal healthcare to all.

Update: Booster shots, a modern day robbery in health

After two tough pandemic years, the world welcomed the year of 2022 by ignorantly breaking its yearly new year resolution regarding “equality” and “equity” for all. As the COVID-19 virus continues to transform and form new variants every few months, the latest variant, Omicron, is the fastest spreading variant to date. The rapid transmission of the disease has caused another wave of global panic as countries begin putting in tougher restrictions and stocking up on the luxurious booster shots, committing, once again, a crime in vaccine inequity. The WHO Director- General Tedros Adhanom Ghebreyesus clearly outlined how booster programs will, “prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate”. This was displayed in the emergence of Omicron as many health experts have suggested that the variant emerged in South Africa where only 26% of the population is vaccinated. When put into perspective it should be accounted that the population of South Africa is 59.31 million (2020) and only about 15 million individuals are fully vaccinated. This great divide in vaccine inequity is what supposedly caused the development of Omicron as vulnerable, unvaccinated individuals became hosts for the virus and allowed it to mutate and live for a long time in the human body. This again stresses the importance of vaccinations as the majority of hospitalizations and deaths were among unvaccinated people, “not vaccinated people without booster shots” emphasized General Tedros.

A Call To Action

The World Health Organization claims to “connect nations, partners and people to promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the highest level of health”. It's high time they deliver what they preach. The WHO must begin working for the people instead of being a “broker for the global elite”. Increase in government influence and funding coupled with volunteering efforts and support from different levels of government are crucial in assisting the WHO in bringing health equity to all. Better support for WHO regional offices would also be extremely helpful in battling health inequity as more training and resources can be distributed to individuals in multiple regions. It must be clear that, “vaccine inequity is rooted in inequalities in ownership and control of resources''. It is time the world puts aside its ignorance and power and treats all humans equally regardless of where they live, ensuring that everyone has access to the gift of health.

References

Burki, T. (2021). Global COVID-19 vaccine inequity. The Lancet Infectious Disease . Retrieved September 18, 2021, from https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00344-3/fulltext.

Kim, H. (2021, July 1). We need people's who to solve vaccine inequity, and we need it now. BMJ Global Health. Retrieved September 18, 2021, from https://gh.bmj.com/content/6/7/e006598.

Miao, H. (2021, December 23). Who says Covid booster programs limit vaccine supply for poor countries, could prolong pandemic. CNBC. Retrieved January 17, 2022, from https://www.cnbc.com/2021/12/22/who-says-covid-vaccine-booster-programs-will-prolong-pandemic.html

Tatar, M., Shoorekchali, J. M., Faraji, M. R., & Wilson, F. A. (2021, July 3). International covid-19 vaccine inequality amid the pandemic: Perpetuating a global crisis? Journal of global health. Retrieved September 18, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252691/.

WHO. (2021, September 17). About the virus. World Health Organization. Retrieved September 19, 2021, from https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov.

WHO. (2021). About who. World Health Organization. Retrieved September 19, 2021, from https://www.who.int/about.