The pandemic won't end until there is global solidarity on vaccines

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December 2020: The first delivery of approximately 4,000 doses of the first approved COVID-19 vaccine arrived in British Columbia. Image: Province of British Columbia/Flickr

As Canadians savour a "return to normal" this summer, our decision makers seem largely oblivious to the fact that almost three-quarters of the world's population has yet to receive even a single dose of a COVID-19 vaccine.

According to "Our World in Data," an online database maintained by researchers at the University of Oxford, only 1.1 per cent of people in low-income countries have received a vaccine dose.

Some of the poorest nations and the percentage of their populations vaccinated with one dose as of July include: Haiti (<0.1 per cent), Congo (0.1 per cent), Syria (0.7 per cent), Mali (1.0 per cent), Yemen (1.0 per cent), Somalia (1.1 per cent), Papua New Guinea (0.7 per cent), Ethiopia (1.9 per cent), Nigeria (1.3 per cent), Mozambique (1.2 per cent), Iraq (1.8 per cent), and Afghanistan (2.1 per cent).

In many of these counties it has been the elites who have been vaccinated, despite the World Health Organization's allocation framework to prioritize health care workers, those over the age of 60, and those who have chronic conditions. Many low or middle-income countries will have to wait until 2023 or 2024 to adequately protect their populations from COVID-19.

The World Health Organization (WHO) has called this inequity in the vaccine rollout "a catastrophic moral failure."

At a high-level dialogue convened by the heads of the World Trade Organization (WTO) and the WHO on July 21, the WHO director-general Dr. Tedros Adhanom Ghebreyesus thanked the pharmaceutical industry for producing vaccines in record time. However, he said: "There remains a shocking imbalance in the global distribution of vaccines. This has created a two-track pandemic: the haves are opening up, while the have-nots are locking down."

Pointing out that more than 75 per cent of 3.5 billion vaccine doses distributed globally have gone to just ten countries, he said that "vaccine inequity is not only a moral failure, it is also epidemiologically and economically self-defeating."

This inequity is a result of the most powerful, wealthier countries in the global North hoarding the bulk of the available vaccines to cater to their own domestic populations. Big Pharma has clearly prioritized profit over people's needs and has sold limited vaccine supplies to those who can pay. Pfizer has been selling vaccines at an 80 per cent profit margin. It's been a similar scenario with medical devices, PPE, vital supplies and oxygen.

These countries -- which include the U.S., the U.K., the European Union, Switzerland and Canada -- now have enough doses to vaccinate their populations three times over. The U.K. ordered more than 500 million doses, enough to fully vaccinate its population of 67 million several times over.

The Canadian government has been the biggest hoarder of all, even dipping into the COVAX vaccine supply. Canada is the only G7 country to draw vaccine supplies from COVAX, the vaccine-sharing initiative coordinated by the WHO. In early June, just before the G7 leaders' summit in Cornwall, U.K., 32 NGOs and civil society organizations in Canada urged the federal government to share at least 10 per cent of its supply. These organizations noted that Canada has ordered 10 doses per capita, more than any other country.

On June 4, 2021, the G7 foreign ministers released a communique which read "we emphasize our support for global sharing of safe, effective, quality and affordable vaccine doses, including working with COVAX when domestic situations permit" (my emphasis).

This "me-first" approach is not only morally bankrupt and self-serving, but it is also self defeating. Leaving billions of people around the globe lagging behind in the vaccine rollout, allows the virus to spread and to mutate, and possibly mutate to a variant that could be immune to the current vaccines.

The higher-income countries in the global North, including Canada, cannot insulate themselves from this virus. COVID-19 is unprecedented for impacting the entire globe at the same time. A global pandemic requires a global strategy with universal access to vaccines. A pandemic can't be resolved within the confines of an individual nation state. This shared experience of a common virus should by itself promote global cooperation, and not narrow, nationalistic approaches.

The speedy vaccine rollout in wealthier countries has helped to improve their economic outlook. For many in the global South, however, this pandemic has become an economic as well as a public health crisis. The social and economic impact on the world's poorest will be severe and long lasting, leading the World Bank to refer to a "lost decade" ahead in order to recover. The pandemic has led to collapsing health care systems, a shortage of medicines, a staggering loss of life from COVID and other preventable diseases, food shortages, a spike in world hunger, a loss of livelihood for many, and children dropping out of schooling.

Global poverty alleviation had already slowed down due to climate change and regional conflicts. The recession caused by COVID-19 will only worsen this. This situation will undoubtedly turn into a political crisis in many countries as we've already seen in Columbia and Tunisia.

The burden on women and girls has intensified through an increase in unpaid care and domestic work, economic insecurity, increased poverty, and working on the frontlines in the most precarious jobs. Women and girls have also suffered a "shadow pandemic" with an increase in domestic violence.

A UN policy paper states that:

"Across every sphere, from health to the economy, security to social protection, the impacts of COVID-19 are exacerbated for women and girls simply by virtue of their sex…With the spread of the COVID-19 pandemic, even the limited gains made in the past decades are at risk of being rolled back."

Same sea, very different boats

Rajni George, a writer based in India, has noted that it is due to scientists collaborating across borders that vaccines against COVID were developed so fast:

"Scientists worked with partners across borders, culminating in the design of viable jabs within just 10 months. Driven by the humanitarian desire to end the pandemic, apart from the usual incentives of monetary reward and professional success, vaccine internationalism prevailed in the scientific community at least."

However, this vaccine internationalism was short lived after Big Pharma took over.

Ironically, Big Pharma had been withdrawing from vaccine production for years. Vaccines were only used occasionally and were seen as being less profitable. Big Pharma was lured and coaxed into COVID vaccine production with massive amounts of public funds and with little oversight into ethical contracting procedures. The exclusive rights to manufacture COVID-19 vaccines are currently held by a handful of pharmaceutical companies that control supply, despite the huge amount of public funding channeled into vaccine development.

This pandemic has exposed a fragile global community, with an increasing North-South divide, and a lack of multilateral co-operation. There is little faith or trust in institutions like the UN or the WHO. It has exposed the divergence between the haves and have-nots within and between countries. Despite lip service by world leaders, there is a profound lack of internationalism.

UN Secretary General Antonio Guterres has challenged "the myth that we are all in the same boat. While we are all floating on the same sea, it's clear that some are in super yachts, while others are clinging to the drifting debris."

While Big Pharma and many world leaders have been motivated by greed and a self-serving approach, the pandemic has also shown the best of humanity. The contributions of scientist, public health, health care and frontline workers have been extraordinary. Across the globe, a plethora of mutual aid initiatives have sprung up to assist the most vulnerable citizens. A multitude of ordinary people and civil society organizations have been motivated to help their neighbours in need. And we've seen remarkable social movements throughout this pandemic such as Black Lives Matter, an Indigenous resurgence and climate activism.

The People's Vaccine Alliance, a broad-based coalition of organizations and activists, has been campaigning for a "People's Vaccine for COVID-19." They are advocating for a patent-free, mass produced, and fairly distributed vaccine available free of charge to everyone, everywhere, as soon as possible.

Campaigners and activists, like Heidi Chow at Global Justice Now, have relentlessly called for an end to Big Pharma monopolies and the suspension of patents and intellectual property enforcements. Activists want every nation to be able to produce or to buy vaccines at affordable costs.

There are openings now, particularly with the Biden administration. Shamefully, Canada and the U.K. have been among the most resistant to global co-operation.

A significant victory was achieved on May 5, when the U.S. trade representative Katherin Tai announced that the U.S. government would support waiving intellectual property (IP) rights on COVID-19 vaccines "until widespread vaccination is in place globally." Under pressure, the Biden administration announced support for a proposal previously put forward by India and South Africa to the WTO to relax IP rights for the vaccine.

On July 12, a year and a half into this pandemic, the Canadian government finally announced that it is donating 17.7 million doses of AstraZeneca, procured by Canada with an advance purchase agreement, to COVAX.

Vaccine apartheid

We are far from being out of this public health crisis. The more contagious Delta variant is spreading in under-vaccinated areas in south-east Asia, Africa and South America. After a period of decline, the variant is boosting cases and deaths, and the WHO anticipates that it will become dominant within months.

In recent weeks, NGOs such as UNICEF and Doctors Without Borders have issued open letters waring that:

"The pandemic will not be over anywhere until it is over everywhere, and that means getting vaccines to every country, as quickly and equitably as possible… We run the risk that new variants -- possibly with the potential to spread in spite of currently available vaccines -- will take hold."

Nine out of ten people in poor countries won't have access to a vaccine this year, unless there is a dramatic change of course among world leaders. It is hard to fathom that life-saving vaccines, which were largely produced by public funds, now face the barriers of intellectual property rights, patents, monopolies and profit. It is also shocking how many world leaders continue to see the world in a colonial framework.

Archbishop Thabo Cecil Makgoba of Cape Town, has likened the vaccine inequity to living under apartheid.

"These vaccines that are available to the global North and the West…it reminds me that we are saying, like apartheid, 'Hey, you guys are not human enough. Wait a bit.'"

A number of wealthy counties are now hoarding even more vaccines for a possible third booster dose. Dr. Michael Ryan, the WHO emergencies chief, said the world would look back "in anger" and "in shame" if the limited supply went to booster doses.

This is undoubtedly the most serious crisis facing the world since the Great Depression of the 1930s. This crisis has shown neo-liberalism's inability to meet the needs of humanity. It has also retrenched the "third world's" subordinate status in terms of global priorities.

The world needs to scale up vaccine production and vaccinate as many as possible, and to distribute vaccines in a fair and just manner. We need universal access, to share the know-how and the technologies, and then plan for a recovery that focuses on people's needs.

We can do our part in Canada by continuing to pressure our own federal government and extending solidarity to the People's Vaccine initiative, progressive NGOs, and the host of grassroots organizations and activists fighting for universal access to COVID-19 vaccines.

Ken Theobald is a community worker based in Toronto's northwest inner suburbs. He previously worked in the global education/international co-operation sector for over two decades, and was a board member with the Canadian Council for International Co-operation (CCIC), now called Co-operation Canada.

Image: Province of British Columbia/Flickr

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