As the U.S. and dozens of other wealthy nations began vaccinating their citizens against the coronavirus, developing countries where billions of people live had yet to even receive vaccine supplies. And although an international plan to send vaccines to more than 100 nations is kicking into high gear later this month, it will take years to implement ― with countless lives lost in the process and the global recovery from the pandemic significantly delayed.
Following the World Health Organization’s approval of the AstraZeneca-Oxford vaccine on Monday, COVAX ― a joint effort by 190 governments and key international health programs ― will begin delivering hundreds of millions of doses of the shot to member states worldwide.
The nations, ranging from Indonesia to Nigeria and Brazil, are home to the vast majority of the global population. COVAX officials expect that 145 of those countries will be able to vaccinate around 3% of their citizens by the summer.
That still leaves billions without a jab that could protect them from severe illness, even as the coronavirus continues to evolve in unexpected ways and pharmaceutical companies continue to provide most of the vaccines they produce to rich nations.
“The vaccine distribution has really been a story of have and have-nots,” Niko Lusiani of Oxfam America told HuffPost.
In the U.S., for instance, all Americans who want a shot will be able to access one by the end of July, President Joe Biden said on Tuesday. Twelve percent of the population has already begun the process of vaccination, according to a Bloomberg tracker. And the U.S. is just the sixth in the world in terms of vaccinating its population, per The New York Times.
In comparison, as of last week, nearly 130 countries had not yet delivered a single dose of vaccine to their combined population of 2.5 billion people, the WHO said.
Amid a truly international crisis, governments are rejecting a united approach in favor of reinforcing inequalities on the basis of national citizenship. And that won’t only hurt residents of countries that are slow to get the vaccine. Experts believe that a lengthy global vaccination process will prolong the coronavirus’s grip on the globe. On Friday, a report in the medical journal The Lancet argued that the current inequitable distribution of vaccines leads to a greater risk of mutations that defy existing vaccines.
“We have to pay attention to what’s going in the rest of the world. Otherwise, we will be constantly threatened by variants and different lineages of the virus that will have evolved outside of the United States,” Dr. Anthony Fauci, Biden’s chief medical adviser, told the “L.A. Times Today” show on Spectrum News 1 in an interview aired on Tuesday.
The WHO has said halting the spread of COVID-19 means vaccinating around 70% of the global population. Not counting this month’s COVAX distribution, the Bloomberg tracker projects that at the current global vaccination rate, it will take almost five years to cover 75% of the world’s population.
The Organization for Economic Cooperation and Development warned last week that doing too little to fairly spread the vaccines being produced would cost the international economy upward of $9 trillion. Yet the U.S., which under Biden has begun to participate in COVAX, and similar countries are still doing relatively little to quickly supply the developing world with a reasonable amount of vaccines.
The organizing principle for COVAX was that by forming a group to invest in vaccine research and production, countries could ensure that each of them would receive enough vaccines for 20% of their populations ― likely to be health workers and the elderly.
“Not only from a moral perspective but from an epidemiological perspective, we would be targeting the vaccine at the most risky areas,” Oxfam’s Lusiani said.
Wealthier nations committed funding to COVAX ― the U.S. has pledged $4 billion through the vaccine nonprofit Gavi ― and poorer countries agreed to buy vaccines through the mechanism or to receive donated shots.
But as officials at international organizations implemented the plan, developed countries rapidly struck their own deals with vaccine manufacturers. The U.S. and the European Union have placed orders for more than 3 billion doses separately from COVAX, while COVAX has only secured 1.1 billion vaccine shots, Duke University research shows.
“Rich countries went into the pharmacy and cleared the shelves. COVAX came in afterwards to try and find whatever was left,” Lusiani told HuffPost. (The Duke figures include agreements to buy vaccines that companies have not yet fully developed, tested or mass produced. Nearly all of COVAX’s current stock is the AstraZeneca-Oxford variety, though it also possesses some Pfizer vaccines.)
Given that they have their own deals on top of their COVAX promises, wealthy nations are now understood to be treating COVAX stock as backups for their own stockpiles, with some humanitarian advocates asking them to commit to donating some of their national supplies to the mechanism once they hit domestic vaccine targets. But that approach has created alarming amounts of competition in the market for vaccines: At least one advanced country, Canada, has used COVAX and its own budget to secure enough vaccines for a population five times its size.
“COVAX itself is competing with rich countries to buy up a limited supply and that to us is the main problem,” Lusiani said.
Some poorer nations are similarly trying to secure vaccine deals outside of COVAX. One way to do so is through separate negotiations with the companies producing the drugs: Duke reports that large countries like Brazil and India have done that by touting their sizable production facilities, while smaller nations like Peru have reached deals to host clinical trials.
Some countries are leaning on political strategy: China and Russia are keen to boost their relationships abroad, particularly among U.S. allies, so governments like Pakistan and Hungary have turned to them, presenting the possibility of their vaccines being used rather than Western drugs as a diplomatic win.
This mishmash of approaches is unlikely to produce a comprehensive solution, however ― and it could lead to broken promises with deadly consequences as firms working with new technology fail to meet all the vast commitments they have made.
Instead, aid groups like Oxfam want a cohesive strategy that prioritizes vaccine delivery over corporate concerns like preventing other companies from learning how to make patented vaccines and securing the highest price from countries in a global bidding war.
“That’ll benefit all of us,” Lusiani said.