Poor and middle-income countries, largely unable to compete in the open market, have a complex vaccine sharing scheme called Covax. A collaboration of international health organizations, Covax was designed to avoid the injustices of a free market for all. But their deals come with restrictions, and health advocates are questioning their transparency and accountability.
By the middle of next year, South African authorities hope to secure their first doses of vaccine under Covax, even as they negotiate the purchase of supplementary supplies from drug makers. But in a country where luxury properties are isolated from invading villages, many hope that the newest vaccines will remain a privilege for residents who can afford to pay out of pocket or through supplementary insurance – a program that disproportionately benefits whites.
“You can go into the local private pharmacy, pay a few hundred rand (about $ 15) and say, ‘Hit me, baby,'” said François Venter, a researcher at the University of Witwatersrand in Johannesburg.
‘Maybe we will get the vaccine in 2025’
The best chance many South Africans have of getting vaccinated soon is to volunteer for a clinical trial and test unproven vaccines on their bodies. But this arrangement raised ethical questions.
The first is whether countries like South Africa, which is supporting tests with four drug manufacturers, should have guaranteed doses if the tests are successful. The government did not receive this guarantee. And, in any case, such an arrangement would be ethically obscure, since it would punish countries that participated in unsuccessful trials.
This month, as Britain was preparing to start its vaccination campaign, dozens of people walked from their shacks in the municipality of Masiphumelele, south of Cape Town, to the gates of the Desmond Tutu Health Foundation.
They waited outside for hours, under the shade of a gum tree, for a chance to enroll in a Johnson & Johnson vaccine clinical trial.