There’s a wild mess on the front lines of COVID-19 vaccines, with the EU discussing export bans and lawsuits to ensure accelerated supply in the coming months.
The other side: The back of the line probably extends to 2023 and beyond. Almost no low-income country has managed to start distribution seriously, and the total vaccinations across continental sub-Saharan Africa currently number in the tens.
Driving the news: The EU must approve a third vaccine tomorrow, from AstraZeneca. But European leaders are furious that initial supplies will be much less than anticipated.
- The EU is now putting pressure on the Anglo-Swedish company to supply it with doses produced in the UK – which had previously closed a deal – to make up for the deficit.
- The EU has managed to vaccinate only 2% of its collective population so far, against 11% in the United Kingdom. The scarcity forced Madrid to stop distribution, and Paris must follow suit.
- Brussels is considering banning the export of doses produced in the EU, including the Pfizer / BioNTech vaccine.
The current situation: The fact that rich countries are not only buying most of the supply of approved vaccines, but also struggling to implement them efficiently, bodes ill for countries that are waiting back.
- Some are paying a premium on smaller-scale bilateral agreements, usually for vaccines from China and Russia.
- The Economist Intelligence Unit (EIU) projects that vaccines will only be widely available in the world’s richest countries this year, while many others (Brazil, India, Egypt) will achieve widespread vaccination next year, and most low-income countries will wait until 2023 or beyond.
What they are saying: “What we are seeing now globally is not what we expected,” said Matshidiso Moeti, WHO regional director for Africa.
- “It would be profoundly unfair if the most vulnerable Africans were forced to wait for vaccines while low-risk subgroups in the richest countries are protected,” she said.
- Barry Bloom, professor of public health at Harvard, says it more bluntly: “Right now, it’s the law of the jungle.”
African health officials are waiting Distribution of the vaccine will begin across the continent in March, initially with about 3 million doses needed to cover healthcare professionals.
- The urgency is only growing as the number of cases increases on the continent and new variants are spreading. “The second wave is here with a vengeance and our systems are overloaded,” said John Nkengasong, director of the African CDC.
- The global COVAX initiative expects to cover 20% of the population in all countries by the end of 2021, and the African Union is trying to supplement this with additional requests.
- If all these pieces fit together, WHO says that 30–35% of Africans can be vaccinated by the end of the year.
What to watch: “To be successful, we need to reach the 60% target in two years. If we don’t do that, COVID will become endemic on the continent,” Nkengasong told reporters on Wednesday.
- The other side: NIAID director Anthony Fauci set a goal of 70-85% in the United States this summer.
- By the numbers: The US, EU, UK and Canada have purchased at least 2.5 billion combined doses, enough to vaccinate all of their residents (with two doses when needed) and still have about 1 billion left over.
The big picture: The outlook in rich countries depends in part on what happens in the poorest, as new variants of the virus originating anywhere in the world can cause new international outbreaks.
- “We are in an arms race, except that it is not an arms race, it is a race between vaccination and mutation,” Israeli Prime Minister Benjamin Netanyahu said this week at the Davos Agenda virtual conference.
Israel, who shot ahead from the rest of the world in terms of vaccinations, it is also on its way to receiving millions of overdoses.
- The government plans to cover the citizens of Israel and then “see what we can do for our immediate neighbors,” the health minister told FT.
- Israel has been criticized for refusing to provide vaccines to Palestinians living in the occupied territories, even though it has vaccinated Jewish settlers there.
EU periphery countries they also hope to access the remaining doses.
- Ukraine, for example, has so far only managed to sign a relatively small agreement for a Chinese vaccine of questionable effectiveness.
- Moreover, the country depends on COVAX and any agreements that can reach European producers and governments.
- The EIU places Ukraine among the countries likely to wait until 2023 for broad coverage, along with parts of South Asia, Central and South America, and almost all of Sub-Saharan Africa.
Canada guaranteed more doses in relation to its population than any other country, and is committed to donating those you don’t need to COVAX.
- But Prime Minister Justin Trudeau – while emphasizing “equitable distribution” – declined to say whether any donations will be made before Canada vaccinates its entire population.
Meanwhile, President Biden raised the hopes of global health experts and WHO by reviewing Donald Trump’s decision to reject COVAX.
- Bloom calls this a “new major factor”, although Biden has yet to make any specific commitments in terms of doses or funding.
- He expects world leaders to see the current dispute in Europe as an indication that a centralized and equitable structure is needed for global distribution. But, he adds, “I’m not optimistic”.
Go deeper: Israel’s COVID crisis deepens even as vaccination rate rises