It’s a wild fight at the beginning of the COVID-19 vaccine line, the EU is discussing export bans and legal action to ensure its supply is accelerated in the coming months.
Flipside: The back of the line probably extends to 2023 and beyond. Almost no low-income country has managed to start distribution seriously, and total vaccinations across mainland sub-Saharan Africa now number in the tens.
News management: The EU is expected to approve a third vaccine tomorrow from AstraZeneca. But European leaders are angry that the initial supply will be much lower than anticipated.
- The EU is now pressuring the Anglo-Swedish company to supply it with doses produced in the UK – which reached an agreement earlier – to make up for the deficit.
- The EU has so far managed to vaccinate only 2% of its collective population, compared to 11% in the UK. The lack has forced Madrid to stop distribution, and Paris is to follow suit.
- Brussels is considering banning exports for doses produced in the EU, including the Pfizer / BioNTech vaccine.
Game status: The fact that rich countries not only buy most of the supply of approved vaccines, but also struggle to deliver them effectively, is bad for the waiting countries.
- Some pay a premium in smaller-scale bilateral agreements, often for vaccines in China and Russia.
- Economist Intelligence Unit (EIU) projects that vaccines will be widely available only in the richest countries this year, while many others (Brazil, India, Egypt) will reach large-scale vaccination next year, and most countries with low incomes will wait until 2023 or beyond.
What are they saying: “What we see now globally is not what we hope for,” said Matshidiso Moeti, regional director for WHO Africa.
- “It would be deeply unfair if the most vulnerable Africans were forced to wait for vaccines, while lower-risk subgroups in richer countries are safe,” she said.
- Barry Bloom, a professor of public health at Harvard, says more clearly, “Right now, it’s the law of the jungle.”
African health authorities hope Distribution of the vaccine will begin across the continent in March, initially with about 3 million doses needed to cover medical workers.
- The urgency only increases as the number of cases increases on the continent and new variants spread. “The second wave is here with revenge and our systems are overwhelmed,” said John Nkengasong, director of the African CDC.
- The global COVAX initiative hopes to cover 20% of each country’s population by the end of 2021, and the African Union is trying to supplement it with additional orders.
- If all these pieces fall into place, the WHO says 30-35% of Africans could be vaccinated by the end of the year.
What to look for: “To be successful, we must reach a 60% target within two years. If we do not do this, COVID will become endemic on the mainland,” Nkengasong told reporters on Wednesday.
- The other side: NIAID Director Anthony Fauci has set a 70-85% target in the US by this summer.
- By numbers: The US, EU, UK and Canada have purchased at least 2.5 billion combined doses, enough to vaccinate all their residents (with two doses where needed) and there are about 1 billion left.
The whole picture: Prospects in rich countries depend in part on what happens in the poorest, as new variants of the virus coming from anywhere in the world could eventually 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 ran ahead from the rest of the world in terms of vaccinations, it is also about to have millions of overdoses.
- The government intends to cover the citizens of Israel and then “see what we can do for our immediate neighbors,” the health minister told the FT.
- Israel has been criticized for refusing to offer vaccines to Palestinians living in the occupied territories, even though it has vaccinated Jewish settlers there.
Countries on the periphery of the EU he also hopes to access the remaining doses.
- Ukraine, for example, has so far managed to sign only a relatively small agreement for a Chinese vaccine of questionable efficacy.
- In fact, the country is dependent on COVAX and any arrangements it can reach with European producers and governments.
- 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 has secured more doses than its population than any other country and is committed to donating to those who do not need COVAX.
- But Prime Minister Justin Trudeau – while emphasizing “fair distribution” – declined to say whether donations will be made before Canada vaccinates its entire population.
Meanwhile, President Biden raised the hopes of global health experts and the WHO by reviewing Donald Trump’s decision to reject COVAX.
- Bloom considers this to be a “major new factor”, although Biden has not yet made any specific commitments on dosages or funding.
- He hopes that world leaders will 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 is deepening even as the vaccination rate increases