As we wash hands and wear masks, we are counting on COVID-19 vaccination to be our escape route from this crisis.
Thankfully, effective vaccines are on the way. Now we must nail the other elements of this global vaccination challenge. We need money to purchase them and capacity to manufacture them in the required amounts; logistics to get them out and health systems to administer them.
We also need a commitment to equity.
This is not about platitudes. No nation is safe until vaccination coverage in other countries is adequate. Uneven rollout raises the spectre of more virus mutations, more travel bans and more lockdowns. We know the terrible economic and emotional consequences of this limbo. That should be our incentive to work together for a global solution.
But as the world’s richest countries accelerate progress, low- and middle-income nations are just getting out of the blocks. According to data compiled by the Duke Center for Innovation in Global Health, on average wealthier countries have ordered over three vaccine doses for every citizen while poorer countries managed just one dose for every two people. The People’s Vaccine Alliance estimates that 90% of people in poor countries will not be vaccinated this year. And the Economist Intelligence Unit calculated that at the current vaccination rollout rate, poorer countries won’t be back to normal until January 2024.
As UNDP Regional Director for Latin America and the Caribbean, Luis Felipe López-Calva, noted last week, here in Latin America and the Caribbean we are off to a slow start. By the end of January, Chile was the only country in this region to secure enough vaccines to potentially cover its entire population. Argentina, Brazil, Costa Roca, Ecuador, Mexico and Panama have also begun COVID-19 immunization campaigns, but so far, they have inoculated under one percent of their populations.
This month, the COVID-19 Vaccine Global Access (COVAX) will kick off the first phase of its vaccine delivery to 36 countries in this region. Using pooled investments, this World Health Organization (WHO) and GAVI mechanism aims to cover 20% of populations. One of three countries in our region is depending entirely on this COVAX solution. However, we need to vaccinate around 70% of people in each country to achieve herd immunity.
And so, Latin America and the Caribbean—the region that was first in the world to eliminate measles, polio and rubella—now risks being on the wrong side of the COVID-19 vaccination divide. We have the expertise and systems, but we do not have an even playing field to negotiate bilaterally with pharmaceutical companies.
We urge the world to learn the lessons of the HIV response. After a quarter century of the AIDS epidemic, treatment finally became available in 1996. But it took six years of activism around drug prices for medicines to become available in poorer countries. During that time millions of people died needlessly.
When lives and livelihoods are at stake, the profit motives of pharmaceutical companies must not trump all else. UNAIDS co-coordinates the People’s Vaccine Alliance, a coalition of global and national organizations and activists campaigning to ensure the COVID-19 vaccine is available to all, everywhere. We welcome governments, civil society and the people of countries being left behind to join the call for a People’s Vaccine.
COVID-19 vaccines should either be sold at affordable prices or be free of charge. Available doses should be allocated fairly. And there should be no monopolies in vaccine and treatment production. By receiving funding for research and development, research institutions and pharmaceutical companies should be made to commit to open sharing of intellectual property. UNAIDS is also advocating for increased investments in the Access to COVID-19 Tools (ACT) Accelerator, a global effort to develop and distribute tests, treatments and vaccines.
This work has already begun. Colombia, Mexico and Panama committed to fund the ACT-Accelerator. Together with WHO Director General, Dr Tedros, Costa Rican President Carlos Alvarado proposed the establishment of the COVID-19 Technology Access Pool (C-TAP). UNAIDS Executive Director, Winnie Byanyima has called this initiative to ensure the best COVID-19 science is made available as global public goods, “the most important multilateral solution we have on the table to unlock supply”. And several countries in the region supported a proposal at the World Trade Organization to waive traditional protections on COVID-19 intellectual property, allowing poor countries to make affordable versions of the vaccines.
Our survival as a region and a global community depends on an equitable global vaccine programme. COVID-19 won’t end anywhere unless it ends everywhere.
Dr César A. Núñez, Director, UNAIDS Latin America and Caribbean Regional Support Team