In 2021, not enough people will be vaccinated to achieve herd immunity. Over 15 billion doses will be needed to immunize the world. China and India plan to help poor countries, but only after their own citizens. Developing countries face logistical problems. The UN has its work cut out.
Geneva (AsiaNews) – As countries prepare to roll out historic vaccination campaigns against COVID-19, a large portion of the world’s population will be excluded, at least for some time. On January 11th, the World Health Organization (WHO) confirmed that not enough people will receive vaccine in 2021 to achieve the touted herd immunity.
On January 18th, WHO warned of “catastrophic moral failure” because of the unequal distribution of COVID vaccines. The statement came with no surprise: the COVAX initiative – launched by WHO itself and other international agencies to immunize people in resource-constrained countries – has committed to cover 20 per cent of population vaccinated by end of 2021. On Christmas day Pope Francis, wary of the global inequality in access to vaccines, had pled for authorities to make COVID-19 doses available to all.
As the first vaccine have been approved at record-breaking time and others will soon follow, the attention shifts to manufacturing capacity to meet worldwide demand.
To immunize everybody will require over 15 billion doses, assuming most vaccines need a double shot to be effective. Their price varies by more than 10-fold, from US$ 6.00 per course up to as US$ 74 per course. Their efficacy appears to vary significantly too.
According to the British Medical Journal the estimated manufacturing capacity by end of 2021 of lead companies will satisfy just one quarter of the global demand for doses, and high-income countries have already secured most of the supplies. With low- and middle-income countries accounting for about 85% of the world’s population, it is easy to imagine who will be left behind.
The largest stake is in Asia, which is home to more than half of the world’s population. China, the most populous country in the globe, has already approved multiple COVID vaccines for emergency use in the country.
Campaigns have started across the country and authorities aim to vaccinate 50 million people by mid-February. India, the second most populous country, on January 16th launched what is likely to become the largest vaccine campaign in history.
The authorities plan to administer 1.3 million shots per day and to reach 300 million citizens in eight months. India has reported more than 10.5 million coronavirus infections, the second-largest caseload after the United States, and 153,000 deaths, the world’s third-highest death toll.
In the effort to contain the COVID-19 pandemic, Asian countries will also play a critical role to meet the global vaccine demand. China seeks to position itself as the public health provider for the developing world and gain international recognition as Global Health leader after the harsh critics for not being able to control the initial outbreak. Chinese vaccine makers are therefore boosting their production capacity not only to meet domestic demand but also other countries’ demand.
Similarly, India has committed to make more than one billion doses available for the COVAX initiative to be distributed to low- and middle-income countries. As a reminder, India is already the leading global vaccine manufacturer, exporting vaccines to numerous countries.
Countries like Korea and Thailand will produce the AstraZeneca vaccine to meet national and regional demand. It is unclear though whether these countries will start to export doses before domestic doses are secured.
Doses availability is only the tip of the iceberg: even with unlimited free doses, weak national health systems will still struggle to immunize everybody. Vaccination campaigns require complex and efficient organizations: beyond the actual dose, one needs vials, syringes, freezers, refrigerators, cold boxes, carriers, transportation, trained staff, database, digital tools, etc.
The complex vaccine logistics will put further pressure to historical far-stretched health systems with scanty resources in low- and middle-income countries, and it is compounded by unresolved health issues such as malaria, HIV, tuberculosis, malnutrition to name a few.
Inequality in healthcare was already predominant and has been exacerbated by the pandemic. Even before the coronavirus stroke, at least half of the world’s population had no access to essential health services and goods, including vaccines.
Only a few months before the COVID-19 crisis began, the United Nations General Assembly adopted a landmark resolution on Universal Health Coverage aimed at ensuring equal access to quality health care everywhere at an affordable price for all.
The COVID-19 vaccination roll-out will be a stress-test for the resolution and states’ commitment as few affluent countries will be soon close to immunize almost their entire population and low-income countries with barely any dose.
The world has no choice but to increase international solidarity, international cooperation and action towards the achievement of health coverage for all. Ultimately, universal access to quality and affordable COVID-19 vaccine dose is everybody’s problem and everybody’s right since “we will only truly end the pandemic if we end it everywhere at the same time” as the WHO Director General pointed out.
*Head of Health Programme at the Terre des hommes Foundation. The opinions expressed in this article are the author's own and do not reflect necessarily the view of the organisation he works for.