Asia behind in Covid vaccination: new type of vaccines needed

In populous countries like India, the rate is 36%; in war-torn Yemen, it is 1.2%. In percentage terms, only in Africa is worse. The storage of vaccines at low temperatures and the shortcomings of local healthcare systems are biggest factors. The solution could be the use of an oral or nasal spray that does not require refrigeration or the assistance of health workers.

Geneva (AsiaNews) – Globally, Covid-19 vaccination is running at two speeds, leaving developing countries barely immunized. International efforts such as the Covax initiative have tried to ensure vaccines for all, but with little result so far.

Highly populous Asian states have fully immunized about one in three citizens, and hundreds of millions of people have not received even one dose. Vaccination coverage is 23% in Bangladesh, 24% in Pakistan, 36% in India, 36% in the Philippines, and 37% in Indonesia. In war-torn nations the figure is dramatic: 1.2% in Yemen, just over 4% in Syria and 9%istry in Afghanistan. In percentage terms, the situation is worse only in Africa.

While SARS-CoV-2has spared no countries around the globe the response to the pandemic has significantly varied, exacerbating the disparities in getting access to healthcare. Thanks to a high vaccination coverage, rich countries have curbed down COVID’s death tolls and hospitalizations, and some like Spain can afford to keep most services up running with limited restrictions.

Even if the current state has recently degenerated it is nothing compared to last year with generalised strict lockdown measures. COVID19 vaccination was so impactful that some experts already suggest that the virus will soon become endemic. This means that as more people are vaccinated or infected, COVID would lose its virulence and severe cases will become rare like a seasonal flu.

In many developing countries, set aside the increasing hesitancy towards inoculation, any vaccine campaign could be a real ordeal even if they had plenty of doses: transportation, storage and administration are central obstacles to vaccine accessibility.

As parts of the world still face zero-dose children (children with not even a single dose of any vaccine), the administration of a full course vaccination for all, or for a large share of the population to reach herd immunity, is a sheer chimera. At best current COVID vaccines require a cold chain, with the most effective ones requiring up to minus 60 degrees Celsius for storage. Just impossible for many countries with poor electricity coverage and basic logistics.

Not to mention the number of health workers necessary to deploy mass immunization campaigns in countries with historical shortages of medical staff. Current COVID19 vaccines are effective and safe but they are fit for high-income countries’ contexts.

Any global COVID strategy relying only on current vaccines is short-sighted. If barriers to vaccination roll out are not surmounted any price’s reduction and even patent lift becomes worthless. New investments for COVID should go towards development of a new generation of vaccines, ideally an oral or nasal spray one which requires no refrigeration nor the assistance of health workers and with at least 12-month shelf-life. Such a vaccine will be suitable for the health system status of many poor countries.

In November, a task force on scaling COVID-19 was held among International Organizations including World Health Organization and COVID-19 vaccine manufactures, with the objective to ensure more equitable distribution of vaccines. The discussions were disappointingly limited only on how to supply more vaccines, how to tackle trade-related bottlenecks, how to diversify manufacturing, etc., without acknowledging many countries' health system weaknesses to support COVID vaccines campaigns in the first place.

This approach does not also consider the conflicting priorities of many countries ravaged by other compelling unresolved plagues as malaria and malnutrition to name a few. To fight COVID19 the international cooperation should simultaneously and massively invest in supporting health systems.

As the pandemic faces no borders, the situation in resource-constrained countries may jeopardise the endemization process itself due to the foreseen creation of new variants. A roadmap to end COVID19 should be inclusive of all countries and not driven by a few. Any pandemic will eventually come to an end. Today’s political choices will determine when and at what human (and economic) cost.

*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.

• covid-19
• asia
• vaccines
• doses
• pandemic
• virus
• cold chain
• economy
• africa