“We believe that it takes between 60% and 70% of the immunized population to break the chain of transmission.” These are the words of the chief scientist of the World Health Organization (WHO), Soumya Swaminathan. This collective protection against covid-19 could be achieved in a natural way by infecting all that proportion of the planet’s inhabitants with SARS-CoV2, the virus that causes the disease. But that would be a “very long” process and “would cost many lives”, has stressed in various forums.
A vaccine prevents both. And there are already two candidates in the final phase of approval to start being supplied. To ensure equitable access across the globe, Covax, a platform of rich and poor countries, was created in April to join forces in research, price negotiation and distribution. The objective of this alliance is provide the 187 partners with 2 billion vaccines in 2021, also to the 92 low and middle income who cannot afford to acquire them.
To ensure that countries without resources receive them in equal amounts and at the same time as the prosperous, the Covax Early Market commitment (AMC), a fund that draws on official development aid from donors, as well as contributions from the private sector and philanthropy to guarantee very affordable prices to the most precarious economies. This piggy bank already has more than 2,000 million dollars. The last 350 (of the 500 collected, including other concepts) came from the European Commission’s pocket with 120 million dollars (100, in euros), another 120 from France (100, in euros), 60 from Spain (50, in euros) and the Bill and Melinda Gates Foundation added 50 more (42.15 million euros), which announced these contributions at the Paris Peace Forum on November 13.
“This financing will allow Covax to reserve and access one billion vaccines for the economies eligible for this mechanism, and it will take at least another 5,000 million in 2021 to acquire doses as there are more in the portfolio,” they point out from Gavi (the Alliance World Cup for Vaccines). However, having the funds is not the only thing that guarantees vaccines for everyone. Oxfam reports that half the dose of the main candidates are already committed by contract with rich countries, which represent 13% of the world’s population. “This is far from resembling universal access, which is a right,” says Eva Iraizoz, from the Fundación Salud por Derecho. “It is essential that safe and effective vaccines reach everyone regardless of their economic capacity or the country in which they live,” he adds.
“There are many reasons why vaccines have to be fair, some are moral and others are self-interest,” he explains. Orin Levine, responsible for the distribution program of the Bill & Melinda Gates Foundation, in a video call. The first have to do with the fact that “we share a planet and access should not depend on the lottery where you were born.” The selfish ones are related to “stopping the circulation of the virus”, which, as the WHO specialist indicated, will not be achieved without a high rate of immunization coverage. “The world cannot completely return to normal, with the resumption of travel and commerce, until the acute phase of this pandemic ends,” they comment from Gavi by email. “No one will be safe until we are all safe,” emphasizes Levine.
There are many reasons why vaccines have to be fair, some are moral and some are self-interested.
Orin Levine, Bill and Melinda Gates Foundation
Faced with the argument that the number of cases and mortality has been lower in poor countries and it might not be necessary to vaccinate their populations, Benjamin Schreiber, UNICEF coordinator for covid-19 vaccines and deputy director of immunization programs, said denies. “We don’t really know what the disease burden is in many of them because the ability to test is limited. So it is not correct to say that they have less incidence ”. And he adds: “This is a pandemic, it affects everyone on the entire planet. It cannot be that the rich countries buy everything and the poor are abandoned ”.
Levine is optimistic that the 5,000 million will be raised to guarantee doses to the least developed. “In a very short time we already have two vaccines, it is an unprecedented scientific achievement,” he says. For this reason, he believes that humanity will be able to undertake and successfully complete a universal distribution like never before: “1 billion doses, for adults and for the entire planet”. “But there has to be a plan with attention to the details of who, how and where receives the vaccines,” he adds. As agreed, Covax aims to immunize first-line health workers and, second, vulnerable populations, Gavi remarks. “Those groups are at risk all over the world.”
This is going to pose a challenge in terms of availability, distribution and demand, the experts list. “We already have working groups with the countries to prepare for the arrival of vaccines: logistics, security and acceptance,” says the head of Unicef. The shortage is going to be a problem, Iraizoz says. “The current vaccine production capacity is limited and it is already known that we will not be able to meet global demand in the next two years.” In his opinion, the scope could be increased if companies shared patents and localized industries all over the planet, including middle-income countries. “But the richest have focused on the race to guarantee their doses from a nationalist and protectionist stance,” he warns. Schreiber is not so clear: “Building vaccine factories is not easy, pharmaceutical companies have to do it, so what we have to worry about is how to run and promote them effectively.”
The other stumbling block is distribution in countries with poor infrastructure. It is not only about transporting them, also to remote areas with difficult access, but about keeping them cold all the way. “Moderna’s presentation is kept at -20 degrees Celsius; that can be taken because there is already equipment for it, as is done with others that require freezing, such as polio. And we hope that soon there will be more announcements of effective vaccines and we will see if they are good options ”, explains the head of Unicef by phone. That of Pfizer-BioNTech requires a temperature of 70 degrees below zero, which makes its transfer more complicated, “but it is not impossible,” Schreiber qualifies. And not everything remains to be done. “Gavi and Unicef have spent years investing in the modernization of the cold chain. These resources are already in operation and will be used to store the covid-19 vaccines at the destination ”.
The covid-19 vaccine will face the usual challenges, with the added difficulty of the scale of the operation
Having the equipment and experience does not fully ensure that they reach everyone. Proof of this is that other vaccines are still far from acceptable coverage in the poorest countries. Despite the progress, innovations, knowledge and experience that have been accumulated in recent decades, especially since 2000, when Gavi, winner of the 2020 Princess of Asturias Award for International Cooperation, was founded. Covid-19 will face to the usual challenges, with the added difficulty of the size of the operation.
One of those common obstacles, which will be even greater in the fight against SARS-CoV2, will be obtaining the approval of the vaccine by the population. “There are a lot of people who are concerned about security. We don’t have to take it for granted that everyone is going to accept it, ”says Levine of the Gates Foundation. “Countries have to work with communities to explain the importance of wearing it and report possible effects, such as fever.”
UNICEF is already working on this, says Schreiber. This organization has extensive experience in the matter, since they already carry out this information and awareness-raising work, together with the governments and actors involved, in very complicated contexts to achieve the success of immunization campaigns in which they also support with specialized health personnel. With their help, polio was eradicated in India, where a large part of the population, predominantly Muslim – representing 22.6% – was refusing to vaccinate their children under the belief that the fevers caused by the vaccine were bad and that girls in the future could not get pregnant. With the covid-19 they are already thinking about how to tackle this challenge.
Digsmak is a news publisher with over 12 years of reporting experiance; and have published in many industry leading publications and news sites.