Soon, the ten-billionth Covid vaccine will roll off the production lines. By January, according to a recent report from the data research agency Airfinity, a tipping point will be reached when there will be enough vaccine doses for every adult on every continent. By June the number of doses will reach 27bn, enough to fully immunise the world’s population twice over.
But despite this manufacturing triumph, we are losing badly in the arms race to actually inject every adult in every country. Next summer, on current trends, more than half the world will remain unvaccinated. We simply aren’t getting doses out to the people who need them.
Until recently this was due to an understandable shortage of vaccines. But now there is a clear and inexplicable failure to distribute them equitably. Poor countries, which have injected just 2% of their adults, are being denied vaccines, while rich countries that have already fully immunised more than 60% of their citizens continue to monopolise access to doses. Thousands will die this month and for the foreseeable future, not because there are too few vaccines being produced but because they are being hoarded in the places that need them least.
The promise made by Boris Johnson, on behalf of the G7 club of advanced economies, that the whole world would be vaccinated during 2021 and 2022 currently has no chance of being honoured. More than 100 countries will now not meet the September deadline to inoculate even the first 10% of their population, and as things stand they have little chance of meeting the further December deadline to vaccinate 30%.
The World Health Organizaton’s Covax programme is the global bulk purchasing agency set up last year to ensure equitable vaccine distribution. But even though the G7 nations promised Covax in June that they would share 870m doses with the poorest countries, just 100m have been released to them, and overall only 4% of all vaccines produced worldwide have been channelled through Covax.
Our collective failure to turn the scientific success of the vaccines themselves into actual protection for all, and to avoid dividing the world into vaccine haves and have-nots, is a moral catastrophe. If the world were a state, we might well call it a failed one.
And we are in a race against time to turn things around. While countries with high vaccine coverage have broken the link between Covid cases and deaths, countries that cannot access vaccines see high case rates driving record hospitalisations and deaths. Unsurprisingly, African nations have registered their anger, with pleas this week from African leaders, the Mandela-inspired Elders group and African NGOs for vaccine equity. Concluding that they can no longer rely on the west’s promises, they set up their own bulk-purchasing agency, and are now intent on building their own vaccine manufacturing capability.
But there is a way forward. An emergency G7 vaccines summit chaired by President Biden should be convened on the margins of the UN general assembly to agree a comprehensive plan to transfer the west’s unused supplies and its over-subscribed vaccine delivery contracts to Covax.
We have more than enough vaccines to do this. Vaccine production is already at 1.5bn doses monthly, and will surpass 2bn per month by the end of the year. By then, we will have amassed more than 1bn unused vaccines. By mid-2022, that figure could pass 2bn.
Until recently, western leaders could defend holding supplies in reserve because they feared interruptions to the manufacturing supply chain. Now there is sufficient capacity to guarantee a rising flow of vaccines for the months ahead. So many doses are being produced that the bigger risk now is that millions may go to waste.
We could begin immediately. By the end of September western nations could release 500m vaccine doses, and another 200m each month thereafter. Under this plan, by mid-2022 every low-income country would have enough doses on hand to immunise 60% of its population, catching them up to rich nations’ current vaccination levels in less than a year.
Vaccine-rich nations don’t have to choose between boosters and donations either. By next year, North America and Europe could vaccinate their populations, including offering boosters and providing for all over-12s, donate to meet the needs of poor countries, and still have doses left over to cover most eventualities. And if China – the world’s biggest manufacturer – were persuaded to contribute to this effort, we could advance that target date by months.
The financial cost is small in comparison with the benefits in resumed employment, commerce and trade. Just $4bn (£3bn) is needed by Covax to cover its projected 2022 vaccine purchases. Comprehensive coverage – including therapeutics such as medical oxygen to save lives, and diagnostic equipment – would cost about $30bn a year. This is just 1.5% of the cost of Biden’s projected $1.9tn Covid stimulus, and, when shared between the advanced economies, eminently affordable.
Denying the world vaccines is self-defeating and will come back to haunt us. As the disease spreads among unvaccinated people, variants could emerge that threaten even our current vaccine coverage. Not only do the health and lives of countless millions hang in the balance, so does the sustainability of our worldwide economic recovery – and the possibility of lasting and inclusive prosperity.
England’s public health agency estimates that vaccination has saved 100,000 lives in England already. We have to ask ourselves whether Africa and the rest of the world will ever again trust us if people there continue to lose their lives from lack of vaccination. As Tedros Adhanom Ghebreyesus, head of the WHO, has said, vaccine equity has become the challenge of our times. It is also a test of whether the world can summon up the will to work together. We must.