As the number of countries that have authorized the use of a Covid-19 vaccine grows, many are sighing with anticipated relief. Yet now comes another challenge: how do we distribute vaccines safely and equitably to those most in need in our own countries and across the world?
We are in uncharted territory. According to Dr. Mike Ryan, director of the World Health Organization’s Health Emergencies Programme, one in ten people around the world may have been infected with the novel coronavirus. A Gates Foundation report reveals this deadly disease to have devastated the global economy and set back the United Nations’ Sustainable Development Goals by an estimated 20 years.
Without collaboration, the rollout of vaccines will be uneven and risks exacerbating inequalities and global tensions. No one is safe until we are all safe.
The good news is that the World Health Organization and international health partners have created the “Access to Covid-19 Tools Accelerator” (ACT-Accelerator) to distribute 2 billion doses of a vaccine, as well as 245 million treatments and 500 million tests by the end of 2021.
That is no small task. We need to share our funds, resources and expertise to increase production of lifesaving vaccines and train healthcare workers, while bringing costs down in a way that ensures no country is left behind.
The United Kingdom was an early supporter of COVAX, the vaccines pillar of the ACT-Accelerator. It has so far pledged over half a billion dollars to the initiative, with the bulk of this going to COVAX’s Advanced Market Commitment (AMC) to help developing countries access approved vaccines.
As of today, 189 economies have signed up or are supported by the facility, but more is needed. The UN has laid out a need of $38 billion in investments through the ACT-Accelerator to purchase vaccines, improve logistics and make sure countries are ready for vaccine distribution. This might seem like a lot. But it is a drop in the ocean compared with the UN-estimated $375 billion lost to the global economy every month that this pandemic rages.
In light of the investment needed for the ACT-Accelerator, the UK has led a match-funding initiative to the COVAX AMC –pledging £1 for every $4 invested up to £250 million — that successfully incentivized other countries to join in this global effort.
In his speech at the UN General Assembly this year, UK Prime Minister Boris Johnson set out a “5-point plan to protect humanity against another pandemic like Covid-19,” which emphasized the global need to develop manufacturing capacity for treatments and vaccines. We know this isn’t as simple as finding one vaccine that works for all — vaccines may have different effects on different populations.
They will also have different storage requirements, which will work better or worse in certain environments. Very few developing countries have capabilities to store doses of vaccines that need to be kept at minus 80 degrees Celsius, for example.
We also know that of the roughly 200 candidate vaccines in development, the vast majority could fail, based on what has been learned from previous vaccine clinical trials. The more vaccine candidates we have, the more likely we are to end the pandemic quickly.
That brings us to equitable access. If distribution is based solely on the ability of a country to purchase vaccines, treatments and tests at scale, poorer countries will be left behind and all of us will be less safe.
We know from previous efforts that distributing lifesaving treatments can highlight inequality built into the international system — just recall the experience of antiretroviral therapies for HIV/AIDS in the 1990s. After some wealthier countries did not take the threat seriously enough or make equitable access a priority, an epidemic surged across sub-Saharan Africa, which killed over 2 million adults and children in a single year at its peak.
We cannot make the same mistake with Covid-19. Collective action is what we urgently need — and this is not at odds with national interests. Quite the opposite.
We know that similar collaboration has worked in the past. This was how the world eliminated smallpox during the Cold War and how Africa eliminated the wild poliovirus earlier this summer.
Indeed, the last thing the world needs is hundreds of different vaccination campaigns. We are in a race against the virus, not between countries or companies.
Collective action is how we defeat this pandemic.
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