As Ireland celebrates reaching the important milestone of administering 1m doses of Covid-19 vaccines, it is vital we do not forget the millions of people in low-income countries for whom the vaccines are still beyond reach.
Data compiled by the University of Oxford paints a stark picture of inequitable global Covid-19 vaccine rollout, highlighting how the low-income countries are lagging far behind.
It shows the 1m doses administered in Ireland translates into one in five people vaccinated with at least one dose of a Covid-19 vaccine.
However, in countries where Goal works, the figure is a lot different. For example, in Sudan, only one in 1,000 people have had a vaccine; in Sierra Leone the figure is one in 122 people and in Malawi one per 100 people.
There are serious international efforts to ensure the vaccine reaches low-income countries. Leading on this is Covax, a global initiative backed by the World Health Organization (WHO). The Vaccine Alliance (GAVI) and the Coalition for Epidemic Preparedness and Innovation (CEPI) are also involved.
Since late February Covax, with support from governments, including Ireland through Irish Aid, has delivered 38m doses of Covid-19 vaccines to 100 economies in collaboration with vaccine manufacturers.
Despite Covax being the largest and most rapid global rollout vaccine initiative in history, it is no way near meeting what is needed to achieve global mass vaccination.
Covax’s target is to vaccinate 20% of the population of the countries it supports, most of which are low-and-middle-income countries. But this is far from the 70%-80% cover estimated to achieve herd immunity. And Covax is short of $2bn to meet its target of 20% coverage.
With support from Irish Aid and other donors, Goal is working with health authorities and communities to support vaccination efforts and prepare the countries we work in for mass vaccinations.
In Sudan we are ensuring the cold chain works in places like North Darfur, repairing or replacing fridges and solar panels. In Malawi, we are running awareness campaigns to counteract misinformation around vaccination, using our community-led action approach which we adapted from our Ebola response in West Africa.
However, currently there is simply not enough vaccine supply. The importance of vaccinating everyone, and not just in Ireland, is three-fold.
Firstly, the right to healthcare, treatment and prevention for all is enshrined in the Human Rights Declaration which all United Nations member states, including Ireland, have signed up to. People in low-income countries have as much of a right to life as those in Ireland, and to get access to Covid-19 testing, treatment and prevention, including vaccines.
Secondly, there is a scientific rationale. Only if we reach mass vaccination will we all be protected from Covid-19. Also, vaccination reduces transmission, and this lessens the risk of new variants of Covid-19 emerging.
Thirdly, with vaccination, we expect secondary impacts of Covid-19 to reduce. Covid-19 has caused devastation to people’s lives and livelihoods in Ireland, with a huge impact on mental health, and the education and wellbeing of our children and our most vulnerable citizens.
Goal has seen similar and often more severe impacts in communities in the 14 countries in which we work in Africa, the Middle East and Latin America. They do not have the safety nets we have in Ireland. Health, education, nutrition, food security, water and sanitation services have been undermined. Livelihoods have been destroyed and violence against women and children has increased.
Capacity to produce vaccines in countries like South Africa exists. However, the knowledge is not being shared by private pharmaceutical companies that hold the intellectual property rights of vaccines that have been developed, despite the fact that a large amount of public funding went into their research.
To address this, South Africa and India have proposed to the World Trade Organization (WTO) that it issues a temporary waiver for the intellectual property rights of treatments and vaccines against Covid-19. While supported by over 50 countries, most of them low and middle income, and in line with WTO’s own commitment, the proposal is opposed by the EU, USA and the UK.
The waiver, if granted, will not solve all of the supply problems, but would allow increased production and supply in low-income countries of Covid-19 vaccines, as well as treatments and much-needed PPE.
Pharmaceutical companies could also voluntarily put their Covid-19 patents for vaccines, diagnostics and treatments in the Covid-19 Technology Access Pool or C-TAP, launched by WHO and Costa Rica in May 2020 and backed by 40 countries. But this is not happening either.
There is another global initiative in the mix, Access to Covid-19 Technology or ACT Accelerator. This is backed by the WHO and partners, including the Bill and Melinda Gates Foundation, and aims to increase access to diagnostics, treatment, vaccines and to strengthen health systems.
At the 75th United Nations General Assembly last year, President Michael D Higgins called for open knowledge exchange on tools to combat Covid-19.
The Joint Oireachtas Committee on Foreign Affairs and Defence is also to be commended for a report released last month in which it called on the Government to endorse the C-Tap initiative to help achieve equitable global access to Covid-19 vaccines.
Solving Covid-19 vaccine supply is complex, but the international community and the pharmaceutical industry must come together and try harder. Lives depend on it.
As a people here in Ireland, we have always shown solidarity with those less fortunate. So let us remember again that, as the Irish man at the helm of WHO Dr Mike Ryan put it, “we are not safe until all of us are safe”.
- Dr Enida Friel is head of monitoring, evaluation, learning and accountability at Goal and vice-chair of Irish Global Health Network