Facing roadblocks, vast global vaccination effort gets underway

By Ruth Maclean

A long-awaited global sharing program designed to make vaccine access more equal began Wednesday, when hundreds of thousands of doses arrived in the West African nation of Ghana — the first of 2 billion that organizers hope to deliver worldwide this year.

The initiative, known as COVAX, was created so that poorer countries that struggle to buy coronavirus vaccines on the open market can get them for free. Officials said it is the largest vaccine procurement and supply operation in history.

But the inequalities remain grim. Despite promises of billions of dollars in funding from wealthy nations, COVAX still has a financing gap of $23 billion. While richer countries have managed to buy up vast reserves of vaccines and inoculate millions of people — including more than 44 million Americans and about 18 million Britons — poorer countries have been left behind.

As of last week more than 130 countries had yet to vaccinate a single person.

By trying to secure more vaccines for themselves, rich countries are undermining COVAX and prolonging the pandemic, the head of the World Health Organization said Tuesday.

“This is not a matter of charity,” said Dr. Tedros Adhanom Ghebreyesus. “It’s a matter of epidemiology.”

Many of the 92 countries that qualify to get free vaccines under COVAX are in Africa, where a new variant of the virus, first found in South Africa, is spreading through populations that may not get wide access to vaccines for years. The rise of new variants raises the risk that existing vaccines will be less effective.

And the need for mass inoculation has been highlighted by new studies showing that the spread of the virus has been much wider than official tallies show.

At least 1 in 5 people in Lagos, Nigeria, may have contracted coronavirus by October last year, according to findings just released by the Nigeria Center for Disease Control, an infection rate far higher than the one reported through the national surveillance system. A study in Accra, the capital of Ghana, released in November had similar findings. One from Zambia showed that undetected deaths from COVID-19 were common in the capital.

“This disease is in Africa,” said one of the Nigerian study’s authors, Professor Babatunde Salako. “We are having underestimation of our figures.”

These studies and others could drastically change how countries go about allocating vaccines, said Salako, director-general of the Nigerian Institute of Medical Research. For instance, those who have had the virus already may only need one dose of those vaccines that ordinarily require two.

Cost-savings like this may be vitally important, as countries cannot rely on COVAX to inoculate their entire populations.

Ghana, a nation of more than 30 million people, is expected to get enough vaccines from COVAX to cover only about 20% of its population by the end of 2021. It will have to separately buy millions more doses.

The distribution of vaccines has been “wildly uneven and unfair,” the United Nations secretary-general, António Guterres, said last week.

High-income countries are bidding so aggressively for the shots that they are not only hurting COVAX’s ability to buy doses, but impeding the execution of deals COVAX has already made, Tedros said.

Last week, the wealthy, industrialized nations known as the Group of 7 announced that they would intensify their cooperation with the international vaccination drive and raised their overall commitment to $7.5 billion.

That includes a pledge by President Joe Biden of $4 billion in U.S. aid and an additional $1.2 billion from Germany. But Tedros said the program remained $23 billion short of what is needed.

President Emmanuel Macron of France called for even more urgent action Friday, saying Europe and the United States should send up to 5% of their vaccine supplies to developing nations.

But even if things go according to plan, vaccinating most of the world’s poorest people this year will be a daunting challenge.

In some countries, there may be resistance to inoculation as a result of false rumors that have spread on social media and messaging apps.

Some claim that COVID-19 is not real and that vaccination campaigns are just a Western ploy to sterilize Africans. Others show people supposedly collapsing after receiving vaccines or, in one extreme case, depict a person turning into a horse.

“There are some rumors that there are a lot of side effects,” said Winfred Adrah, a 28-year-old software developer in Ho, in the Volta region of Ghana. “I’m not too confident about the vaccine. I wouldn’t want to take it now.”

Poorer countries do not pay for vaccines and injection devices under COVAX, at least for up to 20% of their populations. But they do have to pay the costs of distribution within their borders.

To receive vaccines, countries had to submit plans saying whom they wanted to immunize, how they would go about it and how they would monitor vaccinations. They also had to sign an indemnity agreement with the vaccine manufacturer.

Then they were allocated vaccines by a fair formula, according to the United Nations Children’s Fund, UNICEF, which has been planning the rollout along with the World Health Organization and other agencies.

“No country was prioritized,” said Benjamin Schreiber, UNICEF’s coordinator for the COVAX program.

Four countries eligible to apply for vaccines under COVAX did not do so: Burundi, Eritrea, Madagascar and Tanzania.

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