At the United Nations General Assembly (UNGA) in 2019 – practically on the eve of the COVID-19 pandemic – all countries committed themselves to the global development goal of universal health coverage (UHC), meaning all people across the world should receive health services according to their needs.
In the case of vaccines for infectious diseases, this should mean the most vulnerable – those most at risk of suffering serious adverse health impacts – would receive vaccines first, while those not needing vaccines urgently would go to the back of the queue. Little did the world then know that these principles of fairness and equity would be put to the test so quickly, or that the global community would fail so dismally in living up to them.
It is perhaps inevitable that national leaders would try to protect their own vulnerable populations first and then scale up coverage of other groups, but current levels of vaccine inequity indicate an almost complete indifference by rich countries to vaccinate high-risk groups in developing countries.
According to the latest World Bank data, around 70 per cent of the population in high income countries have received at least one dose compared to only two per cent in low income countries, and millions of health workers risk their lives on a daily basis because they are totally unprotected.
Monumental policy failure
As argued by several former world leaders, Nobel laureates and all the major UN agencies, this represents a monumental policy failure which is prolonging the pandemic, inhibiting global economic recovery, and risking a further wave of infections from new variants of the virus – and it is morally indefensible.
In the UK, performance has been particularly poor. Despite UK prime minister Boris Johnson hosting the G7 in June, latest figures show the UK is one of the worst performers in meeting commitments made then to redistribute vaccines from its ever-expanding stockpile. To date, the UK has sent only six million vaccines to the COVAX facility whose specific purpose is to send vaccines to the neediest populations across the world.
Now COVID-19 plans recently announced by the UK prime minister further tarnish the country’s reputation as a global health leader – especially the offer of booster vaccines to everyone over the age of 50 by the end of 2021.
Whereas there might be an arguable case for boosting protection for the most vulnerable – elderly and high-risk groups – the case for offering third jabs to the general population is unproven and quite possibly unnecessary at this stage. It appears the decision to boost protection for a sizeable proportion of the voting population before Christmas is driven more by politics than science.
The opportunity cost in using up these precious commodities rather than sending them to COVAX for onward distribution will potentially mean the deaths of tens of thousands of people in developing countries. Dr Mike Ryan, the World Health Organization (WHO) chief epidemiologist fighting the pandemic, has said: ‘We’re planning to hand out extra life jackets to people who already have life jackets, while we’re leaving other people to drown without a single life jacket’.
Delay the booster programmes
An inefficient use of vaccines also risks new variants developing and spreading, plunging the world back into ruinous lockdown. As the WHO Director General highlights, the world’s population is much better served by the UK and the other G7 countries sending excess vaccine stocks to COVAX immediately and delaying general booster programmes until it is proven conclusively they are needed – likely to be in 2022 at the earliest.
After the G7 summit failed to take any meaningful action in overcoming global vaccine inequity, there were hopes that a special vaccine summit announced by US president Joe Biden would take this agenda more seriously. But whereas the US pledged to double its commitment to donate vaccines to 1.1 billion doses and the European Union (EU) increased its contribution to half a billion jabs, Boris Johnson declined to make further pledges beyond those made in Cornwall which the UK is already failing to deliver.
Furthermore, in his speech to the United Nations (UN) focused on climate change, the UK prime minister barely mentioned COVID-19 and did not refer to vaccines at all. This could not have gone down well with leaders whose most pressing priority is to save the lives of their population in the pandemic.
Such insensitivity also undermines the overall message of the UK prime minister’s speech, that the world needs to work collaboratively to combat the climate emergency. In failing again to show greater solidarity in the current global crisis, what creditability will Johnson have chairing the COP26 climate summit in November when he must demonstrate global leadership in tackling the next existential threat?
Robert Yates, Director, Global Health Programme; Executive Director, Centre for Universal Health.