/ 12 August 2021

No one is safe until everyone is safe: Equitable access to Covid-19 vaccines is not optional

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Hon. Dr Sibongiseni Dhlomo

As long as there are places in the world where Covid-19 continues to spread unabated, no one is safe. To date, Covid-19 has accounted for more than 190-million cases and four-million deaths, globally.  The gaps in the global health systems particularly between low and middle-income countries (LMICs) and high-income countries (HICs) continues to show, with some countries having secured vaccines for more than 100% of their population, while there are countries that have vaccinated less than 5% of their population.

Almost four-billion Covid-19 vaccine doses have been administered globally, and just above one-billion people have been fully vaccinated against the virus. Of the almost four-billion Covid-19  vaccine doses that have been administered, only 1.1% have been administered in LMICs. 

Last year, before any vaccines had become available, HICs negotiated deals to secure large quantities of doses, placing LMICs in real danger of not getting enough vaccines. The HICs sought large quantities because there was uncertainty around which vaccine candidates would work and how quickly they would be approved for use. At the start of the pandemic, the world witnessed several countries pushing for first access to a supply of these products and the hoarding of components for vaccine production increased. Gavi, the Vaccine Alliance, estimates that vaccine nationalism could lead to the unequal allocation of Covid-19  vaccines and cost the global economy up to $1.2-trillion a year in GDP terms. Even if some countries manage to immunise their populations against the virus, if it is not under control in all regions of the world, there will continue to be a global economic cost associated with it.

The African Union aims to vaccinate 60% of the continent’s population to reach herd immunity. So far, only about 1.5% of the population on Africa continent is fully vaccinated. The continent has received 82.7-million vaccine doses of which countries have administered 61.3-million doses.

In many higher income countries where vaccines are widely available, the number of Covid-19  cases has declined sharply, and life has begun to return to normal. Inequitable distribution of vaccines will continue to prolong the pandemic and cause more unnecessary suffering. The brunt of the pain resulting from inequitable distribution of vaccines continues to be felt by low- and middle-income countries. The Covid-19 burden on health systems is increasingly becoming unbearable, with hospitals becoming overstretched, medical oxygen supplies running out, and health workers becoming overloaded and fatigued.  LMICs are experiencing a serious negative economic impact due to Covid-19  that has claimed the lives of the young and the old, and gravely affected livelihoods due to lost sources of income.

As South Africa continues to grapple with the third Covid-19 wave and surges in some cases, the country has seen positive developments involving collaboration between the South African government and private sector. In October 2020, South Africa and India led the call for a waiver from certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement for the prevention, containment and treatment of Covid-19 at the World Trade Organization’s TRIPS Council, a call which was joined by Eswatini and Kenya.

The announcement of the collaboration between South Africa’s Biovac Institute and US pharma giant Pfizer represents a milestone in the battle for equitable access to Covid-19  vaccines. This collaboration will see Pfizer’s Covid-19 vaccine being produced in Cape Town by the Biovac Institute — a public-private partnership between the South African government and the pharmaceutical sector. This announcement follows an agreement made in November 2020 involving South African pharmaceutical company Aspen and Johnson & Johnson to manufacture an investigational Covid-19  vaccine candidate.

As South Africa moves forward to being involved in vaccine manufacturing, the African continent still needs to do more. The continent manufactures less than 1% of all the vaccines it uses.  There is a need to increase the vaccine manufacturing capacity of the continent. Governments need to invest more in vaccine manufacturing and in exploring partnership models with the private sector.

LMICs need to improve their vaccine manufacturing capacity, and it is important that high-income countries honour their commitments to donate vaccines to LMICs. HICs should also support the North-South technological transfer to ensure that capacity is built in LMICs and that there are sustainable vaccine manufacturing projects. The political leadership driving vaccine manufacturing discussions in the continent needs to be sustained.

As more vaccines reach countries in LMICs, barriers related to timely approvals of Covid-19 vaccines due to prolonged reviews by national regulatory authorities need to be addressed. Countries are encouraged to sign and ratify the African Medicines Agency (AMA) treaty, which will facilitate continent-wide co-operation on medicine regulation. — Hon. Dr Sibongiseni Dhlomo – Deputy Minister of Health, South Africa