Covid-19: Warning poorer countries will not be vaccinated until 2023 or later

Wealthy countries face a moral dilemma on whether to vaccinate all their adult populations, or vaccinate only those most at risk – and give spare supplies to poorer countries, according to WHO's Covid-19 special envoy Dr David Nabarro.

Addressing a meeting of the Joint Committee on Foreign Affairs on Tuesday, which was reviewing access to Covid-19 vaccines for low and middle-income countries, Dr Nabarro warned the world was at a tipping point as most poorer countries would not be vaccinated until 2023 or later, which meant the pandemic was far from being resolved.

He strongly endorsed deployment of the Covax programme, which enables poorer countries get vaccine at the lowest price, in combination with rich countries and pharma companies participating in WHO’s Covid-19 Technology Access Pool (C-TAP) without delay. It is a voluntary sharing of intellectual property (IP) rights, data, know-how and cell lines, allowing easier manufacturing of vaccines.

The committee heard only five EU countries have supported the initiative. Ireland has yet to join C-TAP but all committee members who addressed the meeting backed the move in response to a submission by Access to Medicines Ireland (AMI).

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Dr Nabarro said a global action plan backed by an administrative support programme “where the world comes behind poorer countries” was necessary, because the task was beyond individual countries.

“This is nowhere near the end. People say there is light at the end of the tunnel. I’m not sure how far that light is away. I have no idea how long it will take to reach the end of the tunnel,” he added.

Political action

Asked what position the Government should adopt, Dr Nabarro said political action was required "within the nation"; across the EU and through the UN Security Council, but there was also a case for securing the view of Irish people.

Politicians always wanted to help their constituents first, and in this case have as many of them vaccinated as quickly as possible. But perhaps, he said, the Irish population may be prepared to have high-risk people vaccinated first and for spare vaccines go to high-risk groups elsewhere – though the key question then becomes “what is spare?”

Dr Nabarro accepted there were vaccine supply shortages in Europe, putting huge pressure on EU countries, but did not believe manufacturers were hoarding supplies.

Dublin-based GP Dr Kieran Harkin of AMI said effective vaccines brought an expectation the pandemic could be brought under control, but "this is threatened by an inadequate supply of vaccines to facilitate a rapid global rollout".

He added: “Vaccine scarcity and slow rollout will ensure a prolongation of the pandemic as outbreaks re-emerge due to travel between and within countries. Even more worrying is the risk that variants of the virus will emerge which will be more infectious, more dangerous and be resistant to current vaccines.”

‘Artificial’

The current vaccine scarcity was “artificial”, he believed, and could be resolved by increasing production capacity globally.

More companies must license and share IP rights, know-how and technologies to enable others to produce the vaccines, added Dr Aisling McMahon, who is assistant professor of law at Maynooth university.

“It must be emphasised that the C-TAP will only be successful if more governments and companies support it...Global multilateral action is needed, and Ireland can and should be a leading voice on this,” she said.

Winnie Byanyima, executive director of UNAIDS, said "it seems the world has to learn again" – referring to the lessons from HIV-Aids, which resulted in the death of 9 million people in poorer countries because medicines were not distributed equitably.

“Big pharma have too much power in saying who gets the vaccine, when,” she said, “They are protecting their monopolies and IP. Some won’t share data until pressed to do so. Governments have that leverage.”

Charging double

It was not a problem of money, but of not enough vaccines being made, while some pharma companies were charging up to double the price for vaccines in poorer countries, she said.

Ms Byanyima agreed with the view a new “global apartheid” was emerging. “This is not only about justice for the poor. The longer this is not addressed, the longer that Covid remains unaddressed.”

She confirmed she had come to the view that Covid-19 was more devastating than HIV-Aids when economic impact was factored in, “even in countries with lower deaths”.