Since the arrival of the first COVID-19 vaccine in December 2020, there have been around 11 billion doses jabbed in people from 184 countries (track updated values here). While the overall numbers seem to indicate good global coverage, that value blurs the reality of the drastically unequal vaccine distribution seen worldwide. As the pandemic meanders on with the seemingly less dangerous Omicron variant (for more information here), the truth of the “pandemic of the vaccinated” reflects the importance of addressing the inequalities underlying vaccine distribution.
Unsurprisingly, these doses given worldwide tend to favor the richest nations, like the U.S. and Canada. At this point, the U.S. has around 64% of people fully vaccinated at 2 doses, 76% at 1 dose, and 28% with an additional booster. Canada’s rates are even higher, with around 85% with at least 1 dose, and 81% with both doses. These differences point to key factors between nations with no issues in vaccine availability that are easy to understand but difficult to measure, such as vaccine hesitancy and trust in medical research. A study reviewing surveys in 114 countries relating to vaccine hesitancy shows how hesitancy rates are an issue in many global regions, and although the U.S. is often highlighted for some of its people vocal hesitancy, the Middle East and North Africa (MENA) actually have the lowest rates of vaccine acceptance (see countries here).
However, the top end of vaccine distribution is not held by the U.S. or Canada. Countries like Cuba, UAE, U.K. and the EU have some of the highest doses per capita worldwide, possibly reflecting better performance on factors such as public trust in government and medical establishments, decreased vaccine hesitancy, and universal health coverage systems. All these nations scoring higher than the global average represent the barriers that exist beyond access for reaching maximal vaccination rates.
Access, however, remains the predominant barrier to vaccine distribution for countries scoring below the global average, even though vaccine hesitancy may later become the main barrier as access increases. The African continent has been one of the primary regions facing vaccine shortages, though there is a large variety. In the Central African Republic, only 17.9% of people have received at least one dose; in DR Congo, that value is only 0.8%; and in Rwanda, nearly 70% have received at least one dose.
Where does the issue lie? Finances are obviously a major component. In general, the wealth of a nation determines how many doses they can acquire, transport, and distribute. Another culprit is the intellectual property of the vaccines. Since African nations do not have the funds and complex transportation capabilities for importing and distributing the vaccines, the national production of a vaccine would overcome many of these barriers. The U.S The U.K, France, Germany, China, and Australia all produce WHO approved vaccines, facilitating the enormous quantities of vaccines needed to protect their people. No countries on the African continent currently produce an approved vaccine. While it may be easy to assume that less wealthy countries simply do not have the facilities to produce vaccines, this gross oversimplification neglects the main barrier: intellectual property.
African nations in general have the scientific manpower, laboratory equipment, and manufacturing capabilities. But without access to the intellectual property underlying the highly effective mRNA vaccines, African has been unable to provide a vaccine for itself. A group of 60 African charities banded together to demand access, as did a few prominent leaders, including Ethiopian biologist Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO (here is more about 7 of those leaders). While Modern and Pfizer have each spoken broadly about dropping patent enforcements during the pandemic, their desire for quality control have slowed their assistance in providing the training and manufacturing abilities to other nations (Reuters summary).
The most recent development has been under the global mRNA technology transfer hub initiative spearheaded by the WHO, where 6 African nations, namely Egypt, Senegal, Kenya, South Africa, Tunisia and Nigeria, received key mRNA information in February of 2022 (overview here). The hub’s goal is to provide manufacturing training and aid in the licensing process to these nations. With this support, South Africa’s WHO hub managed to create a Moderna vaccine manufactured by Biovac just this past Feb 4th, 2022, though it is still in trials.
Although vaccination rates are high in many countries and herd immunity is being achieved, this global pandemic will not end until all countries are protected. This is an encouraging first step in building the necessary framework for African vaccine production, though the efforts are still in the beginning stages. The global health perspective on the pandemic has highlighted the need to critically evaluate what underpins unequal access to vaccines in terms of financial and intellectual barriers. The value of education in reducing vaccine hesitancy represents another major hurdle in ensuring better global distribution actually means better global vaccine rates.
——————————–
Written by: Dominique
Edited by: María and Natasha
BioDecoded is a volunteer group committed to sharing accurate scientific information. For more information about vaccines and their safety profile, please see previous posts or consult with your personal physician. If you have any questions about this topic, please comment or send them to our email.
References:
More than 11.6 billion shots given: COVID-19 tracker, Bloomberg (2022). Available at: https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ (Accessed: 4 May 2022).
Sallam, M., et al., (2022) “A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review”, Journal of Multidisciplinary Healthcare, Volume 15, pp. 21-45. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760993/
List of vaccine producing countries with functional NRAs, WHO (2022). Available at: https://www.who.int/initiatives/who-listed-authority-reg-authorities/list-of-vaccine-prod-countries (Accessed: 4 May 2022).
Roelf, W.,In world first, South Africa’s Afrigen makes mRNA COVID vaccine using Moderna data. Reuters (2022). Available at: https://www.reuters.com/world/africa/world-first-safricas-afrigen-makes-mrna-covid-vaccine-using-moderna-data-2022-02-03/ (Accessed: 4 May 2022).
Six African countries to receive initial transfer of mRNA vaccine technology, African Development Bank – Building today, a better Africa tomorrow (2022). Available at: https://www.afdb.org/en/news-and-events/six-african-countries-receive-initial-transfer-mrna-vaccine-technology-49460 (Accessed: 4 May 2022).
7 Leaders From Africa Who Are Leading the Charge Against COVID-19 Vaccine Hoarding (2022). Available at: https://www.globalcitizen.org/en/content/leaders-africa-calling-out-vaccine-nationalism/ (Accessed: 4 May 2022).
Comments