Over two years since the first cases of COVID-19, the world is still coming to terms with the virus. While vaccines have been developed and rolled out in record time in high-income countries, the developing world risks falling behind. Less than ten percent of the African continent has been vaccinated, for example, and more booster jabs have been admitted in rich countries than first doses in poorer ones.
This disparity not only has a health impact on low- and middle-income countries (LMICs), but also foments new variants of the virus, such as Omicron, which transmit globally. Moreover, there is an economic cost, with a recent report by the International Chamber of Commerce warning that letting the developing world fall behind could cost the global economy USD 9.2 trillion.
At a 20th January 2022 FT Webinar entitled ‘Is Vaccine Nationalism Undermining the Global Economic Recovery? Bringing the pandemic to an end in 2022’ high profile representatives from global financial institutions, NGOs, and the pharmaceutical industry weighed in on the dangers of vaccine disparity and what needs to be done to fix it as soon as possible.
A USD 12.5 Trillion Hit
From a financial perspective, Managing Director of the International Monetary Fund (IMF) Kristalina Georgieva began by pointing out that USD 12.5 trillion in global economic output will be lost due to COVID by 2024, a figure that the IMF will upgrade thanks to the emergence of the Omicron variant. This figure far surpasses the comparatively modest sum of USD 50 billion that the IMF estimates will be enough to ramp up vaccination efforts in all poorer countries to sufficient levels.
Georgieva added that vaccine disparity is endangering two decades of convergence between richer and poorer nations, putting more and more people into poverty. Winnie Byanyima, executive director of UNAIDS developed this point, noting that 160 million people have dropped into poverty in the last two years and that COVID deaths and hospitalisations are just a small part of the health picture with more women now dying in childbirth and more children dying of preventable diseases in LMICs due to reduced access to healthcare.
Making Billionaires or Vaccinating Billions?
In terms of how we reached this level of disparity – which the ONE Campaign’s Gayle Smith called “a moral obscenity, public health catastrophe, and economic folly” – the panel pointed fingers at both Western governments and the pharmaceutical industry. Smith argued that there needs to be better coordination and more resources put on the table from governments and that pharma companies, despite developing “extraordinary” vaccines, were suffering from a failure of imagination and addressing COVID as if it was a normal problem.
Byanmina went even further, claiming the emergence of a “narrow, self-defeating nationalism” in which humanity’s fate has been left in the hands of pharma companies more intent on “making billionaires than vaccinating billions,” highlighting the huge financial windfalls received by executives at companies like Pfizer and Moderna off the back of their vaccines. She added that Moderna in particular “turned its back on the African continent” for a year and a half and was only now beginning to change its attitude.
Industry Response: “A Different Story”?
Responding to these accusations, Moderna’s Chief Legal Officer Shannon Klinger admitted that her firm had been slow to react and had initially prioritised higher income countries due to the advanced purchasing agreements struck but that “the story is different now.” She stated that Moderna is now the largest single vaccine supplier to GAVI/COVAX and plans to supply one billion doses to LMICs in 2022.
Klinger did push back against some of the criticisms, pointing out that the African Union had actually rejected some doses from Moderna and that while the firm already has 700 million doses waiting to go in warehouses, the supply of vaccines in people’s arms is a problem that NGOs, governments and businesses need to solve collaboratively.
Pushed on whether the pharmaceutical industry was doing enough in terms of technology transfer to LMICs, especially in Africa, Klinger pointed to Moderna’s USD 500 million commitment to African manufacturing and the establishment of fill-finish facilities on the continent by 2023.
However, Smith countered that such timelines were indicative of the industry’s slow response to the pandemic and that if these discussions had been had at its outset, we could be almost two years ahead. She also highlighted the lack of a global plan for booster shots as indicative of short-termist thinking among governments.
Transformational Thinking Needed
Looking forward, all the panellists were united in their call for immediate action. Smith suggested that potential innovative solutions could involve pharma companies coming together and agreeing on a common price for vaccines, making advanced commitments to collective vaccine reservation for LMICs, or making commitments to manufacturing in LMICs over time.
Byanmina – drawing on the oft-quoted definition of insanity as doing the same thing over and over and expecting different outcomes – called for more “transformational thinking” across both the rich world and LMICs as well as an investment in building capacity and capability for future pandemics.
Finally, the IMF’s Georgieva stated that 2020 was the year of scientists, those who developed effective vaccines in record time; 2021 was the year of production; but that 2022 must be the year of delivery of these vaccines more globally.