A year ago, the World Health Organisation (WHO) declared the Covid-19 outbreak a "global pandemic." The virus spiralled out of control and spread across borders at breathtaking speed, becoming the biggest health crisis the world has faced in over 100 years. The pandemic also constituted a global crisis that shook the world's social, economic and political foundations. It revealed gaps in health and economic systems around the world and weaknesses in even the richest countries and the strongest health systems. On the first anniversary of the declaration of the coronavirus as a global pandemic, the world finds itself confronted with a mixed bag of achievements and failures. So far, about 2.7 million people have died due to the pandemic. It is estimated that the economic recession caused by it will be twice as bad as the global financial crisis of 2008. In many countries around the world, from Europe (such as Sweden) to South America (such as Brazil), the response to the pandemic has been framed as a choice between health and the economy, which has led to adverse health and economic consequences. But the world has also developed at unprecedented speed a number of vaccines against the virus. Yet, this achievement has been marred by an irresponsible "vaccine war" between rich countries that have imposed restrictions on exporting vaccines outside their territories in a disturbing embodiment of "vaccine nationalism". Last February, the US announced it would not export any doses of the vaccines until it had ample supplies. Days later, India cracked down on vaccine exports. As for Britain and the European Union, they went into a fierce war over vaccine protectionism amid accusations from Brussels of London's preventing the AstraZeneca company from fulfilling its commitments to Europe and giving priority to Britain. This prompted the European Commission last week to place restrictions on vaccine exports outside Europe. All of this puts extra pressure on Covax, or Covid-19 Vaccines Global Access, a global initiative aimed at equitable access to Covid-19 vaccines led by the WHO, UNICEF, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations. For Tedros Adhanom Ghebreyesus, director general of the WHO, the last 12 months have been a mixed bag of the good, the bad and the ugly. He explained to the Weekly that the world had been able within less than a year to develop several effective vaccines, which was testimony to human determination. Never before have vaccines against a new pandemic been developed so quickly, but there were still major challenges in fair production and distribution. Few drug companies around the world have the know-how necessary to produce the vaccines, and few companies have the capability of producing the vaccines, which makes supply in global markets much less than global demand. "We proposed accelerators as endgames for this pandemic and with two objectives. The first is to accelerate the development of vaccines. The second is fair distribution. On the first objective, accelerating the development of vaccines and other products, the success is there, as the world can see. We have many vaccines in less than a year after the discovery of the new virus. On the second objective, fair distribution, I can say that we are limping," Tedros told the Weekly during a lecture at the London School of Economics in the UK by Zoom to mark the first anniversary of the global pandemic. "We have a target to start vaccination in all countries before 7 April, but that has been challenged. Even those countries that have started vaccinations need to get a constant flow of vaccines, which is another challenge. And the thing which can show you the divide between the haves and have nots is that the target for Covax is to vaccinate around 20 per cent of low-income countries by the end of 2021, while the target for many high-income countries is more than 80 per cent by the summer. Imagine a gap of between 20 and 80 per cent. So, the equity problem is there," Tedros added. Although Covax aims at vaccinating only 20 per cent of the population of low-income countries by the end of 2021, the programme faces a deficit of up to $2 billion to achieve that goal. Some of the world's poorest countries have been warned to expect delays in the delivery of Covid-19 vaccines through the Covax programme after a double blow of slower-than-expected production at a South Korean manufacturing plant and setbacks in securing export licences from the Indian government, UNICEF said. Up to 90 million doses of the AstraZeneca vaccine may be affected by the twin issues, which came after reports that India had put a temporary hold on vaccine exports amid a rise in new cases. Some of the countries expecting doses through Covax over the next week are South Sudan, Mauritius, Iraq, Bosnia and Herzegovina and Yemen. UNICEF said it was not immediately clear how those deliveries would be affected. "The Covax facility has informed participants allocated volumes of the vaccine produced in South Korea that shipment volumes will be lower than planned in March," a spokesperson said. Deliveries will also be affected because of problems regarding licences. The United States, Britain and the European Union have rejected a proposal made by countries such as India and South Africa to waive intellectual property rights for Covid-19 vaccines. "We have already proposed concrete ideas. One is voluntary licencing. And the other option we have is the provisional waiver of intellectual property because we are in unprecedented times. I would actually concentrate on the waiver of intellectual property. If we cannot waive intellectual property now, then when? Why did we even have the provision in the first place in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) if we cannot use it during this time," Tedros asked. At the current rates of spread of the virus, the rest of the world cannot continue to wait for drug companies around the world to produce enough vaccines. According to WHO, there is a tried-and-tested solution, as during the earlier HIV/AIDS pandemic, the World Trade Organisation (WTO) approved a licencing model that expanded access to affordable medicines and compensated major pharmaceutical companies for lowering drug prices. Globally, about 450 million people have received vaccines against Covid-19 in 128 countries, including about 112 million people in America and 77 million in Europe, including 30 million in Britain and the rest in India, China and Russia. The rest of the world has received hundreds of thousands of vaccines through the Covax programme. "We need to increase production capacity and to encourage investment in local production in the developing countries as well. For the long term, there are recommendations that we are now making. But how serious we are for the future will be measured by the action we take now, especially the waiver of intellectual property that is in our hands," Tedros concluded. *A version of this article appears in print in the 1 April, 2021 edition of Al-Ahram Weekly
