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‘But while hundreds of millions of vaccine doses have been administered globally, there are deep disparities. In high-income countries, vaccine supplies are sufficient to provide for around one in four people, on average; in low-income countries, this figure drops to one in 500. At this point, it should go without saying that no one will be safe until we have made these cutting-edge technologies available to everyone. The longer we delay, the greater the risk that dangerous new variants will emerge.’ – An excerpt from the May 12, 2021 Project Syndicate published article ‘What it will take to overcome the pandemic’ by Palitha Abeykoon, Maha El Rabat, and David Nabarro.

According to a science information and analytics company, Airfinity, around 15 billion doses have so far been ordered from manufacturers to be delivered during the current year, and include those orders of vaccines yet to be approved.

In this regard, the situation in Pakistan also presents a very difficult reality, whereby even after assuming a perfect rollout scenario so that all the doses ordered for 2021 also get administered during the current year, only half of the adult population could be vaccinated on the basis of vaccines being order in 2021, since doses ordered per adult stood at one. At this rate, it is likely that even in the best-case scenario of vaccine availability and its rollout in the same year, it may take up till the end of the next year for even rolling out inoculation (on 2-doses per person basis) once, while as data on inoculation deepens it may indicate, as the thinking generally is when factoring in the slow pace of inoculation globally and the coming up of more dangerous mutating variants, that vaccine may cover for a number of months at most. For comparison, doses per person ordered by some other countries stand at Canada (13.1), the USA (6), Britain (10.3), Germany (7.7), Australia (8.7), Brazil (4.8), China (3.1), India (2.3), and Bolivia (7.3). Hopefully, better sense will prevail and vaccine hoarding will be made available to other countries, which have very low vaccine availability with them.

In terms of rollout up till now, vaccine inequality points out that wealthy countries have vaccinated a significant portion of their populations, while the developing countries are lagging far behind. In terms of percentage of adults who have been provided at least one dose up till now, the USA, for instance, stands at 63.6%, Canada (59.2%), Britain (70.5%), Germany (46.7%), France (41.5%), Spain (41%), China (29.7%), and India (16.2%). On the other hand, in most of Africa it is around 1-2%, with only a few countries in that continent going near the 10% mark. Similarly, in Pakistan, only 2.4% of the adults have up till now received one dose of vaccine, which means only 3.84 million adults have received one dose of vaccine up till now, while only 0.7% of the adults have received both doses.

The above situation highlights the serious shortage of vaccine production, and an acute level of its unequal distribution, which drastically needs to be enhanced through temporary removal of Intellectual Property Rights (IPRs) for the duration of the pandemic at least. The situation also highlights the stark nature of vaccine inequality – most vaccines being in the hands of rich countries, as highlighted on the basis of rollout up till now, and also given the status of pre-ordering. Indeed, the world needs a ‘people’s vaccine’, which is reached on the basis of open-source information sharing, and allowed to be produced without the hurdle of IPRs. In this regard, renowned economist Jayati Ghosh argued in her recent article ‘Next steps for a people’s vaccine’ that reaching a ‘peoples’ vaccine’ had become an essential must after ‘the rampage across South America and India’, with the additional serious issue appearing in the shape of ‘dangerous new variants’ given the underlying rapid spread of the virus.

Moreover, she argued: ‘Temporarily waiving IP rights is essential, but it is only the first step. … The next step is to push for concrete measures to facilitate the transfer of knowledge and technology. From Canada to Bangladesh, many potential vaccine producers with the required facilities have so far been denied the licences and technical know-how to proceed.’ Also, she indicated that there is a need for public production of vaccine for mass production, whereby ‘the case for public production becomes even stronger when one considers that private vaccine producers have little financial incentive to meet current global needs. Once the pandemic is contained, the demand for vaccines is likely to revert to much lower “normal” levels.’ Hence, overall, she argued that ‘the world desperately needs the TRIPS waiver and stronger measures to ensure the transfer of knowledge and technology to produce Covid-19 vaccines. But we also need to start preparing for equally exceptional circumstances in the future. The knowledge on which our health and prosperity depend must be both publicly funded and publicly disseminated.’

Important steps pertaining to making vaccine available globally, and in much quicker timelines that are being reached currently include urgent planning on such aspects of the vaccine as aptly discussed in his article ‘Vaccine licencing, production, and global distribution’ by Nobel laureate in economics, Michael Spence, who pointed out in this regard: ‘Although much of the current Covid-19 vaccine debate is focused on the question of waivers for intellectual-property rights, the transfer of knowledge and technology is only the first part. Equally important are global manufacturing capacity and pricing, either of which could still pose a problem.’

About the first hurdle in the way of mass production in the shape of licencing, he argued: ‘Of course, an important variable is what, exactly, is being licensed. Are we talking about the chemical composition of the drug itself, or does the license extend to all of the technology embedded in a scaled-up production process? Increasing global production would most likely require both.’ Next, regarding manufacturing capacity and pricing of the vaccine, he argued: ‘…the point is that even if the IP issue can be resolved, manufacturing and distribution will remain binding constraints, alongside a third key variable: price. … The fairest way to think about this is to base prices on the per capita income of the country whose government is buying the vaccines … an international institution like the United Nations ideally would negotiate for and buy large quantities of vaccines for distribution to countries below a certain income level.’

He pointed out: ‘The Covid-19 Vaccine Global Access (COVAX) facility, launched in 2020 by the World Health Organization, Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations, is intended to do this, with funding from advanced economies. It is a good idea and should be retained. But while it has made progress in acquiring and distributing vaccines, it is underfunded and subject to the same supply problems (vaccine nationalism, licensing requirements, and manufacturing bottlenecks) as developing countries typically face.’

It is important that these issues are dealt with at the earliest possible, and Covid vaccine is made available in a much better way than it has been up till now. This is because, firstly, rich countries with high inoculation rates could still fall prey to rising dangerous mutations appearing due to rapid Coronavirus spread in mainly developing countries where the vaccine rollout rate is very low, primarily on the back of practice of ‘vaccine nationalism’ by rich countries. Hence, even before anything else, this is in rich countries’ own advantage to undo this practice, because ‘no one is safe, unless everyone is safe’.

Secondly, higher inoculation rate in advanced countries has meant rising difference between the economic recovery rate of the advanced countries and developing ones as International Monetary Fund (IMF) highlighted this as the ‘great divergence’ in one of their recent flagship reports. An article ‘The great divergence: a fork in the road for the global economy’ published on IMFBlog pointed out in this regard the following: ‘Most of the world is facing a slow rollout of vaccines even as new virus mutations are spreading—and the prospects for recovery are diverging dangerously across countries and regions. Indeed, the global economy is at a fork in the road. The question is: will policymakers take action to prevent this Great Divergence?

This also raises the concern that developing countries meeting stimulus needs over many months now, along with expenditure made in health sector during the pandemic, coupled with a heavy backlog of debt in many of the developing countries in the first place, could all lead to a ‘global debt pandemic’. Such defaults could create a great global economic disruption.

(The writer holds a PhD in Economics from the University of Barcelona; he previously worked at the International Monetary Fund)

He tweets@omerjaved7

Copyright Business Recorder, 2021

Dr Omer Javed

The writer holds a PhD in Economics degree from the University of Barcelona, and has previously worked at the International Monetary Fund. His contact on ‘X’ (formerly ‘Twitter’) is @omerjaved7

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