December 30, 2021
Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation (WHO), has led warnings from global health bodies that developed nations must do more to achieve ‘vaccine equity’ in 2022 – or face a prolonged and uncertain recovery from the pandemic.
In particular, Tedros called for governments of rich countries to prioritise access to vaccination in poor countries over the roll-out of third doses of the vaccine, known as ‘boosters’, to low-risk groups. The WHO Strategic Advisory Group of Experts on Immunization (SAGE) expressed concern that focusing on boosters in rich countries will exacerbate vaccine inequality, and make further variants more likely.
“Blanket booster programmes are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate,” said Tedros. This warning echoes calls from the WHO earlier this year for a moratorium on booster doses until minimum vaccine coverage levels had been met in each country. The WHO was arguing for 10% in each country by the end of September, and 30% by the end of the year. In fact, the full-vaccination rate is currently 4% averaged across low-income countries, and 8% in Africa.
According to Gordon Brown, the WHO ambassador for global health financing, these figures are “a grim reproach that we appear to value human life in the south far less and far more cheaply than in the north.” He added that allegations from rich countries of ‘vaccine hesitancy’ in the Global South amounted to blaming the victim, as most stock of available vaccines was bought up quickly by the US, UK and EU as soon as it became available. As a result, of the billions of doses administered so far, over 70% have been administered in high-income countries, and 0.6% in low-income countries, far out of proportion with the share of global population.
This discrepancy obscures that fact that enough vaccines are available to immunise everyone. According to Tedros, enough vaccines were administered in 2021 for all countries to reach the vaccination coverage target of 40% by September, but due to “distortions in global supply”, only around half of the WHO’s member nations did. Global health authorities are concerned that the same pattern may repeat itself in 2022. The WHO forecasts that 19.8bn doses of vaccine will be available by June, enough to fully vaccinate the entire global adult population, but, crucially, only if boosters are delayed until the second half of the year. Tedros acknowledged the responsibility of all nations to protect their own citizens, but argued that global coverage was in the interests of all.
For health officials, the sudden emergence and rapid global spread of the Omicron variant is a perfect case in point of the consequences of uneven vaccine coverage. “No one is safe until all of us are safe,” said Olivier De Schutter, UN Special Rapporteur on extreme poverty and human rights, introducing a high-level UN export report in November. “Any other approach which disregards human rights will be counter-productive in our interconnected world, and will increase negative impacts and risks, including the emergence of new variants, such as Omicron, which may render existing vaccines less effective.”In his final briefing of 2021, Tedros underlined the choice facing the world. “As we approach a new year, we must all learn the painful lessons this year taught us. 2022 must be the end of the COVID-19 pandemic. But it must also be the beginning of something else – a new era of solidarity.” The alternative is the risk of further variants, bringing with them further uncertainty, injustice and disruption.
