COVID-19: Why Poor Countries May Have to Wait Years to Vaccinate Their Citizens

The Economist/

As a second wave of coronavirus infections sweeps through Europe, and America continues to break daily records for new covid-19 cases, the need for a vaccine is more urgent than ever. Pharmaceutical companies are racing to bring a viable drug to market. And this week came a bright ray of hope. On November 9th Pfizer and BioNTech, two drug firms, announced that their experimental covid-19 vaccine was more than 90% effective in initial trials. But there is a long way to go before vaccines are available in sufficient quantities to immunise the entire world. Little wonder, then, that countries are scrambling to secure supplies of vaccine candidates, even before their safety and efficacy have been established.

Most of these deals, known as advance market commitments, (AMCs), have been struck by rich countries. Data collected by researchers at Duke University’s Global Health Innovation Centre show that high-income countries account for more than half of all such confirmed purchases.

America alone is responsible for nearly one-sixth of these AMCs, having pre-ordered more than 1bn doses from half a dozen drugmakers. This amounts to three jabs per person. Canada has purchased ten doses for each of its citizens, the most for any country or alliance on a per person basis (see chart). A group of rich countries has already agreed to buy roughly 600m doses of the Pfizer-BioNTech drug, nearly half of the total the drugmakers say they can produce by the end of 2021.

Not everyone will be so lucky. The researchers at Duke reckon that poorer countries will have to rely mainly on COVAX, an alliance co-led by the World Health Organisation to develop and distribute a covid-19 vaccine. The scheme, which is committed to buying 500m doses, has promised equal access to all participating countries, regardless of income. But the alliance only guarantees that they will receive enough doses to vaccinate a fifth of their people.

Some better-off countries are sharing with less fortunate ones. Australia, which has committed itself to buying five doses for each of its citizens, has also offered to provide vaccines to its Pacific neighbours, such as Vanuatu and Kiribati. China, which announced that it had joined the COVAX facility on October 9th, has also promised to share its vaccines with poorer countries with which it has close ties, including Burma, Cambodia and the Philippines.

Of course, all of this will be irrelevant if the supply of effective vaccines proves insufficient. Or if people refuse to take them. In June a group of researchers asked 13,000 people in 19 countries if they would take a safe and effective vaccine. More than a quarter of respondents said no.