End Vaccine Apartheid

Anis Chowdhury and Jomo Kwame Sundaram

Excluding by appropriating

Developing countries now account for more than 85% of global pandemic deaths. By early September, The Economist estimated actual COVID-19 deaths worldwide at 15.2 million, rather than the official 4.6 million.

In six of the ten countries with the highest fatality rates, less than a tenth of their populations were fully vaccinated as of 10 August. In the other four, no more than a third were fully vaccinated.

Now, as rich nations buy up more vaccines for third shots, vaccination inequities are becoming starker. Buying up hundreds of millions of doses, they penalise poorer countries already doubly deprived. Rich countries will likely have about 1.2 billion extra doses by the end of 2021!

More than 5.41 billion vaccine shots have been administered worldwide, with 81% in only ten high and upper middle-income countries. Meanwhile, the poorest countries have only received 0.4%.

In January, the World Health Organization (WHO) Director-General (DG) warned,

“I need to be blunt: the world is on the brink of a catastrophic moral failure–and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”

Profits booster

In early July, Pfizer and BioNTech announced plans to get emergency authorisation for booster vaccine doses. Pfizer then met with U.S. officials to press their case, while Moderna applied for approval this month.

Following the Israeli President’s third shot on 30 July, nearly a million boosters have been administered in the U.S. since 12 August despite earlier official hesitation. U.S. President Joe Biden expects to launch a campaign for a further 100 million booster shots on 20 September.

France began administering boosters to people over 65 from September. The UK has announced offering a third dose from late September. Germany, Belgium and other European countries followed suit.

Now, supply will decline further as Pfizer and Moderna sell booster doses. Two new Pfizer-BioNTech facilities have been approved to manufacture boosters in France and Germany.

Meanwhile, Moderna is scaling up booster production in Massachusetts and New Hampshire. Almost all the 3.2 billion Pfizer and Moderna doses to be produced this year have already been purchased by the U.S. and Europe.

The WHO DG lambasted this “scandalous inequity” at the World Health Assembly in May. The WHO has repeatedly called for delaying booster provision, arguing that the most vulnerable people worldwide should be vaccinated first.

Pfizer and Moderna have not provided details of their booster prices. An economist has estimated:

“Sold at present prices, this would represent roughly a 50% increase in revenue over the longer run.”

Moderna raised its 2021 vaccine sales forecast for its first two doses to US$19.2 billion in May. So, booster sales should add about US$10 billion. Meanwhile, Pfizer raised its own forecast by more than 70% to US$26 billion, with booster sales bringing US$13 billion more.

Profits over science

Rich countries’ practices actually go against most scientific advice. The case for boosters is not scientifically established. Most scientists do not agree that boosters are the best way to deal with new threats. Citing lack of credible data, scientists have opposed boosters in reputable journals, including Nature.

On 6 August, the European Union’s drugs regulator noted not enough evidence to recommend COVID-19 vaccine boosters. A European Centre for Disease Prevention and Control report this month affirmed, “there is no urgent need” for booster shots except for those in frail health.

The WHO noted on 18 August that current evidence does not support the case for booster shots. Scientists described official decisions approving third booster shots as “shocking” and “criminal”. When U.S. authorities approved boosters, two top vaccine officials quit in protest.

Independent research on Pfizer’s two-dose vaccine suggests it provides long-term immunity for years, contrary to the company’s latest claims. Also using mRNA technology, Moderna’s vaccine should have similar longer-term efficacy.

As COVID-19 vaccines are still new, such expectations remain subject to confirmation. As with most vaccines, ‘memory response’ triggers antibody protection when someone vaccinated is infected, even after natural response levels have waned.

Perhaps most worryingly, as big pharmaceutical companies transform their business strategies to generate more profits from boosters, their incentives change. They have less reason to develop vaccines fully immunizing against the COVID-19 virus, or even to ensure that everyone is vaccinated.

Apartheid booster

Supplying boosters reduces vaccines available to others. Supplies to poorer countries have already been greatly reduced by rich countries securing many times more than what their populations need.

Some have even abused COVAX, purportedly designed for equitable distribution to poorer countries. COVAX aimed to deliver a billion vaccine doses in 2021, but had only delivered 217 million by August, according to UNICEF.

Meanwhile, many rich country governments continue to block the request to the World Trade Organization to temporarily suspend COVID-19 related intellectual property rights. This waiver would enable developing countries to affordably produce tests, vaccines, treatments, equipment and other such needs.

Earlier, Big Pharma leaders rejected as “nonsense” WHO’s C-TAP initiative to share technologies and research knowledge to accelerate affordable production of and access to such technologies.

Vaccine equity necessary

There is also a practical reason to seek vaccine equity. We are all safer when everyone is vaccinated. New, more vaccine-resistant variants are emerging, endangering everyone.

Rich countries protecting their own citizens will not prevent new mutants from emerging. New infections risk triggering a resurgence, or worse, with new, more dangerous mutations.

The Delta variant, first reported in India in late 2020, surged in March as few there had been vaccinated. Ironically, the Serum Institute of India has the world’s largest vaccine production capacity by far, but largely underutilised for COVID-19 vaccines.

The IMF warns highly infectious variants could derail economic recovery, cutting global output by US$4.5 trillion by 2025. But the Economist Intelligence Unit estimated the world economy could lose US$2.3 trillion in 2021 alone due to delayed vaccinations, with developing nations losing most.

For the WHO DG,

“Vaccine inequity is the world’s biggest obstacle to ending this pandemic and recovering from COVID-19…. Economically, epidemiologically and morally, it is in all countries’ best interest to use the latest available data to make lifesaving vaccines available to all.”

(Anis Chowdhury writes at JOMO. Jomo Kwame Sundaram is Visiting Senior Fellow at Khazanah Research Institute, Visiting Fellow at the Initiative for Policy Dialogue, Columbia University, and Adjunct Professor at the International Islamic University in Malaysia. Article courtesy: Inter Press service news.)

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Cuba: The First Country in the World to Vaccinate Children Under 12

Gloria La Riva

In the battle against COVID-19, Cuba has been a country of firsts. It is the only country in all Latin America to produce its own vaccines.

Cuba has sent more than 5,000 doctors to help treat Covid patients in 57 brigades to 40 countries around the world since the pandemic began. No other country has come close.

Now, in a major new development, babies and children two years old and up will be massively vaccinated starting in 10 days. Cuba is the first country in the world to vaccinate babies and children under 12.

On Friday, Sept. 3, Cuba’s Center for State Control of Medicines, Equipment and Medical Devices (CECMED) announced emergency approval for the mass vaccination of two-year-olds and children up to age 11 using the Soberana 02 vaccine. Soberana was developed and is produced by the famous Finlay Vaccine Institute. Pediatric innoculations will begin September 15. Trials showed the vaccine to be safe and effective in that age range. Youths 12 to 18 years will receive Soberana starting September 5.

By November 15 all schoolchildren under 18 will return to their classrooms fully vaccinated, and pre-school children as well. For now students will start their fall lessons on Sept. 6 by television, as has been the practice since the pandemic began.

Dr. Olga Lidia Jacobo Casanueva, CECMED Director, told Cuban TV, “It is great news for the Cuban people, for the Cuban family which has waited to be able to vaccinate their children. It is a real achievement for Cuban science and represents an historic moment in our country.”

Since late June, Cuba has experienced a dramatic increase in positive Covid cases amid the ever-harsher U.S. economic blockade and the shutdown of tourism due to the pandemic. From roughly 1,100 average new cases in early June, the figure skyrocketed to an average of 9,504 new positive cases exactly one month ago. The last four days’ average ending Sept. 4 was 6,899.

Despite the many challenges of increased cases and material shortages, Cuba’s socialist government and health institutions are soldiering through with the national plan and its three most effective vaccine lines to cover the whole population.

Cuban President Miguel Díaz-Canel announced Aug. 31–in a special meeting of scientists and health professionals–that by November, 92.6% of Cuba’s entire population will be fully vaccinated with the three-shot process.

The bold project of universal infant, child and adult vaccination is possible because of the country’s highly organized vaccination system that has been in place for decades. Cuban scientists, fully supported by a government that places its trust in their expertise and dedication, work for the common good–free of a profit motive.

Plus, Cuban society has not suffered the polarization whipped up by right-wing politicians and false media in the United States that have actively opposed mask mandates and vaccinations. Millions in the United States have fallen victim to the anti-science hysteria, failing to vaccinate. The U.S. Covid cases and deaths are in the second-highest wave since April 2020 and rising.

The pandemic has been severe for Cuba due to the longstanding blockade further hardened under Trump. The tourism industry–a major source of income for the country and workers–has virtually shut down due to the virus.

Up to now, all vaccines worldwide have been approved for emergency use by corresponding health institutions, due to their highly effective results and the need to take immediate action given the severity of the pandemic.

The pediatric trials in Cuba began June 14 this year. The first stage was 25 adolescent volunteers, 12 to 18 years old, then a larger group of 350. In early July almost 600 babies and children under 12 took part in clinical trials. The children’s vaccine trial was named Ismaelillo, after poetry written by Cuba’s national hero José Martí to his son.

No children are exempt from the highly contagious delta variant, now dominant around the world. The urgency for pediatric vaccination everywhere is greater than ever as the school year begins anew this week.

The struggle against Covid is far from over. But Cuba’s latest achievement is a shining example of the Cuban people and their revolution facing adversity with determination to overcome.

(Courtesy: Liberation News, USA.)