The Global Pandemic Requires A Global Vaccination Plan

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More than 85% of vaccine doses administered to date have gone to people in high- and ... [+] upper-middle-income countries.

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Global public health experts Lisha McCormick, Marion Subah, Eloise Todd and Nahashon Aluoka, discuss why world leaders must commit to a global roadmap to deliver vaccines at the G7 Leadership Summit.


by Lisha McCormick, Marion Subah, Eloise Todd and Nahashon Aluoka

As world leaders gather for the annual G7 Leadership Summit, they have one job: end the pandemic by delivering a global roadmap to vaccinate the world. This must be a comprehensive, coordinated strategy that accelerates global Covid-19 vaccine access and delivery in order to achieve at least 70% coverage in all countries.

Eighteen months into the Covid-19 pandemic, we find ourselves navigating a schism between the haves and the have-nots where those in high-income countries can see a light at the end of the pandemic tunnel while many in poorer countries are experiencing the persistence of this devastating crisis. More than 85% of vaccine doses administered to date have gone to people in high- and upper-middle-income countries. And low-income countries? Just 0.3%. 

What was once the bright spot in the pandemic — the rapid development and manufacture of life-saving vaccines — now points to a vast moral failing. There are many reasons that this has happened, but it boils down to a difficult truth: there is still no end-to-end plan to vaccinate the world to at least 70% coverage and provide the support needed for every country to get vaccines delivered and administered safely.

The system that allowed just a few countries to buy nearly all the world’s vaccine supply needs root and branch reform. But right now, we must collectively do more. We are calling for an end-to-end plan that addresses urgent gaps in vaccine supply and delivery. After all, vaccines alone don’t save lives — vaccinations do.

Addressing Urgent Supply Gaps

Though the commitment of COVAX — the mechanism to accelerate the development and manufacture of Covid-19 vaccines and guarantee fair and equitable vaccine access — is laudable, to date it is not enough. As WHO Director-General Dr. Tedros Adhanom Ghebreyesus said to the World Health Assembly, while COVAX has delivered 72 million doses to 125 countries, “those doses are sufficient for barely 1 percent of the combined population of those countries.” President Joe Biden’s announcement last week that shipments of surplus doses have begun is also promising, but global leaders must do more.  

According to the Launch & Scale Speedometer, the G7 countries (including the whole of the EU) have an excess of 3 billion doses, even after vaccinating their entire population.

G7 countries have the opportunity to do the right thing. We urge leadership to share one billion doses by the end of August, and another billion by the end of the year to support the global vaccination effort.

A Plan to Actually Deliver Vaccines

A study by CARE estimates that for every $1 spent on vaccine procurement, $5 is needed for vaccine delivery — with half of this spent on training, equipping, and supporting the frontline care and health workers, including the community health workers who reach rural and underserved communities. The majority of these frontline workers are women, and in many contexts they receive little or no pay, inadequate training and supervision, and face unsafe and unsupportive working conditions. This is despite the critical roles they play in educating communities to prevent disease transmission, building vaccine acceptance, and connecting marginalized communities to primary health services including vaccination services. 

It is critical that global costing models for vaccine delivery — such as WHO’s and UNICEF’s — include the costs for paying, protecting and supporting all cadres of frontline health workers — including community health workers.

Take Liberia as an example — the country has received 123,000 vaccine doses through COVAX. However, the Ministry of Health didn’t have adequate funding to distribute vaccines to people outside of the capital, creating a race against the clock to administer the vaccines before they expired. The Liberia Ministry of Health worked with partners like Last Mile Health to reach rural and remote communities. Together, we were able to provide the first Covid-19 vaccine dose to more than 63,000 people, including 12,000 community and frontline health workers who are powerful allies in the fight against vaccine hesitancy. 

Last Mile Health conducted focus group discussions in one remote county in Liberia which suggested that while misinformation about the vaccine was prominent in some communities, counselling from community and frontline health workers and encouragement from vaccinated individuals could effectively dispel myths and increase vaccine uptake. 

One frontline health worker said, “If we health workers are not taking the vaccine then we should not be expecting the community to take the vaccine. That’s why I decided to take the leap, so I can show people the vaccine is safe because I took it. Even my family and friends, I was able to counsel them to take it.” 

While these results are only a snapshot of what is required for effective vaccine delivery nationally, they underscore the importance of investing in those closest to the community.

Leaders from high-income countries don’t get to wipe their consciences clean by donating excess vaccine doses alone. G7 leaders must ensure that their donations are delivered.

The government of Liberia is far from alone in their rush to reallocate scarce resources to distribute vaccines. The government of Malawi received 102,000 vaccine doses just three weeks before they were set to expire. They managed to deliver 80% but were forced to publicly destroy 19,610 doses in an effort to mitigate concerns that expired doses would be administered to the community.

Leaders from high-income countries don’t get to wipe their consciences clean by donating excess vaccine doses alone. G7 leaders must ensure that their donations are delivered. Public health leaders in low-income countries shouldn't have to choose short shelf-life products, knowing they don't have adequate support for delivery. It’s time for high-income countries to fully cost a plan to ensure that the vaccine doses they donate are able to reach the communities that need them most.

G7 leaders have the historic opportunity to commit to action and make way for a healthier and safer world, which is good for everyone. The IMF estimates that an investment of $50 billion made now to vaccinate people in poor countries, including at least $6 billion for vaccine delivery — which although a good start is unlikely to cover the full end-to-end costs — would yield $9 trillion in additional economic growth by 2025.

We simply cannot afford to live in a world that is increasingly divided by inequality. The global pandemic requires a global vaccination plan and the time for action is now.

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