Call for a new globally equitable vaccine strategy
European Society of Medicine
Rue le Corbusier 12
1208 Geneva, Switzerland
April 30, 2021
World Health Organization
Dr. Kate O’Brien
Director of Department of Immunization, Vaccines and Biologicals Avenue Appia 20
1211 Geneva, Switzerland
Dear Director O’Brien,
Addressing the highly unequal distribution of vaccines is critically important to putting an end to the COVID-19 pandemic. The vaccine-sharing initiative COVAX was supposed to serve as a lifeline for many countries in the developing world but is failing to deliver even 25% of the doses expected. The initiative will continue to be obstructed by export bans, supply shortages, and hoarding unless extreme measures are taken to put public health first.
Out of the 832 million doses administered globally, 82% have gone to high or upper middle-income countries while only 0.2% have been sent to their low-income peers. The gap is tremendous, and it is widening. 1 in four people have received a vaccine in the high- income countries compared to just 1 in 500 for the poorer countries.
Months after vaccine production began, Bangladesh, Mexico, Myanmar and Pakistan have yet to receive a single dose of the vaccines expected from COVAX. Ethiopia, Brazil, Indonesia and many more countries have received only a small fraction of the doses they were allocated to receive by May 2021.
Meanwhile, other countries are purchasing unnecessarily large quantities of vaccines, to the detriment of the rest of the world. The US has secured 800 million doses, and the UK has purchased 340 million doses, approximately five doses for each of its citizens. Global vaccination is crucial to ending the pandemic; however, the political dialog needed to overcome the challenges of equitably distributing vaccine doses has mostly been symbolic and has not resulted in a coordinated effort to send sufficient vaccine doses where they are needed.
The time has come to take action to ensure a sustainable vaccine supply across the globe. One approach that might better balance economic and political realities while at the same time maximizing global public health benefit would be to implement a program with the goal of preventing the most deaths given a limited supply of vaccine. This would be most easily achieved by establishing a Global Vaccination Program prioritizing the 700,000,000 individuals globally over 65 years of age who have sixty times the risk of a fatal outcome compared to those who are younger. This approach has the further advantage of cutting equitably across all ethnic and socio-economic groups and can be achieved much more quickly than the years required to achieve universal vaccination.
Without a global effort to allow enough vaccine doses to reach all communities, no one will be safe from COVID-19. No organization is better positioned to lead this change than the World Health Organization.
European Society of Medicine
Public Health Policy Center