Maïka Sondarjee is a professor at the School of International Development and Global Studies at the University of Ottawa. His first essay is called lose the south (Écosociété Editions, 2020).
In the event of a shortage of available doses, would you be prepared to be injected with an expired vaccine? The people of Nigeria, Malawi and South Sudan answer in the negative, and with good reason.
Since the start of the pandemic, Europe, the United States and Canada have been singled out for their lack of solidarity with the countries of the South. Rather than seeing vaccines as a common resource, countries that have the financial means are hoarding the doses according to an every-man-for-himself approach. Faced with criticism from scientists and the international community on the lack of vaccine equity, these countries have begun to redistribute doses they had purchased in surplus, understanding (a little belatedly) that everyone must be vaccinated if we wants to get out. And that “everyone” does not stop at borders.
The problem is this: rather than being delivered directly from the factories to the countries that need them, these doses spend time in European, Canadian or European warehouses before being sent to Africa, the Middle East or Asia. . When doses are stored in this way before being redistributed, they are approaching their expiry date when they are finally given.
Nigeria thus had to destroy, in mid-December, more than a million doses of the AstraZeneca vaccine which became expired only a few days later after their reception. The Nigerian population was rightly afraid of being injected with expired vaccines, and the government publicly destroyed them to reassure its citizens.
Vaccines versus vaccinations
Although high-income countries very publicly welcome it, giving millions of doses of vaccine does not mean that it will result in millions of vaccinations. It takes a lot more than vaccines to run a vaccination campaign.
Vaccines need to be stored as soon as they arrive in a country, and many of them require special refrigerators, which keep them at a very low temperature. It is also necessary to be able to transport these vaccines by plane, by train or by road to the various injection sites. It is also necessary to have health professionals available and able to go to the vaccination sites in order to inject the vaccines.
The government of Nigeria, which is on a continent with a vaccination rate of around 2%, is calling on Western countries to use international coordination orchestrated by the World Health Organization (WHO) rather than sending doses of sporadically.
To give ourselves good conscience
The impossibility of managing inconstant flows of vaccines is not due to a lack of capacity on the part of countries in the South. Many governments, such as Nigeria, have more experience than Canada in organizing large-scale vaccination campaigns. But without being able to predict the arrival of new doses, it is difficult to organize properly.
By procuring doses directly from the companies, Ottawa can know weeks, even months in advance, the timetable for the delivery of doses. The doses that are “given” to the countries of the South, for their part, can arrive unexpectedly, a few days or only a week before their expiry date.
It is therefore impossible, under these conditions, to properly plan a vaccination campaign, and this gives the impression that the countries receiving these donations do not have the capacity to carry them out. This confirms persistent myths, while giving countries redistributing vaccine doses a clear conscience. Western governments are sleeping with peace of mind, but they continue to widen the divide of vaccine inequity.
The watchword is therefore better predictability of supply. To do this, you have to go through the WHO, in particular through the COVAX initiative, which does business with regional organizations, such as the African Union and its African Vaccine Aquisition Trust (AVAT). Last November, AVAT and the WHO already criticized the fact that the redistributed vaccines had a very limited lifespan.
It is not necessary to give “country by country”, but to order doses in advance which will be distributed in time and place by the international agencies. Canada currently plans to go through COVAX, and it has already distributed almost half of the 200 million doses promised to countries in the South. COVAX also received 300 million doses of vaccine in December, a third of what it received in all of 2021. But since the start of vaccination, three-quarters of the doses administered have been in high-middle to high-income countries. There is also a need to share research and technologies to promote vaccination rather than simply distributing vaccines.
In the best of all worlds, pharmaceutical companies would not sell to the highest bidder, following capitalist rules of unlimited profits, but would consider vaccines as a global public good. And governments would think long-term rather than short-term in their plan to end the crisis. But, at the current stage, we can always hope.