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A British doctor prepares to administer a Covid-19 vaccine A British doctor prepares to administer a Covid-19 vaccine  (AFP or licensors)

The Pandemic response in an unequal world: Way forward with the vaccine

As Covid-19 vaccines begin to receive approval for use, the Secretary General of Caritas Internationalis, Aloysius John, reflects on the importance of equitable vaccine distribution, in an article first published in L'Osservatore Romano.

By Aloysius John – Secretary General of Caritas Internationalis

The COVID-19 virus has transformed our societies on a massive scale – disrupting economies, communities, families and individuals. A vaccine now appears at the horizon but are we prepared to put it into proper equitable use?

The pandemic did bring to evidence that the whole of humanity is interconnected and that anything that happens in one place concerns the whole humanity. The North and Global South can no longer be seen as isolated. Furthermore, the pandemic today, is not just a health issue, but it presents as a rather complex political, social, economic, cultural and global situation.  

In this situation, vaccine is no more an option but rather part of the solution and one of the means to get out of this pandemic. Access to vaccines must not be taken into consideration in the logic of “an afterthought”, nor can it be considered a national or a financial issue. For this reason, the debate on vaccination has to be holistic, people oriented and based on multilateralism and on the political will to promote access.

Adopting a “people vaccine” logic will certainly help get out of the natural temptation of competition to gain overnight billions of dollars out of the vaccines. At a moment of utter global confusion and taken up by surprise and panic, billions of dollars have been invested in the pharmaceutical companies for finding a quick solution to the pandemic and get back to the normal. This public financing of the research given without conditions has brought the different funders to claim their returns in terms of vaccines for their own population. There is a need for a global regulatory mechanism, but at this juncture, multilateralism has given place to nationalism and national interest and global solidarity is pushed to the second rank.

Access to vaccine is a moral and a global problem which cannot be addressed through nationalistic solution. In the context of interconnectedness, leaving, poorer and low income countries without access to vaccines will cause significant economic damage that will jeopardize and affect decades of economic progress at risk for both the advanced economies and the poorer countries. Failure to provide equitable access to the vaccine will also have dire and long-lasting consequences for human health and make it more difficult to end the pandemic.

One of the lessons learned by COVID-19 pandemic is the interconnectivity between and within our societies. A North-South divide on the core issue of saving human lives in countries where most of the global population lives will boomerang on the richer nations. Furthermore, the global economy cannot be kick-started without vaccinating the world and consequently the post pandemic reconstruction of the society cannot take place if the lack of access to vaccination has condemned some countries to isolation because they remain COVID-19 transmission vectors.

No one must be left behind. Vaccines is a basic human right and should be available and accessible to all, as Pope Francis has often affirmed. Instead, it is estimated that around a sixth of the world population has already reserved more than half of the vaccines for their own national population.

The US and European leaders are thus faced with two options: they can reason in an exclusive manner, only within their own borders and national interest, and put the financial interests of their pharmaceutical companies in the forefront in lieu of the global health, or they can renounce “vaccine nationalism” and stand in solidarity with the world’s most vulnerable people and look for innovative solutions.

This global emergency can be addressed only if affordable and effective COVID-19 vaccine is made available to all corners of the world and protecting people everywhere must be ensured with a political will and with a simple moral decision: prioritize lives over patents and suspend the intellectual property rights on vaccine production, suspend monopolies over the vaccines.

In the global south, achieving herd immunity will be key challenge. All the more, there is not enough capacity to manage the required volume of vaccines. This is due to lack of facilities, infrastructure and also personnel to carry out the work. In many countries people have health problems caused by a combination of malnutrition and poor sanitation and people’s health conditions can be aggravated by vaccination. A thorough follow-up will be needed to take care of them and help them.

In the poorest countries, storing and transporting of vaccine will certainly pose a major logistical problem. With limited or deficient logistical capacity, it will be difficult to distribute vaccines in the optimal conditions without important investment, especially in countries where the rural villages dispensaries do not have the necessary cold storage for the vaccines, poor access to energy, lack of relevant skills. In such places, there is also a need to sensitize and train the medical corps on the different side effects of the vaccine and how to deal with them.

Careful sensitization of the communities must be undertaken systematically to inform, build awareness and also motivate them to come to the vaccination hubs. Embed the vaccine awareness in the community development projects could certainly encourage wider-scale vaccination. The national health commissions of the Catholic Bishops conferences and local Caritas must be involved in the reflection in order to carry out the lobby work at the local level with their government and also to put the Church dispensaries at the disposition of the vaccination process. Leaving people in the Global South without any hope of access to speedy vaccine, will raise the risk that they resort to dangerous traditional cures and medicines.

In the low income countries of the global south, COVID-19 it is also a once-in-a lifetime opportunity to looked into whole health system needs and create solutions for sustainable health system strengthening.

There is a need for an urgent global and international plan with the full involvement of the UN at the level of the security council in order to arrive at an international agreement and set up an international independent body which must also include stakeholders from the global south and civil society organisations. Given the huge global magnitude of the problem an international conference on COVID-19 vaccines, with the participation of representatives from global south, must be held to address allocations mechanism and access challenges.

Moral imperative must be the guiding principle to overcome the potential global divide in vaccine efficacy. The research conducted must be considered as a common good and must benefit every human person. A failure to address this issue is a failure to truly confront the suffering caused by poverty and disease. It is therefore crucial that western governments attach conditions to the public funding given for research to the pharmaceutical companies and ensure COVID-19 vaccines are made a global public good.

At the same time, we must not forget the economic crisis exacerbated by the pandemic. Advocacy for debt cancellation or debt swapping mechanism must be soon initiated in order to reinforce the health systems and also access the vaccines. Without investments the COVID-19 pandemic turn out to be a protracted crisis, difficult to be controlled.  

Finally, the most at-risk population groups, such as migrants and refugees, which are a priority for Caritas, must not be forgotten especially in conflict and war zones. These people in displacement or on the move are highly vulnerable to the pandemic and may not fall in the radar of the vaccination process. Any reflection in favour of the vaccination must take this reality into account. 

23 January 2021, 15:16