The world is witnessing the emergence of more infectious variants of the Sars-CoV-2 virus, but a stuttering race to ensure equitable access to vaccines has seen a handful of countries streak ahead, immunising their own populations, leaving many of the world’s vulnerable people in their wake.
Communities are struggling with impatience and fatigue, which is understandable. However, easing basic public health measures such as wearing masks and social distancing risks fuelling transmission. In combination with more infectious variants and the “me first” attitude of some countries, people who are unvaccinated and those who have received only one dose are at increasing risk.
The world is at a perilous point and we, the special envoys of the World Health Organization’s director general, are calling for a renewed commitment to a comprehensive approach to defeating this pandemic. We have to accelerate along two tracks – one where governments and vaccine manufacturers support all WHO member states in their efforts to create vaccine manufacturing capacity and vaccinate their most vulnerable populations, and the other where individuals and communities maintain a steely focus on continuing essential public health measures to break transmission chains.
The first track requires immediate implementation of reiterated calls by the WHO and its Covax partners on the best use of vaccines. Almost 3bn doses of vaccine have been distributed globally, but only 90m of those have gone through Covax. There are at least 60 countries that rely on Covax for vaccines and those countries have vaccination rates that average less than 3%. The world must implement a strategy at global, regional and national level whereby the most vulnerable people are vaccinated first, rather than leaving health workers, elderly people and those with underlying conditions at risk of severe disease.
It also includes supporting the WHO’s call to vaccinate at least 10% of the population of every country by September, and a “drive to December” to vaccinate 40% by the end of 2021. Achieving the September goal means 250 million more people in low- and middle-income countries must be vaccinated in just four months, prioritising all health workers and the most at-risk groups to save lives.
Such goals align with the bold call by the WHO, the International Monetary Fund, the World Trade Organization and the World Bank for $50bn in increased financing to vaccinate 40% of the world’s population by the end of the year and 60% by mid-2022. Such an investment pales in comparison with the trillions of dollars of economic losses and costs connected to the pandemic.
The WHO continues working to make safe and effective vaccines and other tools available to the world, from issuing emergency use listings (EULs) for 11 vaccines so far, to launching the access to Covid-19 tools accelerator. This will spur development of and access to solutions needed to diagnose, treat and vaccinate vulnerable people in all countries, and enable developing countries to create their own vaccine manufacturing capacity. Manufacturing and diagnostic capacity, virus sequencing capacity, increased case surveillance and other measures are essential components of controlling this pandemic.
Countries with the greatest stocks of vaccines should not hoard them and push to cover their entire populations while other countries do without. It is not even in their best interests, since the intense circulation of the virus in countries with no vaccines increases the possibility of more transmissible and dangerous variants, threatening to make current vaccines less effective.
At the same time, the world must not lose sight of the second track which requires that everyone refresh their commitment to protecting themselves and others by recognising the importance of mask-wearing, physical distancing, ventilation and other actions that have been proven to curtail the spread of the virus. Engaging with communities, building trust and empowering people to feel part of the response are the keys to inspiring them to continue, more than a year into the pandemic.
The urgent call is to save lives. The world has a moral imperative to do so. Global solidarity is needed more than ever. By actively calling for a two-track approach – of ensuring that the most vulnerable people get vaccinated and adhering to sound public health measures, and by calling out those who could be doing more – the whole world can benefit and save lives. No one is safe until everyone is safe.
Dr David Nabarro is special envoy for Europe and North America; Dr John Nkengasong for Africa (Anglophone); Prof Samba Sow for Africa (Francophone); Prof Dr Maha El Rabbat for the eastern Mediterranean; Dr Mirta Roses for Latin America and the Caribbean; Dr Palitha Abeykoon for south-east Asia