Fartun Ali receiving her first dose of Covid-19 vaccine in Somalia. Trócaire
vaccine equity

Irish NGOs worried booster roll-outs will lead to further vaccine inequality globally

Without intellectual property rights waivers to allow developing countries to produce their own jabs, demand will continue to outstrip supply, they said.

IRISH NGOS WORKING in developing countries are concerned that the acceleration of booster programmes in richer countries will lead to even deeper inequality in the access to Covid-19 vaccines in 2022. 

Without intellectual property rights waivers to allow developing nations to produce their own vaccines, charities have said these countries will have to continue to compete for supplies with rich countries that can afford to buy up doses to boost their entire populations.

As the new Omicron variant began to sweep through developed countries and cases surged, a number of governments, including Ireland’s, decided to reduce the gap between second doses and boosters. 

Supplies of vaccines were already limited before the new variant emerged, but the situation is now likely to worsen, Trócaire’s CEO Caoimhe de Barra told The Journal,  and wealthier countries have the buying power to “absorb the bulk of the supply”. 

“That’s obviously a concern,” she said. “It’s not that there isn’t a need for booster campaigns in Ireland and other western countries, but six times more booster shots are being administered daily globally than first doses in low income countries.

What this means is that we’re locking ourselves into a cycle of having to keep giving booster shots while more variants are emerging. It’s deeply frustrating.

The TRIPS waiver

De Barra said richer countries are not only buying up the vaccine stocks, but are blocking attempts to facilitate production in developing countries through intellectual property rights waivers. 

In October 2020, India and South Africa made a landmark proposal to temporarily waive several sections of the agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) – an international legal agreement between all the member nations of the World Trade Organization (WTO).

The WTO agreement enables members to waive elements of TRIPS in exceptional circumstances – such as a pandemic – in relation to pharmaceutical products and so-called “least-developed countries”.

The EU initially opposed the waiver but has since tabled a counter-proposal to use flexibilities in existing WTO rules. A key WTO meeting due to take place in November was postponed indefinitely due to concerns about Omicron.

The World Health Organization has been critical of countries blocking the waiver, stating that the pandemic has become “a crisis of solidarity and sharing” and even US President Joe Biden has called on countries to waive intellectual property protections on Covid-19 vaccines.

Although Irish government ministers have expressed support for the waiver, they have been criticised for not doing more to push the EU on this issue. 

De Barra said blocking the waiver is “shortsighted and self-defeating” and will contribute to further short and longterm suffering in developing countries.

Other charities such as Oxfam have condemned governments’ efforts to block the TRIPS waiver on Covid vaccines, tests and treatments at World Trade Organisation talks. 

Jim Clarken, Oxfam Ireland CEO recently said vaccine inequity had created “the perfect breeding ground for new variants such as Omicron”.

“This should be a wake-up call. We cannot repeat the mistakes of the past 21 months,” he said.

Clarken said leaders need to insist that pharmaceutical companies start sharing their science and technology with qualified manufacturers around the world, “so we can vaccinate people in all countries and finally end this pandemic”.

Rising case numbers in Africa

In mid December Africa was reporting a massive rise in Covid cases, though the number of deaths was lower than with previous waves. 

Over the week to 12 December there had been an 83% rise in cases. Dr Matshidiso Moeti, WHO’s Regional Director for Africa, warned that slow roll-out of the vaccine in Africa would mean both cases and deaths would be “higher than they should be”. 

As of 13 December, only 20 African countries had vaccinated at least 10% of their population – the global target WHO had set for September 2021.

Only six countries had hit the year-end target of fully vaccinating 40% of their population, while only two – Mauritius and Seychelles – had 70%.

Somalia hand hygeine Woman in Somalia washing her hands. Trócaire Trócaire

Low vaccination rates risk providing a breeding ground for new variants, such as the rapidly spreading Omicron strain, which was first identified in South Africa, the WHO has said. 

“We’ve known for quite some time now that new variants like Beta, Delta or Omicron could regularly emerge to spark new outbreaks globally, but vaccine-deprived regions like Africa will be especially vulnerable,” said Moeti.

At the current rate, WHO estimates it will take until May 2022 to have 40% vaccination coverage in Africa and until August 2024 to reach 70% said in mid-December.

Compounding complex issues

Trócaire’s Caoimhe de Barra said NGOs working in developing countries have witnessed the devastating impact the pandemic has had – and not just in terms of health. 

“The reality for us in the countries that we work in is that Covid is a compounder of many other complex issues such as conflict, deep poverty and injustice and then in some you also have political complexities,” she said.

“Two countries in particular at the moment in which we’re seeing political crises are Myanmar and Ethiopia, but many other countries are in a constant state of instability and insecurity.

For people living in these countries what they are dealing with day to day is a multitude of issues of which Covid is really just one.

She said that while there have been obvious health impacts in developing countries, the secondary effects have been “absolutely devastating”.

“Ireland and Europe and most richer countries in the world have been able to get lots of people vaccinated so even if there’s a relatively high prevalence of the virus shops an open and offices can open and people can continue to work,” she explained.

“In poorer countries because the level of vaccination is so low, governments have very few tools in their armoury to address a surge and it means lockdowns are really all they have.

“The vast majority of people on low incomes rely on day-to-day income from labour and it they can’t take the bus to the market to work they can’t buy food, they can’t afford school fees or medicine.”

Zeinab Odowa Colow with her son, Osman in  Dollow CTC Zeinab Odowa Colow with her son, Osman, in Dollow Trócaire Trócaire

She said the restrictions have had a significant impact on children, as ordinary vaccination programmes have been interrupted and they have been kept out of school for long periods of time.

“Education is key to breaking the cycle of poverty and we’re concerned about school closures in these countries, it was one of the only tools governments had but schooling is only recently back up and there’s a cohort of children who will never go back to school – girls in particular around the age of 12,” she said.

“We could see another generation consigned to poverty. Every extra year you keep a girl in school it increases six fold the chance her children will stay in school.”

One bill away from spiralling down

A Covid death can completely change the course of that family’s future security, she explained, as was the case for one woman in Zimbabwe.

“She’s 32-years-old and has two primary-aged children. Her husband worked in South Africa as a migrant labourer – lots of people migrate to South Africa for this kind of work work, which is often informal and can be dangerous. He was living in overcrowded conditions, he caught Covid and he died.

Now she is left raising two children on her own with very few options. Before this they were on an upward spiral to get their family out of poverty, but with the primary breadwinner gone, that spiral goes down again.

“She’s now part of our programme so we’re supporting her to develop her own livelihood but millions of people are suffering in the same way. You can be one bill away from spiralling down when you’re living that kind of fragile experience.”

Meaningful access to vaccines

If global leaders want to avoid the current cycle the are in, de Barra said governments  and companies need to ensure in 2022 that everyone has meaningful access to vaccines.

“If this goes on then booster shots will be needed worldwide, we need to get ahead of this disease,” she said.

We need to see the TRIPS waiver in place, with the transfer of technology, information and know-how to poorer countries through the WHO. Vaccine quality has been raised as an issue but there is a management process in place through the WHO. 

“We also need to realise that the countries we work in have health systems that are in dire need of investment, not only because of Covid,” she said.

“There needs to be a reconsideration of what is a responsible way forward when health systems remain weak, people remain vulnerable to all kinds of infections and the world in general is more susceptible.”

- With reporting from AFP.

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