Fix the global vaccine rollout or face even worse COVID variants, experts warn

The world has "lost the plot" on equitable vaccine access during the coronavirus pandemic and is falling far short of targets to vaccinate the global south, according to scathing assessments from experts as the omicron variant spreads to more countries.

From the early days of the coronavirus pandemic, the World Health Organization (WHO) and several other public health groups have argued the only way out of the pandemic is to vaccinate the entire world.

But McGill University professor in the departments of epidemiology and biostatistics, Madhukar Pai, said the initial response to the omicron variant proved we were a long way from that goal.

"The world has totally lost the plot on this pandemic," he told NPR.

"Especially after the Delta variant pretty much decimated India, we knew allowing this virus to rip unchecked through populations was a disastrous idea. Because new variants will come [and] mutations will happen if billions of virus particles are manufactured in millions of people.

"And since then, me and several other people have been screaming about the inequities that are widening and widening and widening."

Pai is far from alone in calling out the inequities.

There has been a concerted effort among concerned medical workers to call attention to the issue.

And well before omicron was first detected, doctors and scientists staged protests calling for vaccine manufacturers to share their shots, and their formula, more widely.

Now, in the face of omicron, the United States and other rich nations are ramping up domestic booster campaigns while the entire continent of Africa has fully vaccinated just 7 percent of its population.

Pai is in favor of booster doses for people who are elderly or who have underlying health conditions, but he calls booster doses for young and healthy adults "the latest avatar of the added inequities."

Still, some analysts say it's not boosters that are driving the problems, but hoarding.

Richer countries are buying more shots than they are using, even when boosters are taken into account, and not all of the surplus doses are being donated.

This comes at a time when the world is falling short of targets for distributing vaccines.

'Vaccine production and delivery has to dramatically scale up'

The global COVAX program launched in early 2020 with the goal of supplying billions of vaccine doses to the global south and vaccinating huge swaths of the population by the middle of 2022.

It is missing those targets by a significant margin.

It had pledged to deliver 2 billion doses worldwide by the end of this year, but WHO Director General Dr. Tedros Adhanom Ghebreysus said this week the initiative had delivered only 600 million doses so far.

The WHO had also set a target of vaccinating 40 percent of every country's population by the end of 2021, but at a briefing in mid-November, WHO chief scientist Dr. Soumya Swaminathan said more than 100 countries were short of the target.

"We have often said as long as vaccine inequity persists, the more opportunity the virus has to spread and mutate in ways no one can prevent or predict," the New Indian Express reported Dr. Tedros saying on Monday. "And so, we have omicron."

COVAX has announced expanded supplies of doses in recent months, bolstered by donations and by the Serum Institute of India's resumption of exports. Following the emergence of omicron, China has also announced it will send an additional one billion COVID vaccine doses to the African continent.

But Pai said these announcements, while helpful, were "a trickle" compared to the level of support necessary to truly bring the pandemic to an end and prevent even worse variants from emerging.

"I genuinely believe vaccinating the world is the only real path out of this crisis," he said. "And for that to happen, vaccine production and delivery has to dramatically scale up compared to where we are today."

Pai said this would require rich nations to stop hoarding vaccines and meet their pledged donation targets to COVAX. It would also require global support of an intellectual property waiver on COVID vaccines and treatments, and for vaccine producers to transfer technology to drug companies around the world.

The United States announced its support for a waiver on COVID vaccines on May 5, but the World Trade Organization has still yet to reach an agreement, 14 months after a coalition of low and middle-income nations led by India and South Africa proposed it.

"I would also love to see some kind of global leadership. Right now, I'm not sure who's driving this bus, who is in charge of ending this global crisis," Pai said.

"World leaders have to find a way to get together on this. Otherwise we are doomed to the pandemic continuing well into next year and the year after and even worse variants emerging in the future."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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