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Can the world learn lessons from vaccine inequity?
GZERO Media and the Bill & Melinda Gates Foundation convened leading experts in public health, research, development, and philanthropy on Thursday to discuss the uneven state of global recovery from health and economic perspectives. Participants included moderator Natasha Kimani of Africa No Filter; Eurasia Group President Ian Bremmer; José Manuel Barroso, chair of Gavi, The Vaccine Alliance; Dr. John Nkengasong, director of the Africa Centers for Disease Control; Melanie Saville, director of vaccine research and development for CEPI; and Mark Suzman, CEO of The Bill & Melinda Gates Foundation. They discussed vaccine equity and how we can end the COVID pandemic in a way that better equips the world for similar challenges in the future.
On many streets in the UK and US, it’s almost possible to forget that there’s an ongoing COVID-19 pandemic. With so many westerners double vaccinated and boosted, the threat of the omicron variant has eased. In fact, the CDC just lifted mask recommendations for much of the US. But that doesn’t mean the pandemic is over. For many countries, that’s far from the case.
Moderator Natasha Kimani, the research and media programs lead at Africa No Filter, kicked off the discussion by asking where things stand today as the world marks the second anniversary of the pandemic.
“It depends on where you sit,” says Dr. John N. Nkengasong, a virologist and director of Africa’s CDC. “If you’re sitting in Africa, the glass is half empty. If you’re sitting in the global north, the glass may be half full.”
There’s a reason for optimism in parts of the world that have managed to vaccinate a majority of their populations. But in Africa, says Nkengasong, there’s deep concern because the virus, and its effects remain “very unpredictable and very unsettled.” Optimism elsewhere, he warns, should be approached with caution and humility because more surprises may await us. “There’s still a lot we need to learn about the virus,” he says.
Nkengasong is optimistic the world will overcome the pandemic but is concerned by how long it will take. “We are dealing with a very determined enemy — let there not be doubt in anyone’s mind.”
Sadly, many low-income countries are still struggling to get vaccines and distribute them properly. With only 11 percent of the African continent vaccinated, according to the UN, much more needs to be done.
So, why have some countries fared so well while others have languished?
“The world has not provided equitable distribution,” says Mark Suzman, CEO of The Bill & Melinda Gates Foundation, which came at the cost of “lives lost that could’ve been saved.” Before a vaccine was available, countries agreed in principle to distribute a future jab to the most vulnerable. But once a vaccine was developed, Suzman explains, domestic political pressures in western countries led to a free-for-all instead.
Politics aside, the production of such a quick and effective vaccine is remarkable, and the technological innovation is worth heralding. “I think we've put 10 years of development into less than a year,” says Melanie Saville, director of vaccine research and development for CEPI.
But as for the lessons to be learned from their unequal distribution? Suzman points to two areas. First, we must finish addressing the current crisis and ensure effective delivery of vaccines to the unvaccinated. But, second, we must get ahead of future health threats by ensuring there’s enough volume of treatments available in both low- and higher-income countries. To be ready for the next pandemic, he says, we need to have all the tools and structures in place, including good surveillance, research and development, and manufacturing capabilities to respond to health threats within a couple of hundred days.
You would think that a global pandemic threatening millions of lives would pull the world together in search of a solution. Instead, we’ve witnessed political fragmentation in the US and vaccine inequity worldwide.
Russia’s invasion of Ukraine, meanwhile, has managed to take the pandemic off everyone’s radar. What’s a deadly virus compared to the threat of nuclear weapons? “Maybe we should give President Putin a Nobel prize of medicine because, apparently, he made COVID disappear,” quips Manuel Barroso, chair of Gavi, The Vaccine Alliance. Putin, of course, did nothing of the sort, and low oxygen supplies in Ukraine have spotlighted how COVID, as well as many other medical issues, are amplified during times of war.
But the Russian assault on Ukraine has managed to breathe new life into transatlantic cooperation. Could this newfound energy for a bolstered alliance help move the needle on other issues, such as health?
“I think the answer’s yes,” says Eurasia Group President Ian Bremmer. The pandemic wasn’t enough to shake up the dysfunctions in geopolitics, he explains, pointing to the politicization of health care at home and vaccine distribution inequity worldwide.
But the idea of a western collision with a nuclear-armed Russia?
That’s enough to shake up the allies and get them moving forward together, and Bremmer expects that cooperation to be long-lasting and to extend beyond the realms of defense and security (the wildcard being China and its future relationship with Russia), which will hopefully make it easier to help end the COVID pandemic and prepare for future health crises.
Looking back at the fight against COVID, Nkengasong likens the struggle in 2020 to one of fighting “a war with bare hands.” Last year, vaccines became the main tool for fighting back. This year, he says, we need to use every tool at our disposal — including self-testing, vaccines, boosting vaccine equity worldwide, ensuring access to new drugs — to prepare for the next variant, which “might cause severe disease.”
Only then, in late 2022, does he think there’s hope for “seeing the light at the end of the tunnel.”
COVID hypocrisy & misinformation
Ian Bremmer's Quick Take:
Hi, everybody. Ian Bremmer here from sunny Nantucket and going to be here for a little bit. Thought we would talk about the latest on COVID. Certainly, we had hoped we'd be talking less about it at this point, at least in terms of the developed world. A combination of the transmissibility of Delta variant and the extraordinary misinformation around vaccines and COVID treatment means that we are not in the position that many certainly had hoped we would be today.
The United States is the biggest problem on this front. We are awash in vaccines. Operation Warp Speed was an enormous success. The best vaccines in the world, the most effective mRNA, the United States doing everything it can to get secure doses for the entire country quick, more quickly than any other major economy in the world, and now we're having a hard time convincing people to take them. The politics around this are nasty and as divided as the country, absolutely not what you want to see in response to a health crisis.
On the left, I'm seeing so much talk about mask mandates and so much hypocrisy. The mayor of Washington, DC announcing a mask mandate for the entire district and literally within hours, she shows up to officiate a wedding and nobody's wearing masks, including the mayor, Muriel Bowser. You remember back, the governor of California, now under a recall campaign, Gavin Newsom, when everything was shut down and he's there at the French Laundry, a great restaurant, having an indoor party with his buddies mask-less when nobody else was doing that. President Obama, former President Obama now about to have 475 people at a big party for his 60th birthday in the (Martha's) Vineyard while you have so many among the Democrats that are saying, "no, we have to have mask mandates when cases are increasing. You shouldn't be gathering in these larger groups."
At the same time, you've got people like Governor DeSantis in Florida, Governor Abbott in Texas, and others that are saying that vaccine mandates among private corporations should be illegal. That if you're a restaurant, if you're a store, you're not allowed to tell people who are coming into your establishment that they have to show proof of vaccination, which strikes me as a ludicrous thing to do. And certainly, given how extraordinarily effective we know these vaccines are, there's just far too much virtue signaling.
We don't need everyone in the country wearing masks. We just need everyone vaccinated. And there need to be consequences otherwise. And yes, I know the vaccines are not yet proven safe for children. I would not make an argument that we should be requiring children to take vaccines until we know that they're safe. But we also know that those children are at extremely low risk for getting sick and dying from the disease. And given the amount of damage lack of attending classes does to kids and their development for well over a year now, the idea that we have teachers unions in the United States that are saying, "no, we refuse to open up classes again this fall given where the country is," that's extraordinary to me. It shouldn't be allowed. The schools have to open across the country. It's not like the danger of the disease is the only danger that's out there. You've got economic damage. You've got sociological and psychological damage. We have to get people, particularly poor people, at able to live normal lives. And who are the ones that can't effectively homeschool or have private tutors? Those are the ones that are going to be most affected by this yet again. So, I think that's a serious problem.
This outrageous politics-first approach on COVID response promotes misinformation. It is a tax on the poor and the uneducated. The wealthiest 1% in the United States are almost all vaccinated. The people with graduate degrees are almost all vaccinated, but the QAnon supporters, the National Enquirer readers, they are not. And if you believe that Trump actually won the presidency and is going to be reinstated in the next few weeks, of course you believe that the Delta variant is a fraud and that the vaccine is mind control. Bad domestic actors are perpetrating this on America. People are profiting from this. Social media companies are allowing this disinformation to persist. It is not coming from the Kremlin. We in the US are damaging ourselves far worse than Moscow or Beijing ever could. And that's in the United States.
And meanwhile, while the Americans are awash in vaccines that we are not taking and that are even going bad in Africa, the continent is almost fully un-vaccinated. 1.3 billion people on the African continent, 1% of that population is fully vaccinated. It's an obscenity. It can only be allowed to persist if we think that people living in Africa somehow aren't fully human beings, that they don't deserve the opportunities, the health care, the ability to live and protect their families, their children the way that we do in the wealthy countries.
I saw Secretary of State Tony Blinken saying that we are, the United States, sharing as many safe and effective vaccines around the world as possible. I couldn't believe he said that. I know Tony and I understand, and he's not a bad guy, I've known him for a long time, and as secretary of state, you have to be diplomatic. You can't always say what you mean. It's certainly why I shouldn't have that job, but this is just a false hood. The United States is not doing anything close to everything we can for the rest of the world.
We are shockingly ungenerous in the ability and willingness to fund and to provide vaccines for those that don't have them. The COVAX Facility so far, 150 million doses delivered. The plan, the modest and reasonable plan for now was 650 million doses. We are 500 million doses short. It's underfunded. You had 1.8 billion per vaccine delivery that was provided for last month, over a billion dollars short of their modest goals. This was the kind of thing, it's not just the United States, pretty much any G20 economy, maybe not Argentina, any individual G20 economy could have done the COVAX funding by themselves, and they didn't. They all looked, I guess, not even at each other because they wouldn't budge. As long as you're taking care of your own country, that's all you need to do.
In this environment at a time that we are facing the worst crisis of our lifetimes, the United States on the one hand, refuses to follow basic science. We are as deeply politicized as any time we've ever experienced it, pointing fingers, calling names, thinking that we are our own worst enemy while we're not taking care of even the basics. And we can so easily afford to do so for those around the world.
It's much easier not to talk about this. It's much easier to not to focus on it. But if we can't get this right for COVID, how are we going to get it right for the bigger crises to come? How do we get it right for climate? How do we get it right for terrorism, for migration? How do we get it right for the next pandemic or the next variants of COVID? It's challenging and it's something we're going to keep talking about, but something I wanted to address today. As so many of us are thinking about summer and enjoying ourselves and our families and our friends, and that's all wonderful, but spare a thought and some action for those that are not so fortunate.
And I hope everyone's doing well. And I'll talk to you all real soon.
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A person holds a placard as supporters of the Economic Freedom Fighters march to demand a rollout of COVID vaccines, in Pretoria, South Africa.
Africa’s COVID crisis and the politics of selfishness
This time last year, world health experts were speculating about why Africa appeared to have escaped the worst of the global pandemic. Younger populations? Natural immunity created by exposure to past viruses? Something else?
They can stop wondering. Africa is now in the grip of a COVID emergency.
A few bleak facts:
- Of the 10 countries with the highest number of current COVID deaths per capita in the week before July 18, three of the top six are in Africa. That includes Namibia at #1, Tunisia at #2, and South Africa at #6.
- Last week, recorded COVID deaths in Africa jumped 40 percent from the previous week.
- Just 1 percent of Africa's 1.3 billion people are fully vaccinated. African governments will be very lucky if that number reaches 10 percent by the end of 2021.
- African countries were slated to receive many more AstraZeneca vaccine doses from India. That was before India became a global COVID hotspot.
- Of 77.6 million doses that the COVAX facility, a vaccine-sharing initiative, has allocated to African countries, fewer than 16 million had arrived in Africa by July 7.
There are many explanations for Africa's new COVID troubles. Healthcare facilities are below international standards in many of Africa's 54 countries. Governments don't have the bureaucracies to roll out treatments and vaccine doses as efficiently as in wealthier parts of the world. Poor infrastructure in some countries compounds that problem.
But the G-Zero world disorder plays a role here too. G-Zero is a term coined by our boss, Ian Bremmer, to describe an "every nation for itself" approach to global politics that has become the dominant trend in today's world.
It's not that wealthy countries have done nothing to help Africa. Without support from the US, EU, and other rich countries, COVAX wouldn't exist to provide vaccines to anyone. But while it's completely understandable that American and European leaders want to vaccinate Americans and Europeans first, the scale of vaccine selfishness has become a topic of hot debate.
Here's your key data point: According to One.org, an activist organization, "The world's richest countries could vaccinate their entire populations and still have over 1.9 billion doses to share — enough to vaccinate the entire adult population of Africa."
As it is, healthy young people in the US and Europe will be vaccinated months before many frontline healthcare workers, elderly people, and people with serious underlying medical conditions in Africa.
Some may see this as a sad but understandable reality. Wealthier nations and people have always enjoyed advantages while the poor suffer what they must. But there are two obvious responses to that.
First, selfishness can be a matter of degree. It's one thing to argue that "my people must be vaccinated first." It's quite another to horde excess supplies that might never be used and to consider booster shots for young healthy people in one country while frontline health workers in other countries can't even get their very first vaccine dose.
Second, every time COVID is transmitted from one person to another, it mutates. Enough mutations create variants — like the delta variant that has caused COVID to rise not only in Africa, but also in the United States and Europe. Leave enough people unvaccinated and we sharply increase the risk that future variants — maybe more transmissible and more lethal than the now prevalent delta variant — will be infecting vaccinated people everywhere.
India’s COVID calamity
India's latest COVID explosion hits home as one Delhi-based journalist speaks with Ian Bremmer on GZERO World about her own father's death from the virus. Barkha Dutt has been reporting on the pandemic in India since it began, but nothing could prepare her for the catastrophic second wave that has hit her country in the last few weeks—and that has now shattered her own family. Would her father have survived if the oxygen tank in his ambulance had been working, or if the ambulance hadn't gotten stuck in Delhi traffic? She asks similar questions of her national government. Why was it caught so unprepared by this second wave, well over a year into the pandemic? Why has India, the largest vaccine manufacturer in the world, been so slow to vaccinate its own citizens? And how much of the blame falls at the feet of Prime Minister Narendra Modi?
Joe Biden the Candyman
The US president changes his tune about giving vaccines to the rest of the world, and gets a desperate call from Narendra Modi.
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