One of the appalling things about the current pandemic is the great inequality in vaccine availability around the globe, highlighting once more how the wealthy nations are able to corner the market on valuable resources. In this case, since many of the companies that are the biggest producers of vaccines are private ones and they seek to make as much money as they can, they have entered into contracts to mostly supply wealthy nations like the US that are able to pay more, while the WHO consortium that sought to provide vaccines to poorer countries through its COVAX program has found it hard to get adequate supplies.
Safe and effective COVID-19 vaccines were developed in record time. But the virus is moving faster than the global distribution of vaccines. The vast majority have been administered in high- and upper-middle-income countries. If these doses had been distributed equitably, they would have been enough to cover all health workers and older people globally.
WHO set a target for all countries to vaccinate 10% of their populations by the end of September. 56 countries effectively excluded from the global vaccine marketplace were not able to reach this target – and most of them in Africa.
Even more countries are at risk of missing the WHO targets of vaccinating 40% of the population of every country by the end of this year, and 70% by the middle of next year.
Most manufacturers have largely spurned the opportunities to share technology and know-how and public health-oriented licensing, despite a number of mechanisms being set up including the COVID-19 Technology Access Pool and the mRNA vaccine technology transfer hub, which is now moving ahead in South Africa.
The global failure to share vaccines equitably is taking its toll on some of the world’s poorest and most vulnerable people. New variants of concern mean that the risks of infection have increased in all countries for people who are not yet protected by vaccination.
We can only achieve our targets if the countries and companies that control vaccine supply put contracts for COVAX and the African Vaccine Acquisition Trust – or AVAT – first for deliveries and donated doses.
Reader Birger Johansson sent me a link to this article from Nature that says that Cuba, the victim of a brutal, vindictive, and irrational US-led boycott that is a relic of the Cold War, decided to develop its own vaccines and that effort seems to be paying off.
When the COVID-19 pandemic began, Cuba decided not to wait on the rest of the world to develop vaccines. The United States’ 60-year-old economic embargo against the country, which prevents US-made products from being exported there, would make it difficult for Cuba to acquire vaccines and therapies, researchers and officials knew. “It was best, for protecting our population, to be independent,” says Vicente Vérez Bencomo, director-general of the Finlay Institute of Vaccines in Havana.
So the Finlay Institute and Cuba’s other state-run biotechnology centres started developing their own COVID-19 vaccines in the hope that at least one of them would be effective. Their bet seems to be paying off: in a 6 November preprint published on medRxiv1, Vérez Bencomo and his colleagues report that one of the institute’s vaccines, Soberana 02, is more than 90% effective in protecting against symptomatic COVID-19 infection when used in combination with a related vaccine. Importantly, the combination seems to be effective against the highly transmissible Delta variant of the coronavirus SARS-CoV-2, which has caused surges in hospitalizations and death across the world and now accounts for nearly all COVID-19 cases in Cuba.
As of 18 November, 89% of Cuba’s population — including children as young as 2 — has received at least one dose of Soberana 02 or another Cuban vaccine called Abdala, which is produced at the Center for Genetic Engineering and Biotechnology (CIGB) in Havana. The centre reported in July that Abdala, a three-dose vaccine, was more than 92% effective in phase III trials that included more than 48,000 participants, but the full results have not yet been published.
Cuba’s regulatory agency authorized Abdala and Soberana 02 shots for use in adults in July and August respectively, and health-care workers began immunizing children with both vaccines a few months later. The country has begun exporting the two home-grown vaccines to Venezuela, Vietnam, Iran and Nicaragua. And it has asked the World Health Organization to approve its vaccines — an important step towards making them available throughout the developing world.
It is astonishing that Cuba, a country that is, thanks to the US, starved of the kind of normal economic and other exchanges with the world, has acquired the scientific expertise and infrastructure to not only develop vaccines and supply them to their own population, but also to provide them to other countries.
Science and technology needs to be democratized so that the developed world cannot continue to be the biggest beneficiaries of its advantages.