Covid vaccination needs global solidarity

Epidemiologist

The United Kingdom recently released travel guidelines, to be enforced from October 4, which require the mandatory 10-day quarantine and a series of RT-PCR tests for the unvaccinated travellers arriving in the UK. As per these guidelines, even some vaccines which have received emergency use listing (EUL) by the World Health Organisation (WHO) are not recognised by the UK.

Therefore, fully vaccinated citizens of many countries will be considered as being ‘theoretically unvaccinated’ and subjected to all restrictions that apply to the really ‘unvaccinated’ persons.

These guidelines consider the people from India who have received two shots of the Covishield — the Oxford AstraZeneca vaccine, manufactured by the Serum Institute of India — as being unvaccinated. This, in spite of the fact that the Covishield formulation is exactly similar to the Oxford AstraZeneca vaccine being used in the UK, with the only difference being the site of manufacture.

In another example, the UK has sent Oxford-AstraZeneca vaccines to Kenya, Africa. However, as per the country’s guidelines, the Kenyans who have been fully vaccinated with the vaccine supplied by the UK and visiting the UK, will be considered as being unvaccinated.

This travel policy has, understandably, created a furore and many countries, including India, have protested. How can it be explained that a vaccine with a similar formulation is acceptable for the UK citizens but not recognised if received by the citizens of other countries or manufactured in another country? Moreover, some vaccines approved by the WHO have also been excluded. Many countries have termed this as ‘colonialism’ and ‘vaccine discrimination’.

However, a few days later, following diplomatic interventions, the UK Government clarified that the Covishield vaccine is recognised, but the issue is with India’s vaccine certificate. The matter has not been completely resolved yet, and a solution is likely to emerge soon.

At the same time, this move by the UK is just a sequel to the series of mistakes that the world community continues to make with regard to the Covid-19 vaccination.

The Covid-19 vaccines have been in the news and been considered as a ray of hope since the beginning of the pandemic. But, even before the first Covid-19 vaccine was approved, the challenge of ‘vaccine nationalism’ emerged. A few high-income countries secured up to five times more vaccine doses than needed for their population. The criticism from other countries for the same did not stop them from acquiring more doses.

Fortunately, the spectacular success in Covid-19 vaccine research and development meant that nearly 21 vaccines received emergency use authorisation within 21 months of the pandemic.

Yet, of the 580 crore Covid-19 vaccines administered worldwide as of mid-September, 80 per cent have been administered in high-and upper-middle income countries. Only 0.5 per cent of the total vaccines have reached low-income countries, even as the availability of vaccines is equally important for every country.

The rich countries have given two doses to up to 80 per cent of their adult population and are considering giving the third and fourth shots, while in many poorer countries, barely 10 per cent of the population has received one shot. In Africa, only two per cent of the population has been fully vaccinated. This is an example of the blatant ‘vaccine inequity’.

The global collaboration of COVAX (Covid-19 Vaccines Global Access) , co-led by the WHO, the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance, has met only a partial success in getting the vaccines it needs.

‘Vaccine nationalism’ and ‘vaccine inequity’ has shown that while the global community talks about solidarity and cooperation in the pandemic response, the ground situation renders these claims hollow. This cycle doesn’t seem to end.

For countries like India, it is time for self-reflection as well. A lot of data and information related to the Covid vaccine is not easily available. The problem partly originates in the poor health data recording and reporting systems in the country. Else, why should the data of the Covid-19 vaccine clinical trial take months to be synthesised and documented? If it had been planned in advance and if the process strengthened, it could have been submitted to the authorities concerned, including the WHO, earlier.

And in that case, by now, there might have been a decision on EUL by the WHO on India’s second Covid-19 vaccine. Currently, of the two Covid-19 vaccines used in India, Covaxin is not listed by the WHO, and Covishield is facing restrictions in many countries. If this situation continues for long, it may impact the public enthusiasm about vaccines.

‘Vaccine nationalism’, ‘vaccine discrimination’ and ‘vaccine inequity’ are not the only challenges in the Covid-19 pandemic response. In the months ahead, as normalcy returns and travel opens in many countries, there is a risk of similar challenges emerging again. We need to be prepared to prevent such discriminatory vaccine travel policies at all levels.

On many fronts, where solidarity and collaboration are needed, many countries have disappointed the global community. But there is still some time. The countries need to share vaccines with the rest of the world and collaborate with COVAX.

In this direction, the announcement by the Government of India that from the next quarter of 2021, some Covid-19 vaccines would be exported is commendable.

The question is, if the countries do not cooperate with each other during the pandemic, then when would they do it? Time is short, but the global community still has another chance. The coming generation will assess all our steps.