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Covid-19 vaccines: glaring inequality

 Editorial  It was estimated in late May 2021 that only 0.3% of the vaccines against covid-19 administered worldwide had been given in the poorest 29 countries. Western leaders are being called upon to do the right thing: a historic opportunity that must be seized.

By late May 2021, some of the world's wealthiest countries had vaccinated more than half of their adult population against covid-19 and were starting to vaccinate children. Describing this situation as a "moral catastrophe", the head of the World Health Organization (WHO) urged these countries to share their vaccines with poorer countries instead, where supplies are insufficient to vaccinate healthcare professionals and hospitals are inundated with patients requiring lifesaving care.

The WHO and high-income countries have set up Covax, an initiative designed to supply the lowest-income countries with vaccines. But its aim of providing enough vaccines to immunise one-fifth of the population of the 92 countries concerned by the end of 2021 is unlikely to be achieved. One important reason for this is that the main manufacturer participating in Covax, the Serum Institute of India, is prioritising production for the domestic market until the end of the year in order to tackle the growing epidemic in India.

This has resulted in a glaring "North-South" inequality. In late May 2021, it was estimated that only 1.4% of the total population in Africa had been vaccinated and that only 0.3% of the vaccines administered worldwide had been given in the poorest 29 countries, where 9% of the world's population resides.

In October 2020, India and South Africa called on the World Trade Organization (WTO) to temporarily suspend industrial property rights for covid-19-related health products. This initiative is supported by dozens of countries, the WHO and many non-governmental organisations, but it has been opposed by the pharmaceutical industry and industrialised countries, including the United States and the European Union, which prefer to emphasise other barriers, such as lack of expertise and the need for technology transfers to expand production. In mid-2021, the president of the United States generated a new dynamic within the WTO by declaring his support for this waiver on industrial property rights.

The European Union is a key player in this debate, along with the United States. It was still firmly and vigorously defending industrial property rights in mid-2021. The EU would do well to remember the precedent set with penicillin. Many US pharmaceutical companies produced hundreds of billions of penicillin tablets during World War II, thanks to agreements between the US and UK governments to suspend industrial property rights and transfer the necessary technology.

Eighty years on, Western leaders are once again being called upon to do the right thing: a historic opportunity that must be seized.

©Prescrire 1 October 2021

Source: "Covid-19 vaccines: glaring inequality" Prescrire International 2021; 29 (230): 227. Free

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