Volume 374| Issue 6571| 26 Nov 2021
Vax the world
BY Madhukar Pai, Ayoade Olatunbosun-Alakija
25 Nov 20
Earlier this month, while the United Nations (UN) Climate Change Conference convened in Glasgow, countries also gathered at the Global Conference on Health and Climate Change to recognize the climate crisis as a global health crisis—a consequence of increased poverty, food and water insecurity, and infectious disease transmission, among other dangers. Unsurprisingly, both crises are worse in lower-income countries. These countries are also experiencing the greatest number of deaths and collateral damage from COVID-19.
Both climate change and pandemics require countries and people to act as global citizens and go beyond nationalism. If countries cannot share resources to end COVID-19 everywhere, it does not bode well for the world’s ability to deal with the broad impacts of climate change. However, if nations can show global solidarity and vaccinate the world against COVID-19, it will give everyone much needed optimism to tackle climate change together.
Over 5 million people have died from COVID-19 so far, but the true death toll is probably threefold higher. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to rapidly spread, vaccine inequity is the biggest threat to conquering the pandemic. Whereas 66% of the people in high-income countries are fully vaccinated, only 2.5% of the population in low-income countries are fully protected. Moreover, COVID-19 has rolled back most of the global gains in tackling poverty and disease. If the world does not tackle this inequity, all countries will face collateral damage of unimaginable proportions. The UN Sustainable Development Goals (SDGs) will remain unrealized.
Consider the social and economic consequences of vaccine inequity. In 2020, the pandemic led to nearly 100 million more people in poverty, and the UN estimates that developing countries will suffer economic losses of $12 trillion through 2025. This will only get worse, as SARS-CoV-2 (Delta variant) is now primarily affecting countries with low vaccine coverage.
Moreover, the pandemic has disrupted essential health services, especially in the Global South, where fragile health systems are falling apart. For example, routine immunization is suffering not just because of pandemic measures such as lockdowns, but also because personnel and supplies required for childhood immunization are now being utilized for COVID-19 vaccinations. Data suggest that global routine immunization rates in 2020 dropped to levels last seen in 2005. This could well derail global efforts to eliminate polio and result in a resurgence of measles.
Health services for the continuing threats of tuberculosis (TB), malaria, and HIV have been severely disrupted by the pandemic as well. According to a recent World Health Organization (WHO) TB report, 1.3 million fewer people with TB were treated in 2020 than in 2019. According to the Global Fund, HIV testing declined by 22% in 2020. Progress against malaria has stalled as there was no year-on-year growth in provision of malaria services. People with noncommunicable diseases (NCDs) such as obesity, diabetes, and heart disease are more likely to have poor outcomes after COVID-19 infection. Disruption of health services has also adversely affected the treatment of many common NCDs, including cancer and mental health conditions.
Despite the devastating direct and collateral damage from COVID-19, world leaders have failed to ensure rapid and equitable distribution of diagnostics, vaccines, and therapeutics (e.g., monoclonal antibodies). Even as rich nations are administering booster shots, more than 3.5 billion people are waiting for their first dose. Last month, the G20 Rome Leader’s Declaration endorsed the WHO plan to vaccinate at least 70% of the world’s population by mid-2022. However, to end this pandemic, we need to be more ambitious and vaccinate the entire world. Otherwise, it will be impossible to protect any country from the Delta variant and prevent emergence of new variants.
The COVID-19 pandemic is the biggest test of humanity’s ability to think and act as humankind. To pass the test, rich nations must stop vaccine hoarding, immediately redistribute surplus vaccines, meet their pledges to the COVID-19 Vaccines Global Access (COVAX) program, support the Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver, and mandate pharmaceutical companies to transfer know-how for diagnostics, vaccines, and therapeutics.
Vaccinating the world is the best hope for ending this global crisis and for making sure the world is back on track for meeting the 2030 SDGs. And ending the pandemic will restore our faith in humanity and prepare us to face the ultimate test—climate crisis.