As the world has been preparing to gear up to bid adieu to 2021, the last week of November brought much-dreaded news after an arduous but brave fight with the pandemic. The emergence of the new B.1.1.529 SARS-CoV-2 variant left global leaders and scientists perplexed and tense. The variant, which was subsequently named the Omicron variant after the fifteenth letter of the Greek alphabet, was rapidly declared a Variant of Concern (VOC) by the Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE).
The Omicron variant, which was first reported on 24th November in South Africa, presented evidence of a staggering 32 mutations in the spike protein, an enormous leap from its preceding Delta variant (nine mutations in the spike protein). The whirlwind of infection surges and accelerated spread is indicative of these mutations being in favour of the virus. These characteristics are only inferential and have yet to be corroborated by conclusive scientific evidence.
The past waves of Covid-19 infections sent ripples of havoc around the world, and they only further underscored the unpreparedness of countries to deal with the raging number of cases. In this situation, one might wonder what value the vaccination efforts have to provide and why, despite the large number of doses administered globally, there are still new variants emerging.
While there are many questions being raised about the credibility of vaccines, the truth of the matter lies somewhere else. Viruses are one-of-a-kind organisms that quickly adapt to changes in order to increase their chances of survival. Covid isn’t any different. The selective allocation of vaccines in some populations while others remain largely unvaccinated has left a giant loophole in the system, allowing the viral replication to not just escalate, but also change the way it interacts with antibodies, letting it thrive.
The consequences of vaccine inequity can hardly be overstated. It goes much beyond a failure to provide essential protective measures fairly. The current vaccine distribution structure is distinctly skewed, with only 6% of the population in low-income countries (LICs) having received the first dose so far, while some of the high-income countries (HICs) have already started rolling out booster doses to the masses. This heavy imbalance has dampened the global efforts to fight Covid and left countries that have not been able to procure sufficient doses vulnerable.
“More than 80% of the world’s vaccines have gone to G20 countries; low-income countries, most of them in Africa, have received just 0.6% of all vaccines.” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, at the Special Session of the World Health Assembly.
Lack of equity in global vaccine manufacturing and distribution is not a new concept. But with a pandemic like Covid, the monopolization of vaccine production by certain countries or companies is a dangerous tactic, threatening the overturning of the progress made towards recovery.
This phenomenon has broadly been reflected in the reluctance to recognising vaccines produced locally in LICs. The case in point is Covishield, the Oxford-Astrazeneca vaccine manufactured by the Serum Institute of India. Individuals who received both doses of the vaccine in the country or other countries in the region were not considered fully vaccinated and thus weren’t allowed to travel freely to many countries where the primary vaccine was of other brands. It was only in late September, after incessant uproar and backlash, that the United Kingdom included it in the accepted list of vaccines.
Advocates for global vaccine equity strongly condemn the obscuring of vaccine designs and call for the open exchange of valuable information that will allow countries to produce the vaccines locally instead of offering it to them as donations or charity.
Experts believe that even if pharmaceutical companies such as Pfizer-BioNTech and Moderna reveal their vaccine designs, manufacturing plants will be unable to produce the vaccines on a large scale while maintaining their integrity. A major reason behind that is the absence of the tightly controlled production line that many plants will not be able to execute due to a lack of highly specialised resources and personnel.
However, these points are counteracted by the advocates as they are of the opinion that the points raised by the companies and their spokespersons are just a way of exempting themselves from “…relinquish[ing] their control over their patents and technology, even at the cost of millions of lives,” says Achal Prabhala, coordinator at AccessIBSA, a medicine-access initiative in Bengaluru, India.
In his opening remarks at the Special Session of the World Health Assembly, Dr. Ghebreyesus reiterated the importance of transparency in sharing vital information regarding the virus. “The time has come for countries to agree on a common, binding approach to a common threat that we cannot fully control nor prevent – a threat that comes from our relationship with nature itself.” He went ahead to commend South Africa and Botswana to report the detection of the new variant in a swift manner, and expressed his concern about the relaxation of regulations in countries that have already vaccinated the majority of their population.
The future of global health and the course of the pandemic still remain uncertain. The current circumstances must be taken into consideration when re-evaluating protective measures against Covid. Increased access to vaccines, through responsibly allocated manufacturing, should take precedence amongst other mitigation efforts.
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