Hira Bahadur Thapa

With over three million dead and millions more infected by coronavirus globally, the pandemic toll keeps spiking threatening humanity. In no other area is found the stark poor-rich divide as in our fight against the virus, the most challenging global health crisis of our time. How can we be not concerned looking at thousands desperate fellow human beings pleading for most essential medical supplies. Disappointingly, just over 3 per cent of citizens have received vaccines in poor countries while wealthy nations have millions of doses remaining unutilised, having inoculated a large per cent of their population already.
The rich nations reserved the supplies from different pharmaceutical companies before the delivery started. These nations had ordered quantities in excess of their actual needs assuming that they might require them in future. Among them America has the largest stockpile of vaccines, where they are inoculating children above 12 though frontline workers in poor countries are still waiting for vaccination. At the moment the contrast in global vaccination campaign is heartbreaking.
In the US, a large quantity of AstraZeneca vaccines is not utilised the reason being that the Food and Drug Administration, the regulator agency, has not authorised its use in the country. In many countries the same vaccines are used. Even COVAX, a World Health Organisation-led global initiative to facilitate vaccination drive in poor countries, has been supplying them as part of its campaign to promote equitable access to COVID-19 vaccines.

Vaccine apartheid
Why can the US not share their unused wealth with other needy nations is incomprehensible. Of late, President Biden has said that it would donate 80 million doses, albeit a drop in the ocean. We have seen vaccine apartheid resorted to by wealthy nations which deprive the developing nations of getting vaccinated when rich ones are overstocked.
COVAX has been constrained by the supply of vaccines especially from AstraZeneca, with which it has struck a deal because the manufacturing companies have failed to meet the rising demands. One of these companies, the Serum Institute of India, the world’s largest manufacturers, has publicly notified that it would not be able to supply to COVAX as well as to other parties which are dependent on it as per the previously agreed schedule. This has severely affected the nations waiting for the vaccines. One of the most affected nations is Nepal, whose government had made advance payments to Serum Institute of India for 2 million doses a few months earlier but has been supplied just half of that till this time.
Consequent upon this shortage of supply from India, about 1.5 million senior citizens in Nepal who are at higher risk of contraction have been deprived of their chance to receive their second dose. The first doses were administered three months ago. They are supposed to have their final second dose within two to three months from the time they got vaccinated but there is no indication whatsoever when their turn will come. Happily, the Chinese President in his telephone conversation with our President has assured that his country would donate 10 million Chinese vaccines to Nepal. There is a growing fear among some senior citizens that they might lose their immunity gained from the first dose of vaccine.
This anxiety has been compounded by the emergence of new variants of virus, which is so widespread in South Asia. As per Nepal’s Health Ministry, some samples from different parts of the country were lab tested with genomic sequencing in India and woefully, three different mutations were detected. The new strains are more transmissible and deadlier.
This is why public health experts believe that the per capita death rate of Nepal is highest among the countries in the world now, where close to 200 people on an average are dying each day in the last few weeks. Unless urgent measures are in place to contain the spread of coronavirus for which Nepal’s single-handed efforts are not adequate, the death tolls will spike instead of lowering. The most effective way to address the challenge of coronavirus pandemic is early vaccination which is impeded significantly by poor supplies of vaccines.
Injustice
The distributional criterion of COVAX formed by WHO, GAVI, the vaccine alliance, and the Coalition for Epidemic Preparedness Innovations, is based on population. The empirical evidence reveals that the global alliance needs to change this flawed approach of distribution of vaccines to prioritise more vulnerable nations in access to COVID-19 vaccines to save more lives. Under the present arrangement with COVAX every participating nation is allotted vaccines for 20 per cent of the population, which is free of cost for poor nations. That quota remains unfulfilled. It does not do justice to all though apparently looks equitable. Countries like Nepal fighting with increasing infection and death rates are the victims of this injustice.
The change in COVAX distributional policy is morally defensible considering the fact that precious lives that could have been saved, had the poor nations with higher infection and fatalities been prioritised over other participating countries where those rates are lower. In some African nations the COVAX-supplied doses got expired due to distributional challenges. Switching to need-based distribution policy could help low-income countries better where higher per cent of people are contracted and dying too.
Worryingly, in Canada 600,000 doses of AstraZeneca vaccines supplied by COVAX are unused because of wrangling over the efficacy of such vaccines at a time when thousands elsewhere are breathing their last due to vaccine shortage. The good news is that the US and Britain are reopening to gain economic recovery but it needs to be borne in mind that all health is global and outbreak anywhere threatens recovery everywhere.

(Thapa was Foreign Policy Advisor to the Prime Minister in 2008-09. thapahira17@gmail.com)