What next for vaccine equity and the Global South? Covid has paved way for future pandemic preparedness

The Covid-19 pandemic has now claimed more than six million lives worldwide with the IMF estimating the projected cost to global economies at beyond $12.5-trillion. The initial announcement of the first successful vaccines brought the hope that the pandemic would be overcome globally. At the time, it seemed that the main hurdles would be convincing people in high-income countries (HICs) to get vaccinated and improving vaccine access for low- and middle-income countries (LMICs).

But as the vaccine rollout proceeded and the pandemic evolved, it quickly became clear that the challenges to ending the pandemic were massively underestimated. The greatest complication has been the emergence of variants to the original SARS-CoV-2 strain, some of which had higher transmissibility (omicron) or higher virulence (delta).

Even more troubling was the possibility that some mutations would cause vaccine escape, which would effectively render the vaccines obsolete. While vaccines have been available for more than a year now, no one can conclusively say when the pandemic is likely to end, and it seems likely that Covid-19 will become endemic. According to Gavi, the Vaccine Alliance, endemic Covid-19 will probably affect LMICs the most.

Unfortunately, as long as there remains a substantial percentage of unprotected individuals within the global population, variants will likely keep emerging and booster shots will remain a costly norm, especially in HICs. For example, in Israel, authorities are now recommending the fourth jab.

This pattern shows the importance of prioritising global mass vaccinations of those who are still unprotected, which would minimise the rapidity of viral mutations. This approach has become all the more important given that the current dominant variant, omicron, has been spreading faster than any other prior variant, and its subvariant the BA.2 appears even more transmissible.

Numerous organisations and individuals throughout the SARS-CoV-2 pandemic have advocated for vaccine equity. While it is true that LMICs have not been in a position to invest significantly in vaccine research for this pandemic, their exclusion from accessing vaccines is not only to the detriment of LMIC residents, but to the detriment of the global population as well.

Researchers at the Walter Reed Army Institute of Research are pursuing a universal coronavirus vaccine: a vaccine that would be effective against current and future Covid-19 strains and other beta coronaviruses that may emerge in the future. The Walter Reed’s Spike Ferritin Nanoparticle Covid-19 vaccine, or SpFN, has shown positive results in phase 1 trials and is undergoing final review. If the vaccine completes clinical trials and is authorised for global distribution, the next step would be to make the vaccine patent-free as a path toward dramatic production increases and widespread global availability.

Other avenues to combat the pandemic, such as an effort from the Texas Children’s Hospital to make their Corbevax vaccine available patent-free; ramping up vaccine production at the facility in South Africa; and efforts toward inclusiveness and diversity in clinical trials around the world all would provide progress toward global control of the SARS-CoV-2 pandemic. 

Further, these same efforts can be codified in pandemic preparedness plans currently under development to ensure a better, more equitable approach to future pandemics or emerging infectious diseases.

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Dr Tedros Ghebreyesus of the WHO’s words ring true: “[There is] no single country that will be able to vaccinate its way out of the pandemic alone.”

As a global community, we either vaccinate everyone and together overcome the pandemic, or the global community will continue to suffer from each newly emerging variant. 

Covid-19 statistics reported from Africa do not fully depict the situation on the ground. It may appear that the continent is better off than others, but there is also massive under-reporting of cases coupled with a lack of sufficient detection and testing capacity. It is still nearly impossible to confidently estimate the true impact of the pandemic on the continent which already has a very high disease burden.

We need all hands to be on deck as we fight this pandemic and prepare for future pandemics. DM

Zacharia Kafuko is the Africa Chapter Manager of 1Day Sooner. He is a molecular biochemist and a 2017 recipient of the Mandela Washington Fellowship of the Young African Leaders Initiative. He has been the producer and presenter of the award-winning radio programme Science Bench and has been involved in vaccine equity advocacy. He has previously worked as a public health educator under the Water for African Cities programme. He currently lives in Seychelles.

James Wilkinson is an independent infrastructure consultant. He did his doctoral work at UCLA in Statistical Mechanics, and serves 1Day Sooner in support of their philanthropic mission.

 

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