[Rwanda] "Until Africans get the Covid vaccinations they need, the whole world will suffer", Paul Kagame
The current situation with regard to the access and distribution of Covid-19 vaccines vividly illustrates the decades-old contradictions of the world order.
Rich and powerful nations have rushed to lock up supply of multiple vaccine candidates. Worse, some are hoarding vaccines – purchasing many times more doses than they need. This leaves African and other developing countries either far behind in the vaccine queue, or not in it at all.
There are worrying signs of vaccine nationalism in Europe and North America. The pressures on political leaders to vaccinate all their citizens before sharing supplies with others is understandable. But forcing smaller or poorer countries to wait until everyone in the north has been catered for is shortsighted.
Delaying access to vaccines for citizens of developing countries is ultimately many times more costly. The pandemic will rage on, crippling the global economy. New mutations may continue to emerge at a more rapid pace. The world risks reversing decades of human development gains and eclipsing the 2030 sustainable development goals.
In this context, the billions of dollars it would cost to distribute vaccines across the developing world is not particularly high, given the return on the investment. Doing so would unlock global commerce, which would benefit all trading nations during the long road to economic recovery that lies ahead of us. We need global value chains to be fully operational again and to include everyone.
Last year, the world came together to provide additional fiscal space for developing countries through the debt service suspension initiative at the G20. This helped governments in Afica pay for their Covid responses and provide additional social protection, thereby preventing the worst outcomes. We shouldn’t lose that spirit now and give in to an unfortunate erosion of global solidarity.
The Covax facility, led by the World Health Organization, was supposed to ensure doses for 20% of Africa’s people – right from the start and at the same time as richer countries. However, nearly two months after the first vaccines have been administered, it is still not clear when African nations will be able to start immunising people, though the first doses may begin reaching the continent later this month.
What can be done in practical terms? The rich world can help developing countries get the same fair prices that they have already negotiated for themselves. One pharmaceutical firm is reportedly planning to charge $37 per dose for “small orders”. Recently, one African country reported being asked to pay more than double the price that the European Union had negotiated for the same product.
During natural disasters, price gouging for essential supplies is illegal. It should not be tolerated for vaccines during a pandemic either. If prices are fair, and Africa is allowed to place orders, many countries on the continent would be willing and able to pay for themselves. But, given the current market structure, they will need active support from more powerful countries to do so.
The African Union and Afreximbank have set up the Africa Medical Supplies Platform to help countries secure financing by providing advance commitment guarantees of up to $2bn to manufacturers. The platform has negotiated an initial order of 270m doses, but this is still very far from the 60% coverage Africa needs to achieve some measure of herd immunity, and there is no telling when those supplies will be available.
Vaccine candidates from China and Russia are also coming online and may provide an alternative for some developing countries. However, the reality is that most countries will only be able to procure vaccines that have been approved by the World Health Organization. The WHO should speed up emergency use approvals for Covid-19 vaccines in line with action taken by major national regulators in Europe and North America.
Africa is not sitting back and waiting for charity. We have learned our lessons from the past. All we ask for is transparency and fairness in vaccine access, not the protectionism currently in play.
Ensuring equitable access to vaccines globally during a pandemic is not only a moral issue, but an economic imperative to protect the wellbeing of people everywhere. But when will Africa get the protection it needs? If all lives are equal, why isn’t access to vaccines?
Paul Kagame is the president of Rwanda, and the African Union champion for domestic health financing