Less than 15% of the coronavirus vaccine doses that G7 countries have pledged to donate have been delivered to date, according to a report recently published by analytics company Airfinity.
Donations from rich countries forget that vaccines do not get alone
Last June, the leaders of the seven most advanced economies on the planet met in Cornwall under intense pressure to agree immediate and ambitious measures against the huge inequality in global vaccination. Without going into greater detail, the G7 leaders announced the direct donation of at least 870 million doses, and pledged to do so “as soon as possible”, with the aim of delivering “at least half” by the end of 2021. They also said that they were going to “mainly channel” them through the COVAX mechanism, which tries to ensure an equitable distribution.
For its analysis, published last week, Airfinity takes into account previous promises from the G7 nations in other meetings before June, which raised the number of committed doses to around 1 billion. According to their data, to date only 14.8% of the 1.01 billion doses promised by the G7 (including the EU) have been donated, with the United States as the country that has delivered the most vaccines (it was also the country that received the most offered to donate).
Low volumes and short notice
Rich nations have captured most of the world’s supplies, which has been seen as the biggest obstacle to achieving a more equitable distribution of vaccines. Many high-income countries purchased enough doses to inoculate their populations multiple times, even before they were licensed. More than 5.5 billion doses have been administered worldwide. 80% have been injected into high-income and upper-middle-income countries.
In recent days, the WHO, which has set a goal for all countries to vaccinate at least 10% of their population by the end of September, has once again called on donor countries to deliver on their promises urgently. Tedros Adhanom Ghebreyesus has addressed the G20. “As the world’s largest producers, consumers and donors of vaccines, the world’s top 20 economies hold the key to vaccine equity and the end of the pandemic,” said the WHO chief, who asked them to honor their commitments. to share doses “by the end of this month at the latest.” “There has been a lot of talk about the equity of vaccines, but very little action has been taken. We don’t want any more promises. We just want the vaccines.”
Before the G7 meeting in June, the results of which were widely criticized by civil society, the WHO had consistently called for an acceleration of vaccine donations to countries with fewer resources in the following months, and UNICEF called for clear deadlines regarding when they would be available.
The redistribution of leftover doses is not an easy task because it depends on the donor countries, the recipients and the pharmaceutical industry, according to experts, who have long warned that these types of donations often make planning difficult in the countries that receive them. Many surpluses, in addition, are reaching their expiration date.
“At the moment little and badly is being donated,” Belén Tarrafeta, pharmacist and expert in access to medicines, tells elDiario.es. “If the 85% of announced donations that are still missing arrive suddenly, then there may be an absorption problem in the recipient countries. Also, if the donations are not made from origin (factory) and have to be redistributed after they have passed through another country, then we can find more expiration problems, which is what has already happened with lots of vaccines redistributed from Canada and the UK. “
“Surplus management is complex and donating surplus should never be a strategic drug supply option. It can be a temporary and timely solution to an unexpected planning problem, but not a strategy per se,” says Tarrafeta. “In the case of COVID vaccines, promises to donate surpluses have been announced without concrete plans. Donations should follow the vaccination campaigns of the recipient countries, and not vice versa, that is, vaccination campaigns cannot be made in depending on the availability of donations. It’s a matter of mutual respect. ”
In the same vein, Miriam Alía, head of Vaccination at Doctors Without Borders (MSF), who, like Tarrafeta, maintains that the donation process “is a provisional band-aid, not a medium or long-term solution, especially when these donations come from surpluses, with a much shorter expiration date. ” “The process is very complex, for example, for the European Union. The European Commission has signed agreements with pharmaceutical companies, in which it accepts that the pharmacist has the decision of what to do with the remaining doses, if they can be donated or only sold to other countries. This type of contract on a vital product in a global public health emergency is unacceptable. ”
Alía believes that the Airfinity figure “tells us little about real-time availability” and highlights the lack of transparency that has surrounded the donations that countries are making bilaterally (not through COVAX), which ensures that they are being “impossible to follow”. In those of COVAX, he thinks, there is “more visibility”, but not with regard to details such as the exact days of arrival.
“Until now, bilateral donations between governments have had little transparency, and donations through COVAX, little anticipation in terms of arrival dates, expiration dates, and above all, the release of operational costs so that vaccination campaigns are carried out, “Alía tells elDiario.es. “The donation and transport of vaccines is the first step, but vaccines have to reach the arm of health personnel and the vulnerable population. And it is the internal travel, logistics, transport and the cost in human resources that are not being taken taken into account in these vaccination initiatives. ”
Asked by elDiario.es about the evolution of donations, a spokesperson for the main promoter of COVAX, the Vaccination Alliance (Gavi), responds: “Although we value the fundamental role that donations have played, they need to be faster, higher volume and more predictable. ” “At present, they are distributed in small volumes, on short notice and with shorter expiration dates than ideal, which implies a huge logistical effort to allocate them and deliver them to the countries that can absorb them.”
According to Gavi, countries (not just the G7) have pledged to donate about 640 million doses to COVAX. So far, 108.6 million have been shipped, and deliveries continue. “COVAX is working closely with donors to operationalize these pledges in doses delivered to countries with acute needs,” says the entity’s spokesman.
Millions of doses left over
Airfinity’s analysis takes into account the available supply of vaccines in the US, UK, EU, Canada and Japan. Predict what these countries will need in the future and the number of vaccines that are available to be shipped elsewhere.
The company estimates that Western nations could donate more than 1.2 billion doses in 2021 alone, even maintaining national booster campaigns for all adults. Of these, 1,060 million have not been allocated to donations. This figure excludes Chinese vaccines. The inventory analysis also reveals that there are 500 million doses available for redistribution this September (360 million of which have not been earmarked for donations).
In addition to the doses that are currently available, the company says, “there are many to come.” “Global vaccine production has increased rapidly, with a total of 6 billion doses produced to date last month.” According to their figures, manufacturers are currently producing 1.5 billion doses per month and “this number is expected to continue to grow.” “11.3 billion doses are needed to vaccinate the world’s population and Airfinity expects production to reach that level by the end of 2021.”
Airfinity co-founder and CEO Rasmus Bech Hansen said in a statement that, with these predictions, rich countries “can be confident that there are many vaccines on the way and this should reduce the need to stock them.” “How these reserves are distributed, where they go and whether they are resold or donated is ultimately a political decision.”
“Manufacturers and high-income countries have long had the ability not only to vaccinate their own priority groups, but to simultaneously support vaccination of those same groups in all countries. We have been demanding equity in vaccines from the beginning. Not after the richest countries have taken over, “said the WHO director-general. “Low- and lower-middle-income countries are not the second or third priority. Their health workers, the elderly and other risk groups have the same right to be protected. I will not remain silent while the companies and countries they control the world’s supply think that the world’s poor should settle for scraps. ”
In Tarrafeta’s opinion, before the first vaccines were approved, “you could understand this strategy of wanting to buy a lot of different options because you didn’t know which one was going to work.” “But that in May the bilateral agreements between the EU and pharmaceutical companies were reverted, without going through transparent, open and competitive processes, and that purchasing agreements have been established for quantities much higher than necessary and at higher prices. , makes me question not only the vaccination strategy but also the use of public funds for the purchase of vaccines. ”
The expert points out that the figures provided by Airfinity “go in the dynamics of what we could expect.” “There were already other analyzes that suggested that at the end of 2021 there would be a surplus of vaccines.” If these predictions are confirmed, he believes that “it is very possible” that the “surpluses will accumulate and the donation is the solution that best suits high-income countries, and does not respond to the needs of recipient countries. And all this could end. with very significant quantities of expired or deteriorated vaccines due to lack of refrigeration capacity “.
“Taking into account the quantities that have been purchased, the absorption problem can also be found in high-income countries. And in that case the solution of donating surpluses can also create many logistical problems,” he concludes.