By GILBERTO LOPES*
A beautiful idea that did not bear fruit.
"A beautiful idea that did not bear fruit". This is how Duke University researcher Gavin Yamey described it to the prestigious scientific journal The Lancet the result of the project to supply the whole world with vaccines against Covid-19. “Rich countries behaved worse than anyone's worst nightmares,” said Yamey, who worked on the design of the Covax project, an initiative led by the World Health Organization (WHO).
The idea was to distribute two billion doses of vaccines by the end of 2021, ensuring supply to all countries, whether or not they had the money to pay for them. For this, the nations that had more resources had to send money or vaccines to a fund intended for countries that could not pay for them.
The problem, second The Lancet, began when the richest countries began to negotiate bilateral agreements with pharmaceutical companies to guarantee the supply of vaccines for themselves. “Currently, ten countries have applied 75% of all vaccines against Covid-19, but in poor countries, health workers and people at risk do not have access,” said UN Secretary-General Antonio Guterres. The Covax initiative has distributed more than 72 million doses to 125 countries. But this is much less than the 172 million that should have been delivered. Of the 2,1 billion doses administered worldwide, Covax accounted for less than 4%, added Guterres.
At the G-7 meeting in Cornwall, England, in the middle of this month, attended by the President of the United States, Joe Biden, the participants agreed to supply one billion doses of vaccines to the Covax project, either by delivering surpluses accumulated in their own countries, or allocating greater financial resources to it. But the final communiqué of the meeting – which brings together the seven most developed countries – did not specify the commitment of each country, nor set dates for these commitments.
As the WHO said, the G-7 should have secured the supply of 11 billion vaccines, not one billion. “Never in the history of the G7 has there been such a huge gap between what they decide and what the world needs,” said Max Lawson, head of policy against inequalities at the British organization Oxfam. “We don't have to wait for the assessment of history to know that this summit was a colossal failure,” he said. Something similar was said by former British Prime Minister Gordon Brown, who also considered the summit a huge failure, a far cry from Prime Minister Boris Johnson's promises to vaccinate the world.
Money for banks, not vaccines
Between March of last year and June of this year, one year and four months, the central banks of the G-7 countries printed and delivered nine trillion dollars to the banks. To vaccinate the entire world, with two doses if necessary, at current vaccine prices, would require $39 billion, according to figures from the International Monetary Fund (IMF). “A small change in the fate of money that could have saved humanity from Covid-19,” said former Greek economy minister Yanis Varoufakis at a four-day virtual summit hosted by the Progressive International (IP) in mid-June. , on the problem of supplying vaccines in the world.
An initiative of US Senator Bernie Sanders and Varoufakis, the Progressive International has promoted debates on alternatives to current policies on key issues for humanity. In this case, an alternative to a system that allowed the concentration of existing vaccines against Covid-19 in high-income countries.
The G-7 has pledged to donate 600 million vaccines, said Carina Vance, Ecuador's former health minister under Rafael Correa. But the population of low- and lower-middle-income countries alone is 3,5 billion people. If we're talking about vaccines that require two doses, that alone would require seven billion doses.
The IP summit sought to create a platform composed of countries from the South that already have a large capacity to produce vaccines, which are on the verge of validating well-developed vaccine projects, as in the case of Cuba, and which could, in a relatively short period, produce them and distribute them massively.
The number of deaths from Covid-19 is very unevenly distributed around the world. Achal Prabhala, coordinator of the AccessIBSA project, which promotes cheap access to medication, a member of the Shuttleworth Foundation in Bangalore, India, recalled that, since last month, 85% of deaths from Covid-19 have occurred in low- and middle-income countries. Deaths in rich countries represent only 15% of the total. In India, they are dying as a result of a health system that is not able to serve the population. And that it never was, he added.
“The vaccines promised by the G-7 will only arrive at the end of the year, or at the beginning of the next one”, said Prabhala. If we look at the number of deaths from Covid-19 in India, close to 1.400 per day, or in Brazil, which has more than 2.000, and which are currently the two countries with the most deaths from Covid-19 in the world (the United States register numbers slightly lower than 400, Argentina has close to 550 and Colombia, almost 700), in these two countries alone, we have about 100.000 monthly deaths, around 600.000 by the end of the year. “If we pay attention to these numbers, a delay of one day, one week, one month is almost criminal”, said Prabhala.
The block
It is therefore a matter of making vaccines available all over the world, as in the case of Cuba, which already has two types of vaccines produced by the country itself being applied: Abdala (with a recognized efficacy of over 92%, in a three doses) and Soberana plus, with an effectiveness of 62%, also higher than the requirement of 50% by the WHO for the product's effectiveness to be recognized.
The blockade to which the United States has subjected Cuba for almost 30 years has had devastating effects on scientific activities on the island. Despite this, Cuba is the only country in Latin America that will have vaccines developed based on its scientific and production capacities, and could become the first in the world to immunize the entire population with a product from its own harvest, said the specialist in economics and social history at the University of Glasgow, Helen Yaffe.
This lockdown policy was once again condemned worldwide. Last week, the UN General Assembly passed a resolution condemning it by 184 votes. Only Israel followed the United States in rejecting the resolution. Of the three abstentions, two were from Latin American countries – Brazil and Colombia – whose policies are aligned with the United States, as well as those of Ukraine, the third country that adhered to the abstention.
Despite the repeated votes regarding the illegality of the sanctions and their effects on the lives of the Cuban population, the measure continues to be promoted by the different republican and democratic governments that have succeeded each other in Washington, supported by legislation that has become increasingly restrictive against island, with the argument that in this way they promote democracy and human rights on the island.
But the devastating effects of these measures on scientific activities in Cuba have been described in detail by those who run institutions in the sector. Tania Urquiza Rodríguez, vice president of BioCubaFarma, said that the blockade affects “all BioCubaFarma companies and, therefore, the entire national health system and our people”.
The increase in purchases, due to not being able to purchase them in nearby markets, or having to resort to intermediaries who transfer or nationalize the raw materials in a third country in order to be able to supply them, is one of the results of the blockade that affects the sector. These actions, said Urquiza, “make the inputs and raw materials that we have to acquire in order to produce our medicines more than 30% and sometimes 50% more expensive”.
The general director of FarmaCuba, Adis Nuvia Neyra Muguercia, denounced similar problems: 51% of our suppliers “are intermediaries, precisely because of the limitations of direct access to manufacturers and markets”. Not being able to access a natural market like the United States, which is only 90 miles from the country, “we are obliged to work through long replenishment cycles, acquire the necessary inputs at prices increased by 30% to 50%, and have intermediaries in the most contracts.
In a long report entitled “How the blockade affects Cubans' right to health”, the portal cubadebate exemplifies the many ways in which these measures make the development of normal activities in the world of commerce or scientific research in the country more expensive, difficult and sometimes impossible.
Also faced with a resurgence of Covid-19 in some regions, Cuba reported last week a new daily record for the disease, with 2.055, despite more than five million doses having already been administered to its population until last week.
For Helen Yaffe, the difficulties faced by WHO in getting doses of vaccines against Covid-19 to the underdeveloped world, and the confirmed effectiveness of Cuban products, justify Havana's decision not to join the Covax project which, despite good intentions with which it was proposed, faced the reality of the appropriation of vaccines by developed nations. Once Cuban vaccines receive final scientific approval, they will begin to be exported to poor nations.
Latin America and Africa
Countries such as Brazil, Colombia, Chile and Argentina are also facing devastating outbreaks of Covid-19. In Brazil, a commission created in the Senate to investigate the responsibilities of the Jair Bolsonaro government in managing a pandemic that has already left more than half a million dead last week received new information about the scandalous purchase of vaccines in India.
According to Denis Minze, director of the Lemann Foundation, one of the most important in the country, “what is behind this terrible number of deaths is that we are not all in the same boat”. The pandemic does not affect us all equally. Access to health, education and employment is not the same. “Brazil has never suffered a similar crisis. The situation is desperate.” “Brazil has not been able to manage the pandemic well. We have been hit harder than other countries and this despite having a very well structured universal and free public health system. We are also one of the best countries in the world in terms of vaccine production and distribution. We had everything we needed to weather a pandemic. There has clearly been a lack of political leadership and we are paying the price,” said Minze.
What the parliamentary investigation revealed is that Brazil not only did not manage the pandemic well but, over the course of more than 500 deaths, the political sectors linked to the president negotiated the irregular purchase of vaccines in India, which would imply an overprice of more than 300 million dollars, the reduction in the number of vaccines negotiated (the 20 million initial doses were reduced to three million) and the purchase of vaccines practically expired, among other irregularities that the investigation is revealing. A scandal that, according to sectors of the opposition, could lead to impeachment from Bolsonaro.
In Colombia, 40.000 lives have been lost since mid-March; 25.000 new cases are detected daily. “The hospital network across the country has collapsed, with intensive care occupancy in the three main cities – Bogotá, Medellín and Cali – surpassing 97%,” said a report in the British newspaper The Guardian, dated 22 June. “The response to the pandemic has been a catastrophe, a scandal,” said Román Vega, professor of public health at the Javeriana University in Bogotá, to the The Guardian. “First, we had a new wave of cases. Then we have a low vaccination rate. Third, we face a social protest in full swing. Despite everything, the government decided to open up the economy. Finally, we have a health system unable to respond to the challenges. A catastrophe!” Vega said.
The political struggle over vaccines is also manifest in Africa, where African Union Special Envoy Strive Masiyima has accused wealthy nations of deliberately avoiding sending vaccines to the continent. While Britain has vaccinated 47% of its citizens and the United States 45%, less than 1% of the African population is fully vaccinated, she added.
But for Samuel Ramani, a tutor in international relations at the University of Oxford and author of a book on Russia's foreign policy in Africa, it is "the proactive nature of Russia's vaccine distribution program in Africa" that should worry Western countries.
In an article published on June 22 in the journal Foreign Policy, Ramani recalls the concern of French President Emmanuel Macron, who urged the European Union, last February, to supply vaccines to Africa, “to contain Russian and Chinese vaccine diplomacy”. But, as the G-7 meeting made clear, neither the European Union nor the United States is capable of rising to the challenge of vaccinating the entire world, as suggested by British Prime Minister Boris Johnson.
*Gilberto Lopes is a journalist, PhD in Society and Cultural Studies from the Universidad de Costa Rica (UCR). author of Political crisis of the modern world (Uruk).
Translation: Fernando Lima das Neves.