Poor countries like Rwanda will have to wait much long to access any possible COVID-19 vaccine as rich countries have already snapped up billions of doses.
It means that the two vaccines publicised this week and last, showing more than 90% efficacy have already been sold out, even before production begins.
A new study by researchers at Duke University’s Global Health Innovation Center, found that high- and middle-income countries have already purchased 3.8 billion doses, with options for 5 billion more.
“Where we are headed is a situation where high-income countries have enough, and low-income countries just don’t,” said Andrea Taylor, the lead researcher in interview with The Washington Post.
As a result, relatively wealthy nations will likely be able to vaccinate their entire populations, with billions of others relegated to the back of the line. People in low-income countries could be waiting until 2024, according to modelling by the Duke University researchers.
These deals between countries and drug manufacturers, known as advance purchase agreements, are undermining a World Health Organization-linked initiative to equitably distribute vaccines, the study suggests.
As vaccine development is progressing, Rwanda’s President Paul Kagame has been privately courting Global alliance for Vaccines and Immunisations or GAVI, the agency that will likely handle vaccines for poor nations.
On November 6, Kagame held video conference with GAVI CEO Dr Seth Berkley.
Village Urugwiro, the President’s Office, issued vague outline of what transpired in the Kagame meet, but it is obvious he is moving quickly to see how his government can access any possible vaccine.
With an economy heavily dependent on tourism, and at the same time nobody would be willing to visit unless they know they are heading to a safe place, Kagame needs the vaccine as convincing tool that Rwanda is the only safe destination in the region. Tourists will flood over.
Up to 160 countries, representing a large share of the world’s population, have signed on to participate in the GAVI Covid-19 Vaccines Global Access Facility, or Covax, which aims to develop and equitably distribute 2 billion doses of a vaccine by the end of next year.
Under the plan, both rich and poor countries pool money to offer manufacturers volume guarantees for potential vaccines. The idea is to discourage hoarding and focus on vaccinating high-risk people in every participating country first.
But before any of these jabs have been proven to work, there is another looming roadblock: Some parties, including the United States, European Union and the United Kingdom have paid upfront for doses. The phenomenon has been called “vaccine nationalism”.
As part of COVAX, poor countries will pay a subsidised price of up to $4 (Rwf 3,920) for a two-dose vaccine. Initially, COVAX promised free vaccines to low-income countries, but a September decision by GAVI’s board opted to introduce a cost-sharing plan with countries. Still, GAVI says there is some flexibility in this requirement and that countries can make a case for why they cannot afford the discounted prices.
The other challenge emerging is that one of the two vaccines that have proved to work, needs very expensive infrastructure because it requires storage -70 degrees Celsius temperatures. It remains to be seen how Rwanda will for its part afford all this infrastructure.
The other vaccine, will require that those taking it are given two doses, adding another layer on the cost.
Another challenge that governments are grappling with is, with the few doses that could be available, who among the population should get the vaccine first? Essentially, the biggest question on everyone’s mind is which Rwandans will get the COVID-19 vaccine first!
For now, Rwandan may need to get comfortable with the COVID-19 mask and social distance, not forgetting the night curfew, for quite some time. Either government will closed its eyes and completely open up the economy, or the destructive restrictions will remain in place, keeping tens of thousands in poverty.