Explainer: Vaccine inequity and the entry of Omicron

What is vaccine inequity?

The lop-sided distribution of Covid-19 vaccines across the world has created a situation of imbalance in the coverage of people vaccinated across geographies. It is now an open secret that developed countries in the world have cornered a lion’s share of the available vaccines, leaving low-income countries without enough supplies even for frontline healthcare workers.

How bad is it?

The shocking imbalance has been repeatedly called out by public health voices. About a week ago, the World Health Organization chief, Dr Tedros Adhanom Ghebreyesus, spotlighted the inequities again. “Over 7.3 billion vaccines have been administered globally, but nearly 70 per cent of those have gone to just ten countries.

Almost 40 per cent of the world’s population is now fully vaccinated, but in Africa, it’s only 6 per cent.” Worse, developed countries are proceeding with plans for booster doses, though the WHO has called on a moratorium till the year-end. “Every day, there are six times more boosters administered globally than primary doses in low-income countries,” said Dr Tedros in November.

Why is the WHO trying to level the inequities?

The mantra repeated often by WHO officials and public health voices around the world is that “no one is safe, till everyone is safe”. A mix of vaccinated and unvaccinated populations could be fertile ground for variants to rise, say experts.

Has this inequity come home to roost in the form of Omicron?

To quote the WHO chief on Omicron, “the longer we allow the pandemic to drag on – by failing to address vaccine inequity, or to implement public health and social measures in a tailored and consistent way – the more opportunity we give this virus to mutate in ways we cannot predict or prevent”.

Inequities and imbalances in vaccine coverage are not just between countries, but could be within the country as well. And whether the early cases of Omicron are reported out of Africa or other developed countries, as reports now suggest, the attention of healthcare administrators is to get as many eligible people across the world vaccinated (even while vaccine efficacy is being assessed against the new variant), besides ensuring other public health measures are in place as well.

What are the challenges in delivering vaccines to poorer nations?

The WHO says vaccine companies have fallen woefully short of the promises they made to supply Covax, the international system in place to supply vaccines, especially to low- and middle-income countries. Exports from Indian companies such as Serum Institute that supplied vaccines to Covax were put on pause earlier this year, when India saw a surge in Covid-19 cases.

Serum Institute recently resumed supplies to Covax. The WHO has asked the major vaccine makers to prioritise supplying Covax over “shareholder profit” (where supplies go to countries that pay top dollar). In their defence, the companies have urged countries that need vaccines to place orders and ready the infrastructure required to supply it.

By when will the world be adequately vaccinated?

The UN health agency’s approach to end the acute phase of this pandemic was to target vaccinating at least 40 per cent of the population of every country by year-end (involving an additional 550 million doses) and 70 per cent by mid-next year.

To get there, 11 billion doses of vaccines are needed, says the WHO, calling for urgent multi-pronged measures to plug the supply gap.