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How Rich Countries Affect COVID-19 Vaccination In The Rest Of The World


In theory, the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, was talking to the whole world at his press conference last week. I mean, he started with a nod to every time zone.


TEDROS ADHANOM GHEBREYESUS: Good morning, good afternoon and good evening.

CORNISH: But once he started speaking about global vaccine distribution, it was clear he had a specific audience in mind.


TEDROS: Rich countries have bought up the majority of the supply of multiple vaccines.

CORNISH: Forty-two countries have begun rolling out safe and effective vaccines, he said. None of them were low-income countries. The WHO does have a plan - it's called COVAX - designed to get vaccines to low-income countries, a sort of pooled fund that makes deals with drug companies and distributes the vaccine fairly across borders. But one-on-one deals between drug companies and individual countries have undermined that effort. At least that's what Ghebreyesus says.


TEDROS: No country is exceptional and should cut the queue and vaccinate all their population while some remain with no supply of the vaccine.

CORNISH: But that's exactly what's happening. Canada, for example, has bought enough doses to vaccinate its entire population five times over, according to Duke University researchers. Now, some of those vaccines may not ultimately make it out of trials, but the disparity is real. Other countries are still waiting for their first doses - countries like South Africa.

ANBAN PILLAY: It's a bit like, you know, boarding an aircraft. It seems that you'll have to stand by and watch everybody in business class get in.

CORNISH: That's Anban Pillay, deputy director general in South Africa's Department of Health. South Africa has announced deals for vaccines. Twenty million doses, the government says, will arrive mainly in the first half of this year. But in the meantime, it's facing the continent's worst outbreak - 500 deaths a day in a country of roughly 60 million. Pillay told me he realized from his early conversations with drug companies that it was going to be hard for South Africa to compete with richer countries.

PILLAY: We were having a discussion about procuring a vaccine that hadn't gone through the clinical trials yet. There was no certainty about its success. And yet we were already talking about placing orders and payment of money linked to that. For me, that was quite surprising and unusual. And I realized then that many of the more developed and wealthy nations had clearly gone down this path. And so we were having this conversation as a result of a queue already being developed, many developed nations being at the front of the queue and going to access vaccines through this.

CORNISH: You know, a group of South African scientists wrote an op-ed earlier this month saying that it beggars belief that South Africa does not have a better plan for vaccines. They're saying that the concern you raise about risks - it's not the case because you would be committed to buying vaccines only when they're available and when they work.

PILLAY: Yeah, I think it's important to highlight that in terms of our public funds, we're required to invest in a product once we understand that the product works. If we had to put down a payment without understanding whether the vaccine works or how effective the vaccine is, we would then be in breach of our - what we call the Public Finance Management Act.

CORNISH: So South Africa is a part of COVAX, which is this global effort, led in part by the World Health Organization, to get vaccines to kind of middle- and low-income countries. How much will that actually help supplement, help provide for you?

PILLAY: Well, COVAX has been an interesting arrangement. Its intention was to create global solidarity and equitable access to vaccines. I think many countries, you know, spoke about solidarity but didn't necessarily act. And so the COVAX facility has yet to release vaccines to its beneficiary countries, largely because the stock has all been taken up by the developed nations.

The best information we have at this stage is that there may be some stock of a vaccine from Pfizer. But the amount that we're being offered is a drop in the ocean. We're being offered 0.25% of our populations to have access to vaccines for health care workers. We have about six or seven times that number in terms of frontline health care workers.

CORNISH: I understand South Africa is also working with four drugmakers supporting their trials. Does that guarantee you doses if those trials are successful?

PILLAY: Well, the drug trials are done independently of us. So none of the country - companies - sorry - are prepared to make that concession. Basically, that means that they've used South Africans to get data in order for them to register the product and thereafter forgotten about South Africans in terms of providing them with access to a drug.

CORNISH: I understand there's also a drug manufacturer that works with Johnson & Johnson in South Africa. Is that true? Is it Aspen?

PILLAY: That's right. Aspen Pharmacare is - has got a license to do the filling and packaging of the Johnson & Johnson product.

CORNISH: So there will be South Africans actually making a vaccine.

PILLAY: Yeah, they would be doing the filling into vials and sealing and labeling and packaging. And then the product has to be shipped off back to Europe for testing and then distributed around the world. And so we have no right to access that product, as we understand. We would have to negotiate for our place in the queue in order to access the product.

CORNISH: So there could be vaccines tested on South Africans. South Africans would make the vaccine. And South Africans would not get the benefit of any of that.

PILLAY: Sadly, yes. That's basically what the situation is currently.

CORNISH: Anban Pillay, deputy director general of South Africa's Department of Health. And we checked in with a COVAX partner organization who said COVAX anticipates it will be able to provide South Africa and other participating countries with enough vaccine for 3% of their populations in the first half of this year. Transcript provided by NPR, Copyright NPR.