By: Christopher Tufton
It’s a universally acknowledged truth: The COVID-19 vaccine is the light at the end of the pandemic’s tunnel. The return to normalcy depends on global immunity. However, what we see around the world is “vaccine nationalism” instead of “vaccine equity.”
Some countries have cornered the supply so much that they can offer up to four doses per person, while many developing countries have yet to receive a single dose of a vaccine. Even where supplies had been secured, several Latin American, Caribbean and African states do not have enough for the majority of the population.
Statistics from Duke Global Health Innovation Centre show that total confirmed purchases worldwide are concentrated in high-income (4.6 billion doses) and upper-middle-income countries (1.3 billion doses). This kind of imbalance is also true for vaccine administration.
Most Small Island Developing States — SIDS — are relying on a global initiative, COVAX, to inoculate their populations. COVAX, led by the World Health Organization, UNICEF and other groups is working to provide equitable access to the COVID vaccine.
Given financial constraints and their inability to compete with larger countries (some of which are willing to pay above market price) for vaccines, this decision made sense. Wealthy countries supported and subsidized the accelerated development of a vaccine, and less wealthy countries and small island developing states, like Jamaica, Barbados and the Bahamas put their lot in with the COVAX consortium, contributing an affordable amount of money to a common fund that would also be put toward vaccine development and guarantee some vaccines once it was approved.
The participation of Caribbean nations in COVAX was not only to meant to secure access to vaccines, but also to secure access to WHO-approved vaccines. From the outset, almost every Caribbean country has followed world standards in the management of the pandemic. Testing protocol was based on WHO recommendations, discharge criteria were informed by WHO research and analysis, and treatment protocols have followed WHO’s evidence-informed guidelines.
Furthermore, not every vaccine is certain to work. As reported by several media outlets, Australia had reserved 51 million doses of a homegrown vaccine that failed in clinical trials. Sanofi and GlaxoSmithKline Plc had to delay their clinical trials after setbacks. Merck shut down its vaccine program after unsatisfactory early results.
Most Caribbean SIDS decided to administer only vaccines that had passed the strictest international standards. The risk of bringing in a vaccine about which there could be any doubt is too great, damaging the region’s vaccine program for generations to come.
There are three reasons for vaccine delays in many SIDS: First, rich countries have accumulated extensive supply deals. The United States struck unilateral deals for all of its 1.2 billion-dose supply, four times more doses than its population. Wealth has moved some countries to the front of the line. Other countries may have to wait until 2022 or later before supplies are widely available. Some of these richer countries have had higher rates of COVID mortality and have signaled that they intend to eventually share these enormous supplies.
Second, hoarding by rich countries has slowed COVAX’s ability to obtain what had been allocated to them.
Third, some countries are not following as stringent standards as are most Caribbean SIDS, administering vaccines that are not WHO-approved, or not yet WHO-approved.
While Caribbean SIDS have signed up with COVAX, which has faced setbacks, they are also seeking to secure supplies through bilateral and multilateral negotiations with other countries, including China, India, Cuba and Russia. Given the Caribbean’s disadvantage in the global vaccine market, these arrangements are important.
Barbados, Dominica and the Dominican Republic received supplies of the Oxford-AstraZenca produced by the Serum Institute of India through a donation from India, amounting to 100,000, 70,000, and 30,000 doses respectively. Jamaica has been promised 50,000 doses through a similar arrangement. India should be commended for this donation to the region’s nations.
Some countries, including Guyana and Trinidad, have received a small supply as gifts from Barbados’ supply. Dominica also made donations from what it received to some of the smaller Caribbean islands. St. Vincent and the Grenadines received 20 doses of the Russian Sputnik vaccine, an intermediary dose. (The overseas territories in the Caribbean, which include the Cayman Islands, the British Virgin Islands, and the U.S. Virgin Islands, are being taken care of by Britain, the Netherlands, France and the United States.)
Most SIDS are now playing catch-up while their wealthier counterparts have been inoculating their populations, some at a rapid rate. Despite the challenges and constraints, SIDS have remained resilient, relying on a wide array of non-pharmaceutical interventions, including regulations, COVID protocols and innovative policy approaches to fill the vacuum created by vaccine inequity, hoarding and the politics of global vaccination. Larger countries should, as some have promised, take a more equity-seeking approach to the distribution of vaccines.
Dr. Christopher Tufton is Jamaica’s minister of Health and Wellness and member of parliament for West Central St. Catherine, Jamaica.
*Republished from the Miami Herald, first published on March 17, 2021*
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