Vaccination gap: From promises to action
One of the key issues on everyone’s mind will of course be the ongoing pandemic, where the global situation remains very worrying. The health situation is still not under control, the delta variant is spreading around the globe causing thousands more deaths every day, widening inequalities and increasing poverty. Indeed, as the IMF put it last July: "vaccine access has emerged as the principal fault line along which the global recovery splits into two blocks: those that can look forward to further normalization of activity later this year (almost all advanced economies) and those that will still face resurgent infections and rising COVID death tolls.”
“The health situation is still not fully under control: the delta variant is spreading, causing thousands more deaths every day, widening inequalities and increasing poverty.”
The vaccination gap persists
Two months later, this diagnosis remains valid. Global vaccination has accelerated, but the North-South divide remains and vaccination rates still differ significantly. On 16 September, 31% of the world population was fully vaccinated. In the EU, this was the case for 61% of the adult population and the choice of joint procurement of vaccines at EU level has paid off in the end. These percentages were 45% in North America, 36% in Latin America and the Caribbean and 34% in Asia, but only 3.8% in Africa. In fact, only 3.1% of people in low-income countries have received at least one dose (see graphs). And as repeated on numerous occasions, no one is safe until everyone is safe: if this gap persists, we clearly run the risk of new variants emerging that escape the protection of existing vaccines.
The inequality is not acceptable and last June, the IMF estimated that we would need $50 billion, or 0.06% of global GDP, to vaccinate the world's population by 2022 - and that this would generate $9 trillion in additional wealth by 2025. It is hard to imagine a more profitable investment. It would save many lives, limit the risk that new COVID-19 variants emerge and have a positive effect not only for the economy of low-income countries, but also for the global economy. At a recent seminar at the EEAS on the geopolitics of vaccination, a leading European scholar rightly asked what the reasons were for not being collectively able to finance such a relatively cheap common public good with such a high return.
“The IMF estimates that we would need $50 billion, or 0.06% of global GDP, to vaccinate the world's population by 2022 and that this would generate $9 trillion in additional wealth by 2025. It is hard to imagine a more profitable investment.”
The answer lies in the lack of global governance and problems of multilateralism: we have not been able to implement enough cooperation and coordination globally. The world should not wait for the next pandemic before putting in place the global health governance and financing reforms to deal with pandemics more effectively. We will discuss this challenge again at the UN General Assembly, and in particular at the meeting on 22 September organised by US President Biden on this subject.
“By the end of 2021, we should have produced enough doses to vaccinate the entire adult population on a global scale.”
In early 2021, there was a shortage of vaccine production capacity, but this is no longer the case: by the end of 2021, we should have produced enough doses to vaccinate the entire adult population on a global scale (see graph below). Europe in particular has succeeded in rapidly increasing its production capacity, thanks also to the efforts of the European Commission and my colleague Commissioner Breton. However, as Gordon Brown, the former British Prime Minister, noted recently in the Guardian: “Despite this manufacturing triumph, we are losing badly in the arms race to actually inject every adult in every country.”
Since December 2020, the EU has exported close to 700 million vaccine doses to 55 countries. Indeed, we have been one of the world’s main vaccine exporters and the only ones to reach such a high vaccination rate among our population while at the same time exporting on such a big scale. These figures show that Europe cannot be blamed for restricting vaccine exports: the mechanism we put in place last February has ensured transparency without practically limiting these exports. However, these exports were mainly sent to developed countries such as Japan, Turkey, UK or Canada.
“The EU has been one of the world’s main vaccine exporters and the only one to reach such a high vaccination rate among our population while at the same time exporting on such a big scale.”
Regarding the distribution of vaccines in low-income countries, the EU has from the start built on a multilateral solution, namely the COVAX mechansim, set up by the World Health Organisation. This was not necessarily the best way to ensure the visibility of the European Union on vaccines distribution globally, but it seemed the most effective way to ensure global coordination. With €3.2bn in pledges, the EU remains the main financial donor to COVAX, together with the US. That said, we have to recognise that the programme has so far not delivered the way we had hoped for: while COVAX’s target was to deliver 1.8 billion doses by the end of 2021, it has so far just distributed 210 million doses, half of which have been donated by EU, the US and other donors. COVAX does not produce any vaccines, it gets them from manufacturers. Nonetheless, it has struggled until now to obtain sufficient volumes of doses.
To address the challenge of a persistent vaccine divide, the EU pledged last July to donate 200 million doses to low- and middle-income countries by the end of 2021 and our member states have voluntarily committed to larger amounts. In her State of the Union address, Commission President Ursula von der Leyen pledged additional 200 million vaccine doses to low-income countries by mid-2022.
Overall, however, when looking at the figures, we see that our actions have not yet met our aims: as of today, EU member states have given 20 million doses to 65 countries. As Europe has been severely affected by the COVID-19 pandemic, it is understandable that member states prioritised their own citizens before donating vaccine doses beyond their borders. But now that Europe has achieved high vaccination rates and there is no more shortage of vaccines, we must be aware of our moral, economic and health obligations to help vaccinate the whole world and of the geopolitical costs if we fail to do so.
“Now that Europe has high vaccination rates with no more shortage of vaccines, we must be aware of our moral, economic and health obligation to help vaccinate the whole world and of the geopolitical costs if we fail to do so.”
It can also damage our influence and reputation in our immediate neighbourhood, in the Western Balkans or in the countries of the Eastern Partnership, where other actors are very active and an intense “battle of narratives” takes place. This is also the case in Africa, where leaders expect much more of us, given our ambition to be the closest partner of the continent. We are certainly committed to building production capacity on the continent and we have started to work on it, namely in Senegal and South Africa. This is crucial for the future of the continent, but it cannot solve the immediate problem. In Latin America, where the impact of the pandemic has been particularly severe, there is also a strong need for cooperation. So far, nine Latin American countries have received nearly 3 million doses and over 6 million doses will be shared this autumn.
“Now that we have advanced successfully with the vaccination of our own population, we should quickly and significantly increase the volumes of our vaccine donations.”
Again: now that we have advanced successfully with the vaccination of our own population, and with enough doses lined up for potentially needed ‘booster’ shots, we should quickly and significantly increase the volumes of our vaccine donations, both through COVAX and directly to those countries in need that count on the EU for help. This is all the more so, as we are the world's largest producer of mRNA vaccines. We need to assert our role as positive and responsible global actor and reliable partner in an increasingly competitive world.
The issue of vaccine distribution
Beyond the issue of the pure number of vaccines for low- and middle-income countries, there is also the issue of the capacity to distribute them effectively, especially for mRNA vaccines. With our Team Europe approach, associating member states, the Commission and European financial institutions, we have disbursed so far €34 billion to help our partners cope with the COVID-19 pandemic in the health, social and economic fields. We nonetheless still have to go further, also to help distribute vaccines more effectively.
In short: it is essential that we rapidly close the global vaccination gap and the gap between our ambitions and our actions on vaccine donations. This is not only our moral duty and in our geopolitical interest with view to the EU's position in the world, it is also essential for everyone’s health and to get the pandemic globally under control.
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