In his Washington Post column Fareed Zakaria chides “rich countries” for not doing enough to inoculate the entire world against COVID-19, blaming the emergence of the omicron variant of the virus on that failure:
It’s estimated that 100 million of the doses stored by Western countries will expire and have to be thrown away by the end of the year if they are not used — and yet they sit stockpiled while the poorest 1.6 billion people in the world have only about 5 percent of the world’s vaccinations.
This is not a case of global institutions failing. There exists an effective mechanism to share and distribute the vaccines worldwide, COVAX, set up by a group of international health organizations. But rich countries have been stingy about actually making donations. The United States pledged the most — 1.2 billion doses — but so far has delivered just around 280 million. The European Union, Iceland and Norway have collectively pledged about 500 million doses and delivered about 112 million. China has recently increased its pledge to 850 million doses, up from 100 million, and has delivered about 89 million. As a result, 82 countries are at risk of falling short of the World Health Organization’s goal of vaccinating 40 percent of every country’s population by the end of the year, which means that the virus will keep replicating and mutating freely among billions of people. What is the chance that we will not see another variant in the next year?
To some extent I agree with him. Nearly a year ago I said that the U. S. should be sending vaccine to Mexico and the Central American countries as it became available. But I do have two problems with his complaint.
First, the problem isn’t “rich countries” so much as “rich countries other than the U. S.”. We’ve given twice as much vaccine to COVAX as Europe and by “Europe” I largely mean Germany. Germany and the U. S. have about the same vaccination rates so that’s no explanation for Germany’s failure. And China, true to form, has been much better at making pledges than at fulfilling them.
But it’s more complicated than that. The Pfizer and Moderna vaccines have storage requirements that make them impractical for use in the poorest countries in the world and the AstraZeneca and Janssen vaccines, which just require normal refrigeration, aren’t as effective as the Pfizer and Moderna. If we weren’t being berated for not delivering vaccines we’d be scolded for foisting off substandard vaccines on other countries.
Here’s my suggestion. President Biden should order one of the Navy’s hospital ships to be fitted to store the Pfizer and Moderna vaccines properly and make a tour of ports in Mexico and Central America, inoculating anyone who presents themselves (in an orderly fashion, of course). Of course, that would need to be cleared with the authorities in those countries. If they’re turned down, they could go to other countries.
Or the US could approve, produce, and consume (to set an example) a vaccine as effective as mRNA vaccines but only requires normal refrigeration.
There is even a US company with such a candidate (Novavax), that’s been approved in Indonesia, Philippines, and is close to final approval in EU, UK, Canada, Australia. Politico had an article on the tale of woe of how they got to the finish line so late (management woes, federal government inattention, FDA bureaucracy).
Part of the problem is a perception that mRNA vaccines are much better then AstraZeneca. From real world usage in 2021, we now know mRNA vaccines have a peak efficiency at preventing infection of 90+% at 2 months but declines rapidly to something like 50% by 6 months. AstraZeneca has a peak efficiency at 75% and declines to 50% by 6 months. Both are 90% effective against deaths over that time frame. From a public health perspective, they aren’t that different in levels of effectiveness.
When the trials were stopped early last year, the readout was 95% mRNA vs 75% AstraZeneca. It turned out that was peak efficiency, not “sustained efficiency”, but the myth has stayed ever since….
Some countries like S. Africa wanted to send the Pfizer vaccines back, because of no need/interest for them. Ironically, when that statement was made, the very next day the omicron variant appeared.
The basic dynamic of reflexively calling for the “rich†anything to do for “poor†anything gets tiresome and, although assumed to be a morally superior posture, is really not.
The first issue you touch on. The rich (US) generally already do wildly disproportionate things. Second, there are so many who want other rich people to do things, but not themselves. I wonder if Mr Zakaria has purchased and made available for transport $500,000 of vaccine. Actually, I don’t wonder.
The second is that no one asks why the poor are poor, and what they should be doing for themselves. As Ana analogy, any addiction specialist will tell you that the family has no obligation other than moral support, or perhaps facilitate treatment, to help the addict. The addict must take the initiative.
If a country is poor it needs an organic effort to change things. We are fast approaching similar issues here. I pity the normal people in Seattle, Portland, San Francisco or Chicago. But I don’t feel compelled to fix their problem for them. That only subsidizes the problem. Vote the idiots out or suffer the consequences…….or move.
Our economic policies are generally designed to benefit the wealthy so asking them to give back some of that doesnt bother me. That said, solutions that hinge solely upon trying to make the rich pay for stuff are stupid. There ought to be broad support for what we do and a as a practical matter the influence that the wealthy exert to make sure public policy benefits them will also be used to make sure they dont pay for stuff. There are times when we should help poor countries. In the case of vaccines this is probably one of those as we will also benefit and it really isn’t that much money in the greater scope of our spending.
Just looked at those low, low home prices in Seattle, Portland and San Francisco. Yup, the market confirms people are unwilling to live there.
Steve