The global response to COVID-19 is not working. So far this year, despite the development and roll out of effective vaccines, more than twice the number of people have died from COVID-19 than in all 2020. More than 8,000 people died each day in the past week.
A new target to vaccinate 70% of the population in all country income categories by September 2022 could provide the impetus needed to bring the pandemic under control. But as ONE‘s latest analysis shows, the world will fall well short of this target, unless the current rate of global vaccine distribution and manufacturing accelerates urgently.
A dangerously uneven response
For the past nine months, the world has raced to scale up proven, life-saving vaccines to slow the spread and impact of the virus. But 77% of those doses have gone to people in wealthy countries, while less than 1% have gone to people in low-income countries. That‘s not even enough to cover frontline health workers or those most vulnerable to the virus.
This astoundingly unequal response is both immoral and illogical. The longer we allow the virus to circulate unchecked anywhere on the planet we remain at risk of variants that are more contagious, more deadly, and eventually more resistant to the tools we have.
A new target and a new opportunity
The United States has asked other governments to endorse and deliver on a new target to vaccinate at least 70% of the population in all country income categories by September 2022.
This is the first time world leaders have endorsed a collective, time-bound goal to control the pandemic. But it is more than this, because it is also an equity target. It won‘t be met unless 70% of the population of the poorest countries are also fully vaccinated.
Achieving this would help end the threat of COVID-19 and put the world on the path to a sustained recovery. But success will require a massive stepchange in how governments are fighting COVID-19.
The current rate of progress won‘t deliver
Together, the world’s wealthiest countries have fully vaccinated nearly 60% of their populations as of September 2021. Low- and lower-middle-income countries are trailing well behind in vaccination coverage. Without a dedicated effort to close the vaccination gap in the world‘s poorest countries, they will be left behind and the world will miss the target.
What will it take
Reaching the target of vaccinating 70% of the population in each income category by the end of September 2022 will require an additional supply of around 1.6 billion doses, primarily destined for low- and lower-middle-income countries (assuming a two-dose regimen). Low-income countries will need 775 million additional doses, and lower-middle-income countries will need 783 million additional doses.
High-income and upper-middle-income countries are on track to surpass 70% coverage based on their current vaccination rates and relatively stable supply chain. Conversely, nearly all countries in sub-Saharan Africa — home to all but three low-income countries and currently the world‘s least vaccinated region — will need an estimated 1.3 billion additional doses to meet the target.
What are the main barriers to success?
The main barriers to success fall into two categories: supply and speed of scale-up.
- In most low- and lower-middle-income countries, the main barrier remains supply. Most countries in these income categories still do not have access to enough vaccines to meet demand.
- In most high- and upper-middle-income countries, where supply is relatively more secure and vaccination scale-up is more advanced, vaccine hesitancy and delivery are slowing progress.
Scaling up access to supply in places where demand for COVID-19 vaccination is still high is the fastest way to make progress toward the 70% target in the lower-income groups. To that end, higher-income countries hoarding supplies and attempting to reach hesitant people and prepare for eventual booster doses is inefficient and ineffective. High-income and upper-middle-income countries have purchased over 70% of doses to date.
In tandem, strategic, targeted, and medium-term outreach must continue to reach people who are hesitant globally, as this will be the biggest barrier in the “last mile” to reach the 70% target.
Vaccinating 70% of the population in all income groups will require a deliberate and strategic shift from hoarding doses in rich countries to targeting vaccination scale-up in countries and regions with low coverage. G7 countries should take the following steps to put the global response on track for success:
- Share doses faster: ONE estimates that G7 countries will have nearly 600 million unused doses at the end of 2021. That is enough to fully vaccinate 50% of the population in low-income countries. This estimate assumes that 80% of the population aged 5 years and older in each of the G7 countries is willing to get vaccinated, and full vaccination requires two doses. The final calculation assumes that the G7 will deliver an estimated 500 million doses in donations by the end of 2021. The use of booster doses is not calculated into the estimate. These countries should immediately share doses to get ahead of this surplus and more quickly enable low-income countries to protect healthcare workers and the most vulnerable in their societies.
- Stop monopolizing supply: Wealthy countries and major pharmaceutical companies must stop actively restricting access to the vaccine market and enable countries and international bodies such as the AU to buy their own vaccines fairly. G7 countries should allow vaccine manufacturers to immediately prioritise and fulfill their contracts to COVAX and to provide regular and clear supply forecasts so all countries can better plan their response. This will require G7 countries that have contracted high volumes of vaccines to trade their near-term vaccine delivery schedules with COVAX so it can save more lives, faster.
- Increase transparency: G7 countries should release the confidentiality clauses in their contracts to increase visibility into what‘s being supplied. Pharma companies should then provide real time data on the volume of vaccines they will produce, where the vaccines are going, their manufacturing capacities, and the potential cold chain requirements. This will help countries put logistics in place to get doses into arms.
- Fully finance global access to vaccines, tools, and treatments: The Access to COVID-19 Tools Accelerator (ACT-A) has a $16.6 billion funding gap for 2021. G7 countries should fill this funding gap in 2021 to enable all countries to strengthen their COVID-19 response and pledge to do their fair share of funding 2022‘s needs for scaled-up vaccine roll-out.