WHO calls for global access to vaccines as Europe is promised millions more doses

French leader Emmanuel Macron demands more efficient distribution as new tracker is launched

A woman receives a vaccine in Algeria as nations try to secure supplies for their domestic populations. AP

At a time when tensions have erupted over vaccines supplies, Europe's Centre for Disease Control took an important step on Monday with the launch of tracker for inocolation around the continent.

The move to improve transparency showed patchy distribution so far, something that tallied with the anger over constraints on the programme which resulted in about eight million doses being administered so far among a population of almost 400 million. Britain with a population of almost 70 million has also administered eight million vaccines.

French President Emmanuel Macron on Monday demanded greater efforts in production and said German Chancellor Angela Merkel and European Commission President Ursula von der Leyen were keen to see progress too. "It is a speed race that we are leading against the virus," he said. "We Europeans must therefore be even more effective on this subject.

“I know that is also the will of Chancellor Merkel and President von der Leyen. And we will continue in the coming weeks and months to speed things up to move faster on this subject with regard to our populations.”

A phrase unfamiliar just a few days ago has since gained currency — ‘vaccine nationalism’ — a term for countries trumpeting their medical prowess and lauding it over others.

Tempers boiled over when the EU introduced restrictions on vaccine exports last week as it faced a shortfall in supply. The pressure eased somewhat as Pfizer/BioNTech offered an additional 75 million vaccines to be delivered in the second quarter to bring the total number supplied to the EU in 2021 to 600 million.

At the eye of the storm is AstraZeneca, which has now promised an additional nine million near-term vaccines to the EU.

Pressures from home 

Concerns over countries keeping vaccines for their own population have led the World Health Organisation to intervene in the unseemly row that has gripped Europe for the last week.

“Anything that restricts the ability to get these products out will affect our ability to control this disease and prevent variants emerging,” senior adviser to WHO’s director general Bruce Aylward said. “The world is going to have to collaborate to get out of this.”

The European Commission, tasked with negotiating the deal last year, had held up the vaccine order for two months. This allowed a gap to emerge between the number of vaccinations provided in Britain and EU nations.

“There will inevitably be vaccine wars in the sense that people insist their population gets vaccinated first,” said Dr Alan Mendoza, director of the Henry Jackson Society think tank.

“Everyone understands the political pressures on governments and it’ll be a very brave government who says to their own people, and particularly in the UK, ‘look we’re going to delay so people elsewhere can get it’. A government has to be mindful of a duty of care to its home population.”

That view is accepted by Prof David Heymann, a former WHO scientist. “Political Prof Heymann, who dealt with a major Ebola outbreak in West Africa in the 1970s, believes that governments will soon realise that “if they don’t provide vaccines to other countries then they can’t protect themselves from the re-importation of the virus”.

Essentially, Covid-19 won't go away until the entire globe has achieved some form of herd immunity. "Britain can't come out of this alone, there is going to be a need for us to work together because the vaccination programme, has to be global in its outlook. It just has to be," Prof Heymann told The National.

While Germany, Britain and the EU quarrel, there is a feeling on the continent that poor messaging over the vaccine is where governments have gone wrong. “The key problem is that in all cases they’re not developing the communications that should go with their rollout,” Dr Gianluca Pescaroli of the University of London said.

“I hope there will be diplomatic solutions and they won’t escalate because it’s not just vaccines that are the silver bullet to solving the pandemic,” he said from his family home in northern Italy.

Medics baffled by bickering

In fact the Italian, usually based in London and now teaching remotely to students as far away as Taiwan and America, is shocked that he is even discussing ‘vaccine wars’. “While I don’t see a confrontation unilaterally between the UK and Germany, this hostility is not nice to see,” he said.

Like others, he believes the European Commission’s bloated bureaucracy and inability to handle multi-billion contracts is a part of the problem. “The EU should become much less bureaucratic and I say that from a generation that is truly European. There is a need for substantial reform.”

Those on the medical side of Covid-19 are baffled that all the hard work to save lives has resulted in bickering between politicians. “There’s a parallel to the science in politics here, whereby you’re looking at trying to solve the most critical need first and then expand out from there,” said Dr Someit Sidhu, a medical doctor and founder of medical research company Izana Bioscience.

“If the UK can solve the most critical needs it should. But then I think a more outward looking approach is to say ‘how can we replicate that in places that haven’t yet maybe achieved that goal?’”

Prof Heymann, who told The National last August that he feared a rise of aggressive Covid mutations, urged political leaders to think in more global terms. "If you look around the world the equitable distribution of vaccines for smallpox eradication, in polio eradication ... these are examples of what can happen. We need global solidarity and countries need to begin talking about that for Covid."

While the European squabble will continue to simmer, the WHO is appealing on behalf of those in Africa and elsewhere that have seen very little in terms of vaccines.

Even with the South African variant raging in the sub-Sahara there is resignation among medical staff. “We will have to wait till July at the earliest for our vaccines to arrive,” Dr Jamie Rylance said from the general hospital in Blantyre, Malawi. “There’s no real animosity towards the West, it’s generally a resigned shrug. This has happened many times in Africa with many different health emergencies."

Malawi, like other sub-Saharan countries, is in the grip of a huge increase in infections and fatalities. Dr Rylance, 44, of the Liverpool School of Tropical Medicine, who has worked in Malawi for eight years, believes that hundreds if not thousands of lives would be saved if the country received a vaccine shipment. “Those deaths are all preventable if they all get a vaccine. We know that high-income countries have to look after themselves because that’s the politically expedient thing to do. That’s the way the world is, but I think they’ve missed the trick because it’s very much true that no one’s safe till we’re all safe.”

While the debate in Britain is now over whether teachers should get be prioritised for the vaccine so children can return to school more safely, people such as Dr Rylance despair as patients continue to die in their droves.

Western governments should really be having an “explicit discussion” with their citizenship on those who really need the vaccine, because the younger population may get ill from Covid but are less likely to die.

“They need to start thinking more globally over how they will redistribute vaccines to people who need at least as much,” Dr Rylance said. “You certainly feel the inequity here, not for yourself as much as for the country in general.”

Global system 'quickly unravelled'

Back in the West, academics argue that lessons need to be learnt.

“In theory we have a very globally-orientated system but look at how quickly that unravelled with the political importance of vaccines,” Robert Ward of the International Institute for Strategic Studies said. “Furthermore, in a post-EU world the UK will have to depend on open channels. The fragility of the global trading system should be a wake-up call and this week’s vaccine issue shows just how quickly it can unravel more.”

His view is reflected by Dr Mendoza, who would like to be left with a “warm feeling in my stomach” that the world pulls together over the pandemic. “The reality is we’ve been co-operating globally on a number of these issues in the past but this does remind everyone that we are an interconnected world in the 21st century, and that, therefore, it is very important to be mindful of what’s going on in other parts of the globe because they will come back and either bite you or potentially help you.”

Many hope that the row between Britain and AstraZeneca and the EU will be a short-lived spat forgotten about once Europe’s inoculations gather pace. As one EU diplomat put it: “A vaccine war between the EU and UK is one of the worst things that could possibly happen right now.”