AstraZeneca’s halo has slipped. When it partnered with Oxford University, it promised to sell Covid vaccines at cost while the pandemic lasted; now it is signing its first for-profit deals, saying it believes that the illness is moving to an endemic phase. Even after more than 5m deaths, this is a highly questionable assertion. More than 250,000 new cases and 5,400 deaths were recorded globally on Monday.
But it would be wholly wrong to focus on AstraZeneca’s record when its rivals have been minting money while it maximised distribution. Pfizer says it will net $36bn this year from Covid vaccine sales. The problem is that shots are still not going where they are most needed. This is becoming a pandemic of poorer nations. More than 7bn doses have been distributed, but while more than two in 10 people over 12 in the UK have had a booster, fewer than one in 10 health workers in Africa have been fully vaccinated in the first place. This is, in the words of Dr Maria Kerkhove, the World Health Organization’s technical lead on Covid-19, outrageous. Our use of vaccines is too often inappropriate “epidemiologically, economically, ethically”, she said.
Pfizer says that by the year’s end, it will have shipped 1bn shots to low- and middle-income countries – but the more prosperous of these get the bulk of them. In correspondence with Amnesty International, it emerged that of 2bn doses sent by late September, only 15.4m had gone to the poorest nations. According to the research group Airfinity, approximately 84% of Johnson & Johnson’s vaccines and 96% of Moderna’s have gone to upper-middle- and high-income countries – though the latter is reportedly close to a deal to sell more doses to low- and middle-income countries after pressure from Joe Biden’s administration.
There are other signs of modest progress. Pfizer’s partner, BioNTech, is to build the first Covid vaccine manufacturing plants in Africa, in Rwanda and then Senegal. On Tuesday, Pfizer announced a deal allowing its new Covid treatment to be made and sold cheaply in 95 poorer countries. It follows a similar agreement made by Merck with 105 nations. The pills could be especially helpful in areas where people have trouble accessing hospitals.
But, as welcome as the agreement is, it excludes several key countries – notably Brazil, which has been racked by Covid – requiring them to buy direct from Pfizer. A treatment is no use unless people have easy access to reliable testing and healthcare. And, of course, it will not cut transmission as vaccines can.
Overall, we are seeing small, reputation-gilding advances in place of the giant leap needed to save lives. The EU and UK continue to block patent waivers for vaccines, and richer nations still grab more doses than they need. Britain threw away more than 600,000 AstraZeneca doses this summer after they expired and Oxfam believes at least 100m shots could expire unused in G7 countries by the end of the year, while others are given away so late that they cannot be distributed in time. While the WHO urged a moratorium on boosters, the UK will offer third shots to people as young as 40, and similar campaigns are under way elsewhere. Better use of mitigation measures, such as mandatory masking and vaccine passports, would have reduced the need for them.
As experts are now weary of pointing out, hoarding vaccines is not only immoral but foolish, increasing the risk of new and perhaps vaccine-resistant variants emerging as the virus circulates virtually unchecked in many places. Proper sharing of doses and of the information needed to make them is essential. What the world needs is not limited gestures, but large-scale, substantive and principled action.