Illustration of a person getting vaccinated.
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AFP
The World Health Organization wanted, through the Covax mission, to ensure equal access to vaccines against Covid-19 to all countries.
But little by little, some rich countries have made agreements with laboratories, unraveling the principle of this global solidarity.
This epidemic has however underlined the need for multilateralism to favor better access to health.
For today and for tomorrow.
The ambition was laudable: to vaccinate the inhabitants of the planet at the same rate, wherever they live.
But the Covax mission, devised by the World Health Organization (WHO), has not yet proven that international vaccine solidarity weighs more heavily than national interests.
Is it then a pseudo-failure, or rather a first step?
20 Minutes
takes stock.
What is the goal of Covax?
Covax is a "global initiative to ensure rapid and equitable access to vaccines against Covid-19 for all countries, regardless of their income level", synthesizes the WHO.
With the objective of vaccinating at least 20% of the population of each participating country before the end of 2021, to prevent the richest countries from snatching up the doses in contempt of others.
The mission is co-piloted by WHO, the Coalition for Innovations in Epidemic Preparedness (Cepi) - for the research and development side - and Gavi, the Vaccine Alliance - which deals with the purchase and the distribution.
Clearly, rich countries and private individuals, including the Bill and Melinda Gates Foundation, are bribing so that poor countries that could not afford vaccines can receive them for free.
Thus, the EU promised 500 million euros to Covax in November 2020. In mid-January, it hoped to deliver at least 2 billion doses by the end of the year, of which at least 1.3 billion to 92 low-income countries.
“We remain on the objectives of disaster medicine: vaccinate caregivers and the most vulnerable, underlines Jean-François Corty, doctor and former director of operations at Médecins du Monde.
And a lot
many countries expect a lot from this multilateralism.
"
The idea was born from the first confinement, the WHO wanting to act on three pillars: diagnosis, treatment and vaccine, Covax taking this third mission.
"We lacked equipment, from mask to respirator, everywhere," recalls Nathalie Ernoult, co-director of the Health Observatory at the Institute for International and Strategic Relations (Iris).
The countries were stunned to see that we were fighting on the tarmacs for masks.
Everyone said to themselves: "we have to work together on vaccines".
»A wishful thinking?
Not for Jean-François Corty.
“Our leaders have understood that global solidarity for access to vaccines is not just a question of value, but a principle of public health.
If there are still active sites of the epidemic, anywhere, variants can multiply and reach us.
In the future, other health risks will arise and there is a need for multilateralism.
"
"The mission had to be a giant, it will be a dwarf"
But this beautiful idea is struggling to translate into concrete ... "The major disappointment is that for the moment, Covax has not delivered any vaccine to any country!
»Storms the researcher at Iris.
For several reasons.
First of all, the mission bet on the wrong horses.
“It has neither Pfizer nor Moderna in its vaccine portfolio, the first two validated,” she continues.
What may soon change: The mission mainly pre-ordered AstraZeneca vaccine, which could get the go-ahead from WHO in February.
Second concern: order volumes.
“They bought 300 million doses from Astrazeneca.
To vaccinate the populations of 192 countries, we are not going to go very far ”, ironically Nathalie Ernoult, also head of advocacy at Médecins sans frontières (MSF) Good news, on January 22, the WHO proudly announces an agreement with Pfizer-BioNTech .
But to receive ... 40 million doses.
“It's really to save face, corrects Nathalie Ernoult.
And we still do not know how they will distribute them, in which country and on what criteria… ”A chronic transparency problem.
"Very quickly, the mission lacked transparency on the agreements, the prices," she continues.
This has not helped to ease the confidence of rich countries.
"
A phony excuse or a substantive reason, this has encouraged some states to go it alone.
So much so that on January 8, the WHO banged its fist on the table and urged the rich countries to stop orders from labs… “The Americans have not played the game: they have made bilateral agreements.
The Europeans followed, recalls the researcher.
The Covax found itself unraveled by these economic heavyweights.
The African Union has also organized itself to negotiate on its side.
And placed an order in mid-January to receive 300 million doses, four months after Covax promised him 230 million.
“We can see that everyone is passing by.
The mission had to be a giant, it will be a dwarf.
"
Redistribution, a more realistic principle
Worse: some countries will, if all vaccine candidates receive a green light, enough to vaccinate up to five times their population, such as Canada.
When others cannot protect their most vulnerable population.
At the Davos Forum on Tuesday, Angela Merkela nevertheless insisted: "the important thing is to have an equitable distribution [...] in this period of low availability of vaccines", pleading for a "multilateral path" and against protectionist temptations.
Remember that Germany was one of the first countries to place orders in addition to the doses provided by the European Union ...
For his part, the South African president lambasted the rich countries which “monopolize” the anti-Covid vaccines.
“Today, dozens of African countries are in difficulty, which was not the case during the first wave, and none received a vaccine,” warns Jean-François Corty.
“From the start, there has been a double discourse, adds Nathalie Ernoult.
Which leads some African countries to speak of "vaccine apartheid".
It's scandalous.
"
But global solidarity could materialize through a system of redistribution of unused vaccines.
"This" dose sharing "is
currently discussed, she says.
It would be interesting to do it now, not in eight months!
We will not wait to have vaccinated 70% of the population of Western countries to generously give 5% of the vaccines.
Despite many disappointments, therefore, there may still be some hope of saving Private Covax.
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