Coronavirus Vaccine gap between rich and poor countries must be wide – according to THL’s Nohynek, Finland’s vaccination strategy should also be discussed

About one year after the first coronary vaccinations were introduced, about 58.1 percent of the world population has received at least one dose of the vaccine. However, there is a wide gap between countries in vaccination rates: in low-income countries, only 8.4% of people have received at least one dose.

The situation is particularly dire in Africa. In Nigeria, only 4.6 percent of the continent’s most populous countries have received at least one dose, and 7.9 percent in Ethiopia. Only a good percentage of Ethiopians have received a full series of vaccinations. In the Democratic Republic of Congo, only 0.25% of the population has received at least one vaccination.

Africa the low vaccination rate in these countries is explained by the chief physician of the National Institute for Health and Welfare (THL) Hanna Nohynek contributes to a lack of motivation. Covid-19 does not appear to pose a serious threat in the same way as in Europe, for example, because the population of most African countries is very young. There are other diseases in Africa that are more dangerous than the coronavirus.

However, the main reason is that there are simply not enough vaccines.

Poor countries cannot afford to buy vaccines themselves, so they receive them through the international Covax utility. Covax has already delivered about 900 million doses of the vaccine to 144 countries.

“But it has been slow, much slower than expected. Even though the countries had promised donations, they had not come to the same model, ”says Nohynek.

“Of course, one might ask that if donations had come at that rate, would companies have been able to deliver vaccines at that rate. After all, production capacity is by no means enough for the world’s urgent needs. ”

The basic problem, then, is that there is still a shortage of vaccines, which means that they are not produced enough to meet needs. According to Nohynek, the vaccine shortage should start to subside by mid-2022, but it is still working.

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“When people are not vaccinated, it exposes all of humanity to new variants.”

Even when vaccines are available, the bottleneck is often logistics. RNA vaccines, the Pfizer-Biontech and Moderna vaccines, are particularly challenging because they require storage at very low temperatures.

“Even if vaccines are brought to poor countries in central locations where those cold stores are, the question mark is how to get them there to the regions. Once the vaccines are mixed, they should be used within a few hours. Cold chain logistics is really challenging, ”Nohynek explains.

Jurisprudence has also been a slowdown, as liability issues for the use of donated vaccines have proved more complex than expected.

Global Professor of Health Policy Meri Koivusalo The University of Tampere says that it has been sad to see the uneven distribution of vaccines. What is illustrative, he says, is that third doses are already being given at a good rate in rich industrialized countries, when many health workers have not even received the first dose in poor countries.

According to Koivusalo, there are numerous challenges in the background, but the main problem is the availability of vaccines.

“A large part is related to the fact that production has not been expanded enough. The question of why this has not been done is the next root cause, ”says Koivusalo.

“The industry has not wanted to share know-how and the opportunity to produce vaccines more widely.”

Koivusalo points out that vaccine production in India, for example, was expected to be of great help in pandemic control in the early part of the year, but when the virus delta caused a severe corona wave in India, vaccines produced in India quickly went to the country’s own needs.

Nohynek says the excessive concentration of vaccine production has been criticized, but the matter cannot be resolved quickly.

“Such a production facility is not set up overnight, but is a lengthy process. It is not only that institution, but also the workforce that needs to be trained. Vaccine production has been largely concentrated, and this is partly due, of course, to the fact that it has not had terribly big money. Now, of course, it’s a whole different way. ”

There has also been talk that industrialized countries can donate their own surplus vaccines, but Koivusalo says it will not solve the global availability of vaccines.

“It also has its own inconveniences, because those surplus vaccines usually have little shelf life left.”

Vaccine industry has at times relied on a shortage of raw materials in the slow pace of production.

“Still, at the same time, it has apparently been possible to produce vaccines for animals from similar raw materials. So is it really a shortage of raw materials, ”Koivusalo says.

The industry has promised to increase its production volumes, but accelerating doses of boosters could quickly eat up production.

Koivusalo says that he expected that companies that received a lot of public support for vaccine development would have been satisfied with lower profits and supported joint actions more strongly and more openly.

“It’s a pity. The industry could have done a great global job through these first vaccines. But its own interests have been guarded so strongly that many are now asking whether the industry has been given an overly central role in vaccine production. ”

According to him, industrialized countries have also contributed to the situation by protecting the interests and exclusive rights of their own companies. In the World Trade Organization, for example, the EU and Finland have opposed an exemption for industrial exclusivity, especially for vaccines, during a pandemic. The initiative is supported by more than a hundred states and the leadership of the World Health Organization. The human rights organization Amnesty has also called for the initiative.

“Finland should publicly support the temporary flexibility of intellectual property rights”, Amnesty Finland’s Executive Director Frank Johansson said in a statement.

Amnesty also sharply criticized this week for prosperous states and pharmaceutical companies that it sees as bitterly failing to distribute vaccines equally.

“When people are left unvaccinated, it exposes all of humanity to new variants. The only way to break this cycle is to secure vaccines for everyone, ”said Amnesty’s secretary general Agnes Callamard said in a statement.

According to Amnesty, rich states and pharmaceutical companies have ignored calls from Amnesty and the WHO to ensure at least 40% vaccination coverage in poor countries by the end of 2021.

Vaccine shortage at least it has not been facilitated by the fact that rich countries have accelerated their third vaccinations, especially with the spread of highly contagious micron transformation, which has increased the hoarding of vaccines. According to Nohynek, the WHO considers the activities of rich countries to be very arrogant.

The third doses are a two-barreled thing. Studies have shown that the effectiveness of the two vaccinations against self-infection is significantly reduced, and the third dose significantly increases protection. On the other hand, it seems that even in basic healthy people, two doses retain their protection against serious disease, even with omicron.

“If we really want to prevent these infections and mild diseases, which is currently the strategy in Finland as well, then, of course, third doses are needed. But it is against the principles and statements of the WHO, ”Nohynek recalls.

According to Nohynek, in Israel, for example, it is already being seen that the protection of the third dose against the infection is waning after a few months, and there are already fourth doses given to the elderly and fragile. As current corona vaccines are so-called leaking vaccines, ie they do not provide permanent protection against infections, there is also virtually no level of global vaccination coverage that can achieve herd protection against mild infections as well.

According to Nohynek, the aim of vaccination should be discussed.

“After all, in Finland we started with a vaccine strategy that aims to avoid serious illness, death and loss of life, and to maintain the carrying capacity of healthcare. But then it was changed in November to include infection prevention. ”

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According to Koivusalo, third-party vaccinations cannot be considered unjustified and are necessary, especially for at-risk groups, but globally, it would be more important to get people vaccinated for the first and second time.

For the rich vaccination in some countries has angered not only the WHO but also the governments of many poor countries. Developing countries already have a strong experience of injustice because they have not received enough support from industrialized countries to tackle the climate crisis.

In this international setting, vaccine diplomacy between China and Russia, for example, may seem attractive if it is too difficult to obtain Western vaccines.

For example, although many African countries have survived the pandemic with relatively little, they are also not protected from the effects of the coronavirus. Their health systems are also more fragile than in industrialized countries.

“Yes, there are a significant number of older people all over the world, and not even in low-income and especially middle-income countries. And when resources have to be used for pandemics and related activities, they are not enough for malaria or other communicable disease programs, or for basic health care, ”says Koivusalo.