Even if we find a coronavirus vaccine, will the WHO ensure you get it?

Millions of lives are at stake, but politicians will have a hard time resisting the urge to hoard as many doses as possible, write Andrea Venzon and Colombe Cahen-Salvador

Human trials of a potential coronavirus vaccine have started in the UK (Getty Images)

When Russia’s prime minister, Mikhail Mishustin, tested positive for Covid-19, President Vladimir Putin stated that this is proof that “the virus does not discriminate.” Yet, the most vulnerable groups are paying a disproportionate price in this pandemic.

In New York State, black and Latinx people are dying at twice the rate of white people, reflecting economic inequalities and differences in access to health care. Similar instances are happening all over the world. Despite its 7,500 ventilators for 20 million people (one for every 2,700 inhabitants), New York is struggling to deal with the outbreak; the Central African Republic has just three ventilators for its 5 million people (one for every 1.7 million inhabitants), with many other countries facing a similar fate.

Health workers are at higher risk of getting infected, and of becoming seriously ill from coronavirus. In Wuhan, for example, 15 per cent of the initial cases of health care workers who contracted Covid-19 were critical or severe.

With inequalities in terms of access to medical equipment and healthcare more visible than ever, a key question remains: when a solution is found, who will benefit from it? And, more importantly, who will be left behind?

“A vaccine is the only long-term solution to the pandemic,” said Dr. Soumya Swaminathan, the chief scientist of the World Health Organisation, in front of hundreds of activists from all over the world during NOW!’s latest digital town hall. There is little room for doubt: while many politicians hoped for herd immunity to develop, it's now clear that's not possible to achieve. In an international hotspot like Geneva, Switzerland, for example, only 5 per cent of its population could have already been infected by the coronavirus - far off from the 70-80 per cent required to achieve that goal. Without a vaccine, Dr Swaminathan explained, “millions of people have to die by the time you achieve herd immunity.”

The good news is that hundreds of vaccines are already being tested, and seven are already undergoing clinical trials. Whether one will be considered safe and successful enough to roll out globally remains to be seen. Yet, even if a vaccine does prove to be effective, there won’t be enough supply for everyone - at least in the short term.

In an ideal world, a supranational authority representing the citizens of the world would be able to ensure fair and equal access to a vaccine and medical equipment for all, regardless of nationality, gender, race, or socioeconomic background. Health workers would be prioritised, followed by essential workers and the most at-risk population, before reaching the general public.

However, this is far from being the case. To ensure fair distribution, the WHO “needs the cooperation and consensus of all member states,” confirmed Dr Swaminathan. As a body ruled by those very member states, plagued by controversies and power stand-offs, the WHO has no binding power on this fundamental issue that is fair distribution. The most it can do is to issue public statements for collaboration and push world leaders to pledge their support. In short, the WHO “can make guidelines, but [it] cannot enforce them” said the chief scientist.

Last week, some world leaders (not all: the US, China, Russia, and India were not in attendance) pledged to accelerate cooperation on a Covid-19 vaccine and to share research, treatment, and medicines around the globe. On Monday, several countries under the guidance of the European Union joined a rather general pledge to donate $8bn to fight the disease in the next two years.

While this is what should happen, one cannot but question whether words will be met with actions to share the hopefully upcoming vaccine. Countries have taken a drastically different approach since the beginning of the outbreak. From closing down borders and banning the export of medical goods, to blaming one another, most global players have made it clear through a lack of collaboration that it’s every nation for itself in this pandemic, regardless of their carefully-worded public statements they may make.

While the WHO’s goal might be equal access, history tells a different story. The H1N1 influenza outbreak in 2009 saw wealthy nations buying all vaccines and“effectively monopolising the global vaccine supply, with little reaching the rest of the world. Australia went as far as initially refusing to export its vaccine, to ensure that its citizens got it first.

Millions of lives are at stake. Both nationalists and globalists from the global north will have a hard time resisting the urge to flex their economic muscle and hoard as many doses as possible. With pressure to go back to “normal” life, and elections looming in many countries, pledges could fade away quicker than they were written. Even health workers, the first line of defence in this crisis, might be sacrificed on the altar of highest bidder takes all.

Considering the WHO’s lack of clout, it is up to the public to ensure that we do not simply “hope that the world will largely come together." It has to be forced to act in concert.

While the public should hold their governments accountable for following their pledge to fair distribution, it is also fundamental to agree on who will be getting this vaccine first: it will take at least 12 months to vaccinate the world, starting from the moment a vaccine is actually available. Coming up with a global system to coordinate response during pandemics is direly needed, but realistically might not happen this time. An interim solution must be found.

A functioning health system is the best tool that countries have to tackle, or at least slowdown, the pandemic. A functioning health system depends for a vast majority of its operations on people: nurses, doctors, cleaners, cooks, technicians, and any other supporting personnel. All of these people face a tremendous risk of contagion. For many months, people around the world have clapped, cheered, and supported the “angels of Covid-19”: health care workers that have strenuously fought on the front line of this crisis. While those people have been portrayed as heroes, physical strains are not the only price they have paid in this battle. Often under-equipped and under-staffed, the “white army” has counted hundreds, if not thousands, of deaths. Besides, a severe mental health crisis for medical personnel is beginning to emerge, from burnouts to an increased rate of suicides in the sector.

No country should be left behind, and no health care professional should be sent to the frontlines without adequate protections. After clapping for health care workers, it’s time to stand by them: the first available vaccines need to be given to those who are not only needed to protect the world but are also the most at risk.

It is the most realistic way forward: a few hundred thousands of doses would be enough to ensure that health systems will not collapse, anywhere in the world. “There should be some consensus that healthcare workers, nurses, and doctors should get it,” confirmed the WHO’s chief scientist. A popular saying goes like this: “Put your money where your mouth is.” Instead, let’s put the vaccines where our heart is during this crisis: with medical personnel, whatever country they come from.

Andrea Venzon and Colombe Cahen-Salvador are co-founders of Now!, a global movement pushing for humanity to work as one to solve the biggest challenges of our time