As omicron spreads, vaccine inequity risks creating further variants NPR's Ari Shapiro chats with Madhu Pai, a global health expert at McGill University, about the state of vaccine deliveries to Africa and the global south.

As omicron spreads, vaccine inequity risks creating further variants

As omicron spreads, vaccine inequity risks creating further variants

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NPR's Ari Shapiro chats with Madhu Pai, a global health expert at McGill University, about the state of vaccine deliveries to Africa and the global south.


Scientists and world leaders have warned from the beginning of the pandemic that nobody is safe until the entire world is vaccinated against the coronavirus. Here's how President Biden put it on Monday.


PRESIDENT JOE BIDEN: We need to do more than vaccinate Americans. To beat the pandemic, we have to vaccinate the world as well, and America's leading that effort.

SHAPIRO: And yet the entire continent of Africa has vaccinated just 6% of its population. Professor Madhu Pai teaches epidemiology and global health at McGill University, and he's been tracking vaccination efforts in Africa and other parts of the world.


MADHUKAR PAI: Thanks for having me.

SHAPIRO: There's one statistic that I think sets this in really stark relief, which is that there have been more booster shots given out in highly developed countries than the total number of vaccine doses given in low-income countries since the start of the pandemic. What does that tell you?

PAI: It's incredible. What it means is that the world has totally lost the plot on this pandemic. Right from get go, especially after the delta variant pretty much decimated India, we knew allowing this virus to rip unchecked through populations was a disastrous idea because new variants will come. Mutations will happen because if billions of virus particles are manufactured in millions of people, bad stuff will happen. And since then, me and several other people have been screaming about the inequities that are widening and widening and widening. And the booster doses is the latest avatar of the added inequities because now rich nation after rich nation have decided that the way to handle omicron is to just boost ourselves, ban travel from Africa, and then we'll be fine. That is the most myopic policy I've ever heard of.

SHAPIRO: But there is a global policy to vaccinate developing countries. It's a program called COVAX. It set a goal of distributing 2 billion doses by the end of this year. It's shipped just over a quarter of that amount, a fraction of the goal. Why has it fallen so far short?

PAI: Oh, my God, so we have to vaccinate 70% of the world by middle of '22, next year. And we are nowhere close to that because COVAX is absolutely failing to meet its targets. As you pointed out, not even 20-, 25% of the pledges that have been made have actually reached people, so we are seriously under-delivering. And I worry that the omicron panic is actually pushing more and more rich nations to hoard and offer them as boosters for all adults rather than actually dole out the - deliver the pledges that we've already made.

SHAPIRO: A coalition of African health organizations put out a statement this week saying the problem is not just the number of doses African countries have received. It is the quality of those doses. The statement says in part, the majority of the donations to date have been ad hoc, provided with little notice and short shelf lives. This has made it extremely challenging for countries to plan vaccination campaigns. Tell us more about that.

PAI: Absolutely. So I lived and worked in India for the first 30 years of my life. You - if you do not even have a clear plan for when the next shipment is coming and if you have frequent stockouts - if I go to a clinic and I see closed, vaccine not available, that is very demoralizing for anyone. And I think interruptions of supply and dumping vaccines with one-month expiration - come on, that's just dumping. It's not even a donation at that point. So we are messed up. And I also want to point out for you most rich nations have only given away things that they think is not good enough for them. In other words, Canada primarily delivered or donated AstraZeneca after Canadians decided that AstraZeneca was not good enough for us as Canadians.

SHAPIRO: When you look at all of these big, complicated problems, what steps do you think could begin to solve them?

PAI: As we wrote in an editorial in Science published last week, "Vax The World," I genuinely believe vaccinating the world is the only real path out of this crisis. And for that to happen, vaccine production and delivery has to dramatically scale up compared to where we are today. That requires rich nations to stop vaccine hoarding, move out the pledges to COVAX program from its miserable current status to as high a number as possible, support the TRIPS IP waiver and then transfer the vaccine technology or know-how to as many companies around the world that are willing to take it up, including the mRNA hubs in Africa.

SHAPIRO: I just want to clarify, you refer to the IP waiver - that's the intellectual property. And transferring it would allow countries to manufacture the vaccines on their own in South Africa, Brazil, et cetera.

PAI: Absolutely. And then lastly, I also believe given the new variant urgency and given that vaccines still haven't reached people, we also need those anti-viral medicines urgently because if I'm dealing with a big surge and if I'm mostly unvaccinated, like Africa is, if I had molnupiravir, if I had the Pfizer antiviral pill, at least I have something in my armamentarium. I would also love to see some kind of global leadership. Right now I'm not sure who is driving this bus. World leaders have to find a way to get together on this. Otherwise, we are doomed to the pandemic continuing well into next year and the year after and even worse variants emerging in the future.

SHAPIRO: Professor Madhu Pai is Canada research chair of epidemiology and global health at McGill University.

Thank you for talking with us.

PAI: Thank you.

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