Earlier this month, Namibia's president was invited to join the World Health Organization's weekly press briefing to talk about World Health Day. The idea was for him to help explain to the hundreds of reporters from around the world what was happening with COVID-19 immunization efforts in his southern African nation.
In what has become all too common during the pandemic, the video connection was unstable. President Hage Geingob kept freezing on the screen. The audio would become muffled and incomprehensible, or the sound would drop out entirely.
Then at times there would be bursts of clarity. "It is COVID apartheid!" Geingob shouted.
"We already made our deposit!" he insisted. It became clear that the president was using his time not to speak to the press but to harangue WHO officials in the room to finally deliver the vaccine doses he'd already paid for through COVAX. That's the WHO-led initiative to procure and equitably distribute vaccines, particularly for low- and middle-income nations.
"We have made the advance payment but there is this exclusion. COVID apartheid is now prevailing," he said, comparing the inequity in global access to vaccines to the South African apartheid system that divided the country along racial lines and trapped millions of Black Africans in poverty.
"Up until now, we didn't get any," he said of the vaccines Namibia has ordered. The few hundred doses that Namibia has been able to secure are "only because our good friends, China and India, gave us vaccines."
Namibia has given fewer than 3,000 COVID-19 jabs so far. This is a fraction of what a mass vaccination site in the United States, such as the Javits Center in New York City, administers each day.
In the United States, nearly 40% of the population has now gotten at least one dose of a vaccine. In Namibia, less than 0.1% of the population has gotten a shot.
The U.S. has administered more COVID-19 vaccinations than any other country in the world. Ingrid Katz, the associate faculty director at the Harvard Global Health Institute, says the U.S. is now in "somewhat rarified air" in the global vaccination effort. "There are a few other nations out there who are with us." Globally, just 2.3% of the world's population is fully vaccinated. In Africa it's less than 1%.
"It you look at the data globally," Katz says, "you'll see that about 75% of the vaccines have gone to only 10 countries globally. There's massive, massive inequality."
The countries that have managed to get a lot of people vaccinated — the U.S., the United Kingdom, India — all happen to have manufacturing plants that are producing the vaccines. They also have had export restrictions that have meant their own citizens have been at the front of the line to get immunized. Important regional players such as South Africa have fully vaccinated only half of 1% of their population. In the Philippines it's less than 0.1%. Even wealthy nations in Europe such as Germany, Spain, Italy and France haven't gotten above 7%.
Katz says this is no way to tackle a global health crisis. "If we assume that it's fine just to vaccinate American citizens but no one else in the world, we're going to be in big trouble," she says.
Katz had a paper in the New England Journal of Medicine in which she and her colleagues calculated that based on the vaccination rates happening globally at the end of March, it would take 4.6 years for the planet to reach herd immunity against SARS-CoV-2. Since then the number of shots being given each week has increased.
"But we're still talking years. It's not going to be months" until this pandemic is under control, she says. And if the virus continues to spread and mutate for several more years, there's a good chance that a variant could emerge to which the vaccines provide no protection.
At that point the U.S. would be in no better position than a country that hadn't vaccinated at all.
Getting the whole world immunized "is an investment in our own self-interest," Katz says.