ARI SHAPIRO, HOST:
There's a new coronavirus variant surging around the world.
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UNIDENTIFIED REPORTER: COVID cases continue to surge in India. The South Asian country has recorded over...
VEDIKA BAHL: After a lull in cases since April, there's been a resurgence of COVID-19 in France, with a 45.5...
SHAPIRO: Last week BA.5, a subvariant of omicron, became the most dominant strain of COVID-19 in the country, according to the CDC. And the White House COVID response team said Tuesday this marks a new moment in the pandemic.
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ASHISH JHA: We have been watching this virus evolve rapidly, and we've been planning and preparing for this moment.
SHAPIRO: Dr. Ashish Jha is the White House COVID-19 response coordinator.
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JHA: We have tracked this carefully. We are not surprised that we are here at this moment - and more than not being surprised, we are prepared.
SHAPIRO: This strain has a greater ability to evade immunity from prior infection or vaccination. That means even if you're vaccinated or you recently had COVID, you could still get sick again. In the U.S., new infections are far higher than this time last summer. And public health officials acknowledge that at-home testing means the true extent of this latest surge is hard to gauge. Hospital admissions, while still relatively low, have doubled since May. Dr. Anthony Fauci said there is some good news.
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ANTHONY FAUCI: The vaccine effectiveness against severe disease, fortunately for us, is not reduced substantially or at all compared to other omicron subvariants.
SHAPIRO: Of course, that's only good news if you live in a country with easy access to vaccines. The U.S. is one of those places. And on Tuesday, White House officials said variant-specific vaccines could roll out later this fall. But millions of other people around the world still have no vaccine access at all.
ATUL GAWANDE: Variants come out of these places that don't have adequate vaccination and control. And that is a risk to us and the entire world.
SHAPIRO: Dr. Atul Gawande is head of the U.S. Agency for International Development's global health office. He told NPR right now USAID does not have the funding it needs to bring vaccines, tests and treatments to countries that need them.
GAWANDE: That means substantial parts of the world will go - are going unvaccinated for months to come.
SHAPIRO: CONSIDER THIS - in the U.S., we are grappling with a new dominant variant and preparing for a fall campaign of booster doses. But in some of the world's poorest countries, many people still haven't gotten a single shot. From NPR, I'm Ari Shapiro. It's Tuesday, July 12.
It's CONSIDER THIS FROM NPR. In the third year of the pandemic, millions of people around the world have lost their lives prematurely.
GAWANDE: COVID-19 has created an increase in deaths that has resulted in the first global reduction in life expectancy in a century.
SHAPIRO: But Dr. Atul Gawande, head of USAID's global health office, says not all of those avoidable deaths have come directly from COVID-19.
GAWANDE: Instead, it's been the effects on the health system - with health care workers out, with health care needs being diverted to COVID, but then also food shortages, and malnutrition has skyrocketed. Add to it climate disasters with heatwaves, climate events like cyclones and hurricanes, and then war that has further cut food supplies, and you have a situation where total death rates in the world have gone up more than 20%.
SHAPIRO: USAID provides foreign aid and development assistance to middle- and low-income countries. But Gawande warns that's becoming harder to do because Congress has not authorized another round of funding for global vaccination efforts.
GAWANDE: The number of deaths in the world depend on us being supportive of getting the whole world to stop the pandemic. Our efforts to bring vaccines around the world, to bring tests around the world and antiviral pills will grind to a halt. It is grinding to a halt.
SHAPIRO: Public health experts say to slow COVID infections, you need high vaccination rates all over the world. USAID has been trying to help with this, but Gawande says they're still having trouble getting shots into arms in those lower-income countries.
GAWANDE: The lower-income world - that is the bottom 2 billion in income in the world - have fragile health systems, not a lot of staff. They don't necessarily have the cold chain and the refrigerators in place. And the way we approach that has been providing resources and technical know-how to enable that to happen. But in many cases, it's only been in the last 6 to 9 months that the major supply of vaccines have reached those countries where we had already gotten them, you know, first in line.
SHAPIRO: In Africa, only a fifth of people are fully vaccinated. Last month, the World Trade Organization reached a deal to ease patent protections, so poorer countries could produce vaccines themselves. But overall, plans to bring more doses to African nations have fallen short.
AYOADE ALAKIJA: There's a narrative that is beginning to concern me, where there are those saying that, well, you know, perhaps we don't need to vaccinate 70% or as many Africans as we had thought because so many of them have caught COVID already anyway, that surely there's a wall of natural immunity brewing. But the same people are not saying that there is a wall of natural immunity brewing in America, where there has been widespread infection, or in Europe or in the U.K.
SHAPIRO: Dr. Ayoade Alakija is an infectious disease specialist and co-chair of the African Union's Africa Vaccine Delivery Alliance. That group is responsible for sourcing and distributing vaccines across the African continent. Alakija has seen firsthand what happens when COVID vaccines, testing and treatments are not available. She told me about a woman named Elizabeth (ph) who was a part of her household in Abuja, Nigeria.
ALAKIJA: A phone call that I received - my husband and I - at 11:30 one night from three screaming children whose mother had collapsed on the floor of their house, and she was not breathing. She died. She subsequently died. And initially, there was no diagnostics. That countermeasure - just a simple test. So they assumed it was something else. Nobody had done a test. But for me, as a clinician, it was clear that this was COVID, and it was clear that she was dying for want of a breath, for want of oxygen and also because she was unvaccinated. These are the real-life stories.
SHAPIRO: I asked Dr. Alakija to give us a snapshot of what the vaccine effort looks like right now in Africa.
ALAKIJA: Well, I mean, as you say, I've been working over the last couple of years at the forefront, not just for access to vaccines, but for access to all countermeasures, which includes diagnostics and now treatments as they become available, to ensure that those in the low- and low-middle-income countries of the world, many and most of which are on the African continent, have the same access to vaccines, diagnostics, which are tests and treatments like things like Paxlovid and other - and oxygen, the very basics that people in the U.S., the U.K., EU and other parts of the world have. That has been a deeply depressing role to be in, really, over the last couple of years, as we have seen that the high-income countries of the world have clearly prioritized themselves but forgotten that this pandemic is affecting all of us.
So from where one sits and where one looks at it, we as a global community have failed. We failed to stop a virus that continues to march on. And even today, as we speak, we're seeing new subvariants that are causing increasing infection, increasing hospitalizations and increasing deaths in countries and parts of the world where it shouldn't be happening because of this lack of equity, this lack of access to the countermeasures for all of the world.
SHAPIRO: What does that inequality translate to in terms of human experience? You told The New York Times, people are dying silently.
ALAKIJA: People absolutely are dying silently. And it's not just inequality, Ari - it's inequity. You know, there's a very clear difference. The inequity means that people - the very measure of the impact of this pandemic, the very - around the world so far has been - it's how far a health system's been affected, how a hospital's been overwhelmed. You know, we saw in the early days those awful images from New York hospitals from America and from hospitals in Brazil. And that was the measure of the impact. But what do you do in countries where you do not have health systems to be overwhelmed?
So we have said for parts of the world and parts of Africa that, oh, well, they hadn't had COVID, but that is not true. COVID has not affected them - that is not true. It is just we haven't had the cameras being able to roll that b-roll in hospital wards because those wards do not exist, in ICUs because, in many communities, ICUs do not exist. So people have died silently. Many of these deaths have gone unrecorded. And therefore, there has been a silent pandemic, a silent toll on parts of this world where the inequity in measuring the impact of the pandemic itself is pushing the inequity of access to the countermeasures and to the tools needed to prevent further infection.
SHAPIRO: World leaders are sounding the alarm about the more transmissible BA.5 variant, and in the fall, the U.S. and other highly developed nations are expected to get boosters that specifically target variants. Do you expect that those supplies are likely to reach African nations?
ALAKIJA: Absolutely not. I mean, this is - this has been the core of my voice over the last two years. I mean, many African nations - yes, now the vaccine doses are beginning to - are rolling out to the African continent, but far too little, far too late in many ways. You know, we were left at the back of the queue. I mean, I also - you know, I'm a special envoy for the Access to COVID Tools Accelerator for the world - you know, the global Access to COVID Tools Accelerator. And from that vantage point, one is seeing that whilst the world and many leaders are pushing to get vaccines and tests and treatments, yes, to Africa and other low-middle income countries of the world, the rest of the world has moved on.
You know, the rest of the world is providing not just fourth boosters - you know, what we're calling the primary series plus a booster - but they're also now looking at variant-adaptive vaccines. They're looking at the next generation of vaccines because, clearly, we need better vaccines against this virus that continues to march on, this virus that continues to best us. It is pushing against us. And we as a global community need to push back. But the only way to push back is pushing back with equity, with health justice, and ensuring that some people are not left - being left behind.
SHAPIRO: And so having waged this fight for equity every day over more than two years of this pandemic, do you have any hope that this gap can be closed?
ALAKIJA: That - do I have hope? One must always have hope. Do I have hope that the equity gap can be closed? I think the equity gap is due to so much more that is fundamental within our systems. I think the equity gap is due to the fact that the global health and global development infrastructure is flawed and fundamentally broken. You know, when a foundation of something is destroyed, it is very difficult to build upon a flawed or a destroyed foundation. Many of the systems we're working with today, the Bretton Woods institutions, were put together post-World War II to fix Europe. Listen to what I just said. They were put together to fix Europe. And yet they are being used - they are being applied to the rest of the world. They are being applied to high-, low-income countries. They are not fit for purpose. They are based largely in high-income parts of the world, in Europe and in the Americas. They are not fit for purpose for low- and low-middle-income countries.
So what we must do is we must reshape, we must reimagine, we must rebuild the global health and global development architecture of this world to make it more inclusive, to make it such that the voices from the South can be heard and can be understood, not in a tokenistic manner, not in a paternalistic manner, but in a fully, fully participatory manner, where we build it again together for the good of the whole world, not just for some of the world, so that all may have a chance at life and quality of life and the true definition of health.
SHAPIRO: That's Dr. Ayoade Alakija, an infectious disease specialist and co-chair of the African Union's Africa Vaccine Delivery Alliance. It's CONSIDER THIS FROM NPR. I'm Ari Shapiro.
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