The missing actions on vaccine fairness (II)

The emergence of the Omicron strain of the coronavirus not only teaches many of us a further letter of the Greek alphabet but also provides a further education on both the politics of the pandemic, and its simple geography. As UNICEF points out, a pandemic cannot be solved one country at a time: “The pandemic will not be over anywhere until it is over everywhere.”

Many South Africans feel that they are being punished for their unusually strong approach to genomic sequencing. Their leading scientific position has enabled the early identification of this new strain, as it also did of the so-called Beta variant from the earlier stages of the pandemic (and of the Greek alphabet). It’s unlikely that South Africa is a particular hotspot for the development of new strains of the virus – though it is possible that the presence of a relatively higher population of immuno-compromised individuals because of the HIV/Aids challenge in that nation may provide some driver and scope for evolution of the virus. Much more significant is that the country is better than almost any at genomic sequencing of the virus and so is quicker to pick up issues than others.

It is very likely that Omicron has been active in a number of countries for some time but remained undetected until it came to the attention of the greater sequencing in South Africa.

Whatever its origin, the key lesson of Omicron is as a reminder that we need to share vaccines more fairly. We will not be able to prevent the development of new strains of virus and their spread unless there is much greater vaccination globally. Even if the rich North continues greedily to vaccinate its populations, the under-vaccinated nations of the global South are likely to prove pools of further and future infection – by strains that may not prove as mild in their health impacts as Omicron currently appears to be.

This is also why the pills now being offered cheaply in developing economies are not the answer. That’s not only because Merck’s pill now appears to be only 30% effective, not the 50% previously reported (note, this is the US, not the German, Merck). It is also that these pills – the Pfizer one will also be made available cheaply in these countries – are a treatment to alleviate the worst symptoms of Covid. It is great that they save lives, but they do not stop people getting (or, very likely, passing on) Covid, they just render the virus less lethal.

This means that the disease persists, and potentially mutates further and more lethally. Meanwhile, the pharmaceutical companies can continue to sell their vaccines at high prices in developed economies. In effect, booster jabs become a rich world (double) annuity for them. The pandemic persists, the fear persists – and the profits persist.

See also: The missing actions on vaccine fairness

An open letter on vaccine dose donations, UNICEF to G7, June 7 2021

Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19, Merck, November 26 2021