The Shame of COVID-19

[This article was originally published in La Vanguardia]

Shame. One cannot feel otherwise in the face of the widespread lack of solidarity and the protectionism of rich countries in the international management of the pandemic. We started 2021 with the mantra that no one is safe until everyone is safe. It was a good slogan—scientifically questionable, but morally necessary. We ended the year with the feeling that no one would ever be safe if it depended on an effective international response. The inequitable response, in fact, has only widened disparities and gaps in global health.

Rather than globally rewarding and recognising South Africa’s molecular and epidemiological surveillance services, an entire region was unilaterally and capriciously punished and isolated

The discriminatory measures applied by the European Union against citizens of (and people travelling from) Southern African countries are the most recent example. Citizens of these countries were physically and commercially isolated before there was any evidence of the severity or contagiousness of the new Omicron variant of the virus, and before we knew whether it was already present in Europe (all signs suggests that it was), even though it was more than obvious that these measures could not prevent the spread of a variant that was already on its way to becoming predominant (at most, they would delay its arrival by a few days).

Rather than globally rewarding and recognising South Africa’s molecular and epidemiological surveillance services, an entire region was unilaterally and capriciously punished and isolated. These measures also offended and stigmatised African populations, as has been done to Chinese citizens throughout the pandemic.

This is the latest example of Europe’s indifference, short-term thinking and hyperventilation when faced with what is happening in distant populations, especially poor ones

Once the health authorities sounded the alarm, Omicron was quickly detected in many other countries outside of Southern Africa, providing evidence of local transmission and the unstoppable advance of the variant. Has Europe isolated all of these countries on similar grounds? Would they have done the same if the new variant had been detected in the United Kingdom? Or in Switzerland? I doubt it.

Even after Christmas, when the Omicron variant probably already accounted for a majority of the cases diagnosed in Spain, vaccinated people from Southern Africa with negative PCR tests were still subject to quarantine requirements. In other words, our hubris—or ignorance, or disdain (call it what you like)—has prevented us from recognising our mistakes and correcting them in a timely manner. This is the latest example of Europe’s indifference, short-term thinking and hyperventilation when faced with what is happening in distant populations, especially poor ones—an attitude that perpetuates a two-speed world.

Photo: Maksim Goncharenok / Pexels

We continue to see this with the vaccine supply. The head of the World Health Organisation (WHO) recently reminded us that there were enough doses in the world to have vaccinated 40% of the population of all countries by September 2021. Regardless of whether the proportion of vulnerable populations differs from country to country—and it is higher in rich countries—there is no doubt that enough vaccines have already been produced to protect the most vulnerable populations everywhere in the world.

20% of global vaccine production is being used for boosters in rich countries, with many doses going to people under age 50 without risk factors

However, in Africa, less than 10% of the population has received even a single dose of vaccine. Three out of four African health workers are still not vaccinated. But this inequity is only getting worse. Currently, 20% of global vaccine production is being used for boosters in rich countries, with many doses going to people under age 50 without risk factors.

Photo: Denis Ngai / Pexels

In the midst of an international crisis, children in rich countries—in whom COVID-19 is very rare—are being vaccinated before older people in many poor countries. This is like vaccinating Europeans over age 70 against papillomavirus rather than ensuring that adolescent girls in African countries with a high incidence of cervical cancer are protected. It is like feasting in front of the hungry. And we do it, shamelessly. Don’t get me wrong: if your children are offered a COVID-19 vaccine, accept it—it will further reduce their chances of having a severe case of COVID-19. To do otherwise would be to commit a double mistake: not only would there be a poor international health response, but vaccine doses would go to waste or expire in storage, waiting to be used.

The real solutions entail working cohesively and comprehensively during pre-pandemic periods, establishing leadership, mechanisms and structures at the international, regional and local levels that will enable us to be better prepared

While useful and vital, initiatives such as COVAX—which promotes the equitable distribution of COVID-19 vaccines—are insufficient successes. In a pandemic crisis, the solution should not be limited to this sort of North-South charity—sending vaccines to countries with fewer resources, where there is also a lack of capacity for local supply and for maintaining the cold chain; where there are no personnel or resources to vaccinate those who need it; and where there is a low perception of risk, for which, by the way, rich countries are largely responsible.

The real solutions entail working cohesively and comprehensively during pre-pandemic periods, establishing leadership, mechanisms and structures at the international, regional and local levels that will enable us to be better prepared. Formal assessment exercises, such as that of the WHO Independent Panel, have identified a number of key factors for a fairer, more equitable and less shameful response to the next pandemic.