For Covid-19 Vaccines, Some Are Too Rich — and Too Poor

Global inequality is shaping which countries get vaccines first. In South Africa, people’s best chance for vaccines anytime soon is to join an experimental trial.

A few months from now, a factory in South Africa is expected to begin churning out a million doses of Covid-19 vaccine each day in the African country hardest-hit by the pandemic.

But those vials will probably be shipped to a distribution center in Europe and then rushed to Western countries that have pre-ordered them by the hundreds of millions. None have been set aside for South Africa.

The country, which will help manufacture the vaccine and whose citizens have enrolled in clinical trials, does not expect to see the first trickle of doses until around the middle of next year. By then, the United States, Britain and Canada may already have vaccinated more than 100 million people.

The first year of the Covid-19 pandemic revealed that a country’s wealth would not spare it from the virus. Overconfidence, poor planning and ignored warnings felled some of the world’s richest nations. But now, money is translating into undeniable advantages.

Over the past few months, rich nations like the United States and Britain have cut deals with multiple drug manufacturers and secured enough doses to vaccinate their citizens multiple times over. China and Russia have conducted their own trials and begun mass vaccination programs.

Yet countries like South Africa are in a singular bind because they cannot hold out hope for charity. Although its government is nearly insolvent and half of its citizens live in poverty, South Africa is considered too rich to qualify for cut-rate vaccines from international aid organizations.

“Where you’re not rich enough but you’re not poor enough, you’re stuck,” said Salim Abdool Karim, an epidemiologist who leads the country’s coronavirus advisory council…https://247sports.com/college/utah/board/59490/contents/redditstreamsbills-vs-patriots-live-stream-reddit-nfl-free-157970015/

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Poor and middle-income nations, largely unable to compete in the open market, rely on a complex vaccine sharing scheme called Covax. A collaboration of international health organizations, Covax was designed to avoid the inequities of a free-market free-for-all. But its deals come with strings attached, and health advocates are questioning its transparency and accountability.

By the middle of next year, South African officials hope to secure their first vaccine doses under Covax, even as they negotiate to buy supplemental supplies from drug manufacturers. But in a country where luxury estates are walled off from sprawling squatter villages, many expect the newest vaccines to remain a privilege for residents who can pay out of pocket or through supplemental insurance — a program that disproportionately benefits white people.

“You’ll be able to stride into your local private pharmacy and pay a couple hundred rand (about $15) and say, ‘Hit me baby,’” said Francois Venter, a researcher at the University of the Witwatersrand in Johannesburg.

‘Maybe We’ll Get the Vaccine in 2025’

The best chance that many South Africans have to get vaccinated anytime soon is to volunteer for a clinical trial and test unproven vaccines on their bodies. But that arrangement has raised ethical questions.

First is whether countries like South Africa, which is supporting trials by four drugmakers, should be guaranteed doses if the trials succeed. The government hasn’t received such a guarantee. And at any rate, such an arrangement would be ethically murky, since it would punish countries that participate in unsuccessful trials.

This month, as Britain prepared to begin its vaccination campaign, dozens of people walked from their shacks in Masiphumelele township, south of Cape Town, to the gates of the Desmond Tutu Health Foundation.

They waited outside for hours, under the shade of a gum tree, for a chance to enroll in a clinical trial of the Johnson & Johnson vaccine.

“The people at the top, they’re going to get the vaccine, the people who have power,” said Mtshaba Mzwamadoda, 42, who lives in a one-bedroom corrugated metal shack with his wife and three children. “Maybe we’ll get the vaccine in 2025.”