Director-general warns of ‘catastrophic moral failure’ if richer countries hoard treatment


The world is on the edge of a “catastrophic moral failure” in the distribution of Covid-19 vaccines, with just 25 doses administered across all poor countries compared with 39m in wealthier ones, the head of the World Health Organization has said.

It was the sharpest warning so far from Tedros Adhanom Ghebreyesus about the dangers of vaccine hoarding since inoculations started being administered in 49 mostly high-income countries.

Guinea is the sole low-income country to have delivered any shots so far, last week providing doses of the Russian Sputnik vaccine to a mere 25 people, including its president.

Tedros told an annual meeting of the WHO’s executive board on Monday that it was wrong to see people at low risk in wealthy countries being vaccinated while most of the world still did not have access to the jabs.

“It’s not right that younger healthier adults in rich countries are vaccinated before health workers and older people in poorer countries,” he said.

A global vaccine-sharing fund, Covax, says it is preparing to deliver its first doses in February but is competing with nations striking their own, often more lucrative deals with manufacturers to secure limited supplies of vaccines.

There had been 44 such deals last year and 12 signed so far in January, Tedros said, accusing countries of “going around Covax, driving up prices and attempting to jump to the front of the queue”.

“This could delay Covax deliveries and create exactly the scenario Covax was designed to avoid, with hoarding, a chaotic market, an uncoordinated response and continued social and economic disruption,” he said.

“The world is on the brink of a catastrophic moral failure and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”

The WHO director-general also criticised some manufacturers for prioritising getting their vaccines approved in wealthy countries, where they could make greater profits, over submitting regulatory data to the WHO to speed up the process of having the vaccines approved for inclusion in the Covax portfolio.

“Ultimately these actions will only prolong the pandemic,” he added, urging countries to avoid making the same mistakes made during the HIV pandemic, in which wealthy countries were accused of hoarding treatments for years until the death toll rose to more than 8,000 people a day.

The identification of more infectious variants of the virus in the past month has intensified the scramble for vaccines among countries who can afford it. The Guardian understands that talks among European countries over building a “humanitarian stockpile” of inoculations for refugees and others who may not be vaccinated by governments have been temporarily shelved.

Israel, Bahrain and the UAE have delivered the most doses per capita, with more than one in four Israelis having received a dose of the Pfizer-BioNTech formulation. Just over 6% of people in the UK have received a vaccine dose, along with more than 4% of US citizens.

Duke University’s Global Health Innovation Centre estimates there will not be enough vaccines to cover the world’s population until at least 2023.

India and South Africa have led a push at the WHO to waive intellectual property rights for Covid-19 vaccines and treatments, which activists say could significantly increase supplies of both by allowing any qualified manufacturer to produce them without fear of being sued or prosecuted.

Countries including the UK, US and Canada have opposed the IP waiver while at the same time buying up or reserving enough vaccine to inoculate their populations at least four times over, should all the candidates they have pre-purchased be approved.

Covax was established to avoid a repeat of the scramble for vaccines in the aftermath of the 2009 H1N1 pandemic, “when richer countries purchased much of the available vaccine, and the African region got vaccines much later and when it was too late to be of any benefit”, said Prof Helen Rees, the chair of the programme and policy committee at Gavi, a vaccine alliance that cofounded Covax.

“[Covax] is inventing a new global health structure in months,” she said. “It’s essentially try to do something that has not ever been done before in the context of a pandemic.”

She said the scheme was being undermined by a rush of bilateral deals, attempts by countries who make vaccines to limit their export, and ambivalence on the part of vaccine manufacturers to “come to the party” by prioritising Covax over deals with governments.

Covax says it has secured at least 2bn vaccine doses for 2021, though it has not provided details on when it will receive them, amid fears manufacturers will seek to prioritise honouring contracts with governments.

The African Union announced last week it had secured 270m doses for the continent in another side deal, a sign that lower- and middle-income countries were seeking to find ways to compete with wealthier countries to bolster their own vaccine supplies.

The WHO also raised “concerns” about the unequal distribution of coronavirus vaccines in Israel and the occupied territories, where Palestinians have yet to receive any vaccine shots, an official said Monday.

Rights groups say Israel has the responsibility as an occupying power to provide vaccines to Palestinians in the West Bank and Gaza. Israel says it has no such obligation and that its own population — including Arab citizens — is the priority, but that at some point it might consider sharing its supplies.

Additional reporting by the Associated Press