As Congress returns this week, it should quickly address the unfinished business of global pandemic vaccination coverage, which is losing momentum. Some $5 billion was omitted from the last covid-19 funding bill in a political compromise. But there can be no compromising with this virus. It must be fought in many lower-income countries, where vaccine uptake is low, to reduce the chances of another destructive variant.
The vaccine rollout has been lopsided for more than a year. All told, 11.5 billion doses have been administered worldwide. According to the World Health Organization, high-income countries, with a population of 1.17 billion, and upper-middle-income countries, 2.6 billion people, have achieved 74 percent uptake of those primary doses, but the lower-middle-income countries, or 3.3 billion people, have achieved only 51 percent coverage, and in the lower-income countries, 665 million people, the uptake is only 11 percent. The target of immunizing 70 percent of the population has been met by only 52 of the 194 member states of the WHO. Not a single lower-income country and only three of the 54 lower-middle-income countries have reached the goal. Many of the poorest countries are below 10 percent. Of the WHO members in the African region, more than half decreased their vaccination rate in the month that ended April 11.
At the early stages of the vaccine rollout, supply was the main bottleneck, and many poorer nations chafed at being left behind. Over the long run, it is vital that manufacturing capacity be expanded to permanently serve these nations and right the balance in vaccine distribution for future crises. At this point in the pandemic, however, supplies have caught up. The Serum Institute of India, a key supplier to developing countries, stopped making fresh batches after its stockpile grew to 200 million doses. Some organizations, including the Africa Centers for Disease Control and Prevention, have asked the world to pause and better stagger vaccine delivery.
The problem now is on the demand side — to overcome logistical hurdles and vaccine hesitancy to get more shots from airports into arms, especially among at-risk populations, including the elderly, and health-care workers. This can be difficult; many countries do not have resources to create campaigns to promote vaccines, and publics, faced with misinformation and disinformation, don’t know whom to trust. Another factor is that other diseases, from measles to malaria, remain pressing threats in some areas and are competing with coronavirus vaccines for scarce resources. According to the Biden administration, efforts by the U.S. Agency for International Development to help surge support for vaccination to the neediest countries will be curtailed if Congress does not act.
In this period of relatively low infections in the United States, it can be easy to slip into complacency. But the virus never stops evolving. All the major variants have originated outside the United States. The best way to avert a new one arising — and causing us more pain and misery — is to vaccinate as many as people as possible around the world, as soon as possible.