In September 2021, Amnesty International launched The 100 Day Countdown. Our campaign calls on states and pharmaceutical companies to share vaccines with low and lower-middle income countries, so that millions more people can be protected from Covid-19 in 2021.
More than 1.2 billion additional people in low and lower-middle income countries could be vaccinated by the end of the year, if rich countries and vaccine makers agreed to redistribute more fairly. Are they up to the challenge?
Background: Scandalous inequality
An end to the Covid-19 pandemic is in sight. For almost a year now, we have had the safe and effective vaccines we need to finally bring this virus under control.
But we won’t beat this pandemic until everyone has access to a vaccine. Not just people in rich countries, whose governments have struck deals with a handful of pharmaceutical companies – everyone. And right now, that moment is a long way off.
As of late October, 63% of people in high-income countries are fully vaccinated. But elsewhere it’s a very different story:
- About half the global population has not received a single dose
- Just 1.4% of people in low-income countries, and 17.5% in lower-middle income countries, are fully vaccinated
- Only 2.8% of people in low-income countries have received at least one dose, and 35.6% in lower-middle income countries. In high-income countries, it’s 70.5%.
[* Source: Our World in Data. All figures as of 21 October 2021]
The unequal global roll-out of Covid-19 vaccines is a stark reminder of how the pandemic has magnified existing inequalities. While Europe, the US and a handful of other states emerged from lockdowns in the summer of 2021, parts of Africa, Asia and Latin America were plunged into renewed crises.
Meanwhile, the threat of new variants, which spread more easily among unvaccinated populations, remains. If we continue down our current path, the end of the pandemic will remain a glimmer on the horizon.
Who is responsible?
This shameful inequality, which is stalling our progress against Covid-19, was not inevitable. It is a manufactured crisis, brought about by the decisions key pharmaceutical companies and wealthy governments have made. There are enough vaccines to go round – but they’re not being shared.
Despite receiving billions of dollars in government funding, most pharmaceutical companies have insisted on maintaining control over production, which stunts the global supply of vaccines.
By refusing to waive intellectual property rights or share their technologies, most western vaccine developers have blocked other companies from manufacturing much-needed doses.
Intellectual property rights also mean companies can set the price of vaccines. Unsurprisingly, many have chosen to sell them at sky-high prices, which often only higher income countries can afford.
Pharma prioritizing rich countries and restricting global supply
Amnesty International launched a report in September 2021 about vaccine inequality. Among our key findings:
- Pfizer and BioNTech had so far delivered nine times more vaccines to Sweden alone than to all low-income countries combined.
- Moderna had not yet delivered a single vaccine dose to a low-income country and had provided just 12% of its vaccines to lower-middle income countries.
- AstraZeneca delivered the most vaccines to lower income countries, sold at cost price, and had issued some voluntary licenses to other manufacturers. However, it has refused to share its knowledge and technology with WHO initiatives, and has opposed efforts that would allow for expanded manufacturing such as the WTO TRIPS Waiver.
WHO has set up a number of initiatives to encourage technology sharing and boost supply, but pharma companies have refused to join.
In June, WHO established the mRNA vaccine technology transfer hub in South Africa, so that African manufacturers can make mRNA vaccines like Pfizer/BioNTech and Moderna’s. But these companies have refused to participate – despite knowing full well that doing so could save tens of thousands of lives.
Nor have any of these companies joined the Covid-19 Technology Access Pool (CTAP), established to support the sharing of open and non-exclusive licences. They have also lobbied aggressively against proposals to temporarily lift intellectual property rights, such as the WTO TRIPS Waiver proposed by India and South Africa.
Rich states hoarding excess doses
Since the very beginning of the pandemic, wealthy states have been hoarding vaccines by buying up almost all the world’s supplies. Many now have a significant surplus of doses.
A conservative estimate by data science company Airfinity found that by the end of September 2021, wealthier states had more than 500 million excess vaccine doses in stock.
- 174 million+ among EU states
- 160 million+ in the US
- 140 million+ in China
- 26 million+ in the UK
- 16 million+ in Canada
These stockpiled doses are gathering dust while millions of at-risk people worldwide remain unprotected against Covid-19.
We can still fix this!
In July, a task force led by the World Health Organization (WHO) set a target to vaccinate 40% of people in every country by the end of 2021. But so far, less than 10% of people in low and lower-middle income countries are fully vaccinated.
On 21 September Amnesty International launched the 100 Day Countdown, calling on states and pharmaceutical companies to take urgent action to meet that lifesaving target.
We calculated that if 2 billion vaccines were delivered to 82 low- and lower-middle income countries, an additional 1.2 billion people could be fully vaccinated by the end of 2021. That’s the number of vaccinations needed in for the WHO to meet its 40% target in these countries.
Airfinity estimates that between 100,000 and 225,000 lives can be saved for every 100 million doses delivered – meaning that meeting this target could save at least 2 million lives.
Amnesty found that this could be achieved if:
- Pharmaceutical companies deliver 50% of vaccines they produce between 21 September and 31 December to low and lower-middle income countries. More than 2.6 billion vaccines could be provided in this way.
- States redistribute the hundreds of millions of surplus vaccines currently in their stocks. Right now, more than 500 million vaccines could be made available immediately if Australia, Canada, China, the EU, Japan, UK, and US, redistributed their spare vaccines.
- Both states and pharmaceutical companies urgently increase global supply of Covid-19 vaccines through knowledge and technology transfer to local and regional manufacturers by joining initiatives such as the WTO’s TRIPS Agreement Waiver, the WHO’s mRNA vaccine Technology Transfer Hub and the Covid-19 Technology Access Pool (C-TAP).
The World Health Organization and the UN High Commissioner on Human Rights have expressed strong support for the 100 Day Countdown. You can sign the petition here.
Is this realistic?
Our analysis showed that there are enough vaccines available to meet the 40% target, if states redistribute surplus doses, and companies prioritise deliveries to COVAX, the African Union and other mechanisms benefiting lower-income countries.
Many lower-middle income countries have already given one dose to over 20% of their populations – showing that systems are already in place in these countries. Others may need additional resources, support and time to be able to implement vaccine rollouts effectively – so it is also crucial that assistance is provided to ensure effective distribution systems.
What about people in wealthy countries who haven’t been vaccinated yet?
Given the high vaccination rates in higher-income countries, and the fact they have ordered many times more vaccines than required, redistributing doses should have no significant impact on vaccine access in these countries.
Countries with surplus vaccines have already inoculated the most at-risk people in their populations. Many are now giving booster jabs to these groups, and offering the vaccine to teenagers and schoolchildren. Meanwhile, in other countries, health workers, older people and those with serious health conditions are still waiting.
We need to end vaccine inequality now
Fair access to Covid-19 vaccines will save countless lives lives. It will make all of us safer, because global vaccination will reduce the likelihood of dangerous variants developing. The longer we wait, the more time the virus has to mutate.
States and pharma companies hold millions of lives in their hands. With enough pressure we can ensure they respect everyone’s human rights, no matter where they live.
There is no more time to waste. No one should spend another year living without access to these life-saving vaccines.