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The lack of vaccine supplies in Africa and Latin America, parts of Asia, is a major problem in 2021. Of the 66 million doses of vaccine planned to be given to Africa under COVAX plan only 19 million have been delivered. In total about 49 million doses have been delivered. Vaccine shortages are a result of the huge wave of coronavirus in India in April, so that vaccine shipments from India have stalled. Of the countries in Africa a few have made some progress- Egypt, Ghana, Nigeria. Other problems in Africa are lack of trained people to give vaccination. Last week 2.3 billion dollars in additional funds were raised at a donor conference for COVAX, the initiative for poor countries vaccines. That is enough to buy 1.8 billion doses. US and UK have not exported vaccines. India has made a good start in shipping vaccines to many countries in Africa, Asia and Latin America as shown in the Ministry of External Affairs website of the Indian government. For India to do this once it meets its own needs and resume exports, vaccine patent protection needs to be lifted for sometime, which the US is now accepting. ...

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The French British collaboration effort will bring a new vaccine to the global effort against coronavirus. This vaccine was expected in February 21. It will be ready by the third quarter of 2021 just as vaccine supplies are being ramped up. The Sanofi Pasteur unit and GSK Glaxo SmithKline are the two companies in this vaccine venture. This vaccine will address the problem of new mutations of the virus in the British and South African versions and can be stored at normal temperatures. 
 

The new vaccines will boost supplies just when the situation is bleak for vaccine supplies in Latin America and Africa, South East Asia, places left out in the vaccine race in advanced countries and in India. Britain has ordered 60 million doses. 

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In some countries such as Tanzania and Chad the vaccination drives have not even begun says this report in the DW.com. A new surge now underway in Africa as cases increase by 30% in June comes at abad time with African vaccination drives stalled. Only 31 million doses adminstered in Africa for a population of 1 billion people. Less than 1% of world vaccine supplies are going to poor countries in Africa and Latin America.

Vaccine companies chose to sell their vaccines to the highest bidders, putting Covax  behind. Aims of Covax are also coming down and watered down to vaccinating 20% or 30% of the population in poor countries, says this report in DW.com.

This means new variants could develop and move back to Asia and Europe, the US in 2022. It means the coronavirus could affect African economies in 2022 and beyond.

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Stephanie Nolan's reports from Africa provide the few glimpses one can get today of the situation in Africa where variants are growing as a result of lack of vaccines (vaccine inequality) and the faltering vaccination drive, shortage of medicine and food supplies. Her report from South Africa showed how healthworkers and scientists in South Africa are working hard on the frontlines. This one from Zambia looks at the vaccination centers and vaccination workers as vaccination drives falter. The African continent with 1.4 billion people received 404 million doses. Today only 7% of the population is vaccinated in Zambia and the rest of Africa. People in Zambia do not have car transport so they have to walk 3-6 kilometres to get to a vaccination center, when they turn up at a center and it is out of vaccines they stop coming. Other problems are the social media accounts that show the vaccination drives as harmful to people, or CNN and other news that talk about blood clots that when carefully understood affect a tiny fraction of people. There are other issues also. Ida Musonda, a nurse in a clinic near Lusaka says after not many people turned up that she should go to markets and churches, but says there is no fuel for the vehicle to get clinic workers there. Bernadette Kawango is shown with her children. She works at an auto parts store and lives in a low income neighborhood in the edge of Lusaka. She ignores all the social media accounts that scare people from vaccines, yet she says she worries more about cholera, TB and malaria, and also HIV, AIDS. And she does not know anybody diagnosed with coronavirus.  The result is that there is vaccine shortage resulting in a kind of vaccine indifference (why walk miles to a center if it may not have vaccines), compounded by other problems such as the other diseases that also pose a threat in Africa, and the low incomes in a shrinking economy. And with about 8% vaccinated in Africa, the problem of variants can only be tackled by consistent and not erratic supply of vaccines. ...

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Worldwide coronavirus vaccine development and distribution is covered in the The guardian. There are surprising results in a 2019 Lancet study about how strongly people in each country think vaccines are safe. Only 17% of people in Japan and Lithuania think vaccines are safe. Most of Eastern Europe, some western European countries, Russia and China are shown as countries where about half of the people have doubts about the safety compared to 87% in Bangladesh and Uganda. In India and most of Africa people think vaccines are safe says this report showing the Lancet study results in a graphic.

Vaccines once developed will require cold storage for distribution and adminstering the vaccine. Some vaccines may require ultra cold storage of -60 degrees  or -80 degrees centigrade which may be hard to find in many countries. Most of the cold storage containers available have already been acquired by countries.

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How do you setup a vaccine business. Consider Mr. Adar Poonavalla in the city of Pune in India. His company Serum Institute of India, remains family owned. Founded in 1966 by Cyrus Poonavalla, it produces billions of doses of vaccines for measles, polio and other diseases. It is expected to be one of the key sources of vaccines because of its expertise and the stocks of vials and other supplies that it has in stock for the next 2 years of vaccine production. It is working on a separate facility for coronavirus production that could turn out 800 million doses of vaccine at a price of about $13 a dose over 2 years. Serum Institute is working with 3 companies that are doing the research on the vaccine for coronavirus in the U.S. and Europe, and will play a key role in the manufacturing of vaccines. To respond to the question how do you setup a company to produce vaccines for the people of the world. This is what Mr. Poonavalla says- he will only work with ethical long term funds and sovereign funds because he does not want to be in the situation where he has to charge high prices to give them returns. Unlike most countries in the world, India is unique in making certain that most of the basic pharmaceutical drugs are available to over a billion people at a low cost. Serum's goal is low cost quality vaccine production so that over a billion people in Asia can be "protected from the birth onwards." As the U.S. and Europe and large parts of Asia, Africa and Latin America, face the second vaccine phase of the coronavirus response following difficulties in PPE, Ventilators, and Masks in the first phase, they can have confidence because of companies such as Serum and the research centers in U.S. and Europe like the one at Oxford University. ...

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The Oxford vaccine is shown to be effective for older adults over 70 years in age. One of the key features of the Oxford vaccine is that it is designed to be accessible in cost for not just high income countries but across all parts of the world including the countries in Asia, Africa and Latin America where some of the poorest people live. The cost will be a fraction of the cost of the Moderna and Pfizer vaccine. Results for regulatory approval are expected by Christmas. This vaccine is expected to cost about $4 a dose compared to $25 for the Pfizer or Moderna vaccines. Oxford also uses a technology for the vaccine that has already been proved effective with least side effects fr other virus such as Ebola virus. Oxford researchers took the existing vaccine technology and modified it to tackle coronavirus in a way that proves effective for this virus also. Countries such as South Korea say they will not rush into the first vaccine that is available and have not responded to requests for sale from Moderna or Pfizer. India's Serum Institute is the leading manufacturer of vaccines in the world. It is preparing for production of the Oxford vaccine. India's vaccine effort includes other vaccines developed by its research institutes. The focus of India is for a vaccine that is effective as well as meet cost so that it can be used to vaccinate over 1.3 billion people. Because India has strong already established manufacturing capabilities for vaccines and is collaborating with Oxford and Astra Zeneca for a low cost vaccine it is in a position to drive the campaign for an effective plus low cost 100% accessible vaccine for people around the world. Another aspect of the Astra Zeneca partnership with Oxford is that it has committed not to make a profit from the vaccine. This is important for Oxford researchers and its organizational goals. ...

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The third or booster dose of vaccine is needed to take out the Omicron variant. The UK Health Security Agency analyzed data from 581 Omicron cases and thousands of Delta cases to calculate how effective vaccines such as Pfizer and Astra Zeneca were against the Omicron variant. This early analysis shows a third booster dose prevents around 75% of people from getting any coronavirus symptoms. The double dose of the vaccine however provides good protection against severe coronavirus that needed hospital treatment says the UK Health Security Agency. Of equal concern is the rate of spread of the Omicron variant. Here this BBC report shows graphs of UK National Health Security Agency which show the rate of spread is rapid with cases doubling every 2-3 days. For the UK which on December 10 had about 1265 cases this means says this BBC report that the number of Omicron cases could be well above 100,000 in the UK by the end of December. The BBC graph shows the curve for Omicron cases moving in a close to vertical direction upwards. Reports say the experience in South Africa where the Omicron variant was first detected is similar in pattern causing rapid spread. ...

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A Phase 1 trial of over a thousand volunteers shows the Oxford vaccine works well with minimum side effects that can be handled with acetaminophen. Phase 2 trial is underway with volunteers in UK, Brazil and South Africa. Participants given the vaccine had significant increase in antibodies to neutralize the disease, and T cells for long term protection. About 70% reported fatigue or headaches which can be handled with acetaminophen. After the Ebola crisis of 2014 in West Africa the British government invested 120 million pounds to form a group to develop vaccines for top 10 likely threats dubbed "Disease X." On this list was the coronavirus. Scientists at the Jenner Institute at Oxford formed a team as part of this effort. Sarah Gilbert and Adrian Hill led the scientists at Jenner and pioneered research for  a new way to do this- to first replace a part of the virus with a component of the new virus. Then to remove the part of the virus that allows it to replicate in humans. This method is called recombinant adenovirus vector. The Oxford scientists used existing technology in new ways to increase the chances of getting a good vaccine early.  The first vaccine could be developed and tested for mass production by September. A 30,000 participant trial begins in U.S. in August. About 1 billion doses could be manufactured by end of 2020. India's Serum Institute has the manufacturing facilities to do this near Pune, India.  ...

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Moderna has made the initial batches of doses of the vaccine for the variant of coronavirus including South African variant, and shipped these to the National Institutes of Health in the US. If the test results are positive the vaccine for variant could be given authorization by the third quarter of 2021. It is becoming crucial to stay ahead of variants developing from the coronavirus and pharmaceutical companies Pfizer, J&J, Astra Zeneca are working on the technology to tackle this.

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The Moderna and Pfizer vaccines are effective against the virus variant identified in Britain. It is less effective against the virus variant from South Africa. The U.S. banned all travel to and from South Africa effective Jan 30. U.S. coronavirus cases were at 125,000 on Jan 24 down 20% for the week. 

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This report in The Guardian says what India urgently needs is for the US to lift export restrictions on supplies for India's vaccine factories, and tools such as genome sequencing to identify and control emerging variants of the coronavirus.

The report also points out that of the 1 billion vaccine jabs about half are in the US and Europe and the low income countries have only a tiny fraction of vaccinations. India which sent 64 million vaccine doses to countries including Brazil and Morocco, Bangladesh, in 3 months prior is reported to have sent only 1.2 million doses this month.

The crisis in India also shows the need says The Guardian for an international approach to the crisis no a country by country approach. It says the Bush plan for Aids and the the 2014 plan for Ebola in West Africa are models of an international approach that is needed now.

 

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Weak and poorly equipped public health systems, densely crowded conditions, make coronavirus spread extremely serious in South Asian and African countries. India imposed a complete lockdown of the entire country. South Africa imposed a 21 day lockdown enforced by the military. Decisive and strong action is needed early. Pakistan acted early to quarantine pilgrims entering the country from Iran. Pakistan's government has announced a $20 monthly wage subsidy for poorer households. The average in Africa is 20, according to the UN, and South Asian populations are also very young. Generally hotter climates may offer some offsetting factors to makeup for the lack of strong public health systems. India made major strides in direct deposit to bank accounts of 1.3 billion citizens by the government for many social safety net schemes in the last 5 years. It has also computer records of all citizens under a plan underway for a decade. The nationwide rollout of 4G mobile technologies has connected every citizen including remote areas. This should assist in the identification and isolation of affected areas and people. Other factors that mitigate the spread will be access to medicine when medicine and vaccine is developed for the virus. India has a large pharmaceutical industry, scientific labs and other medical resources similar to South Korea, which should help limit the affected areas and people. ...

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Latin America has made a huge turnaround through successful vaccination drives. Today more people are vaccinated as a percentage of the population in Latin America at 62% than in the US at 56% or Europe at 60%, according to Our World in Data project at Oxford University. There is little resistance to vaccines in Latin America after successful vaccine campaigns against yellow fever and other diseases. During the first year of the pandemic Latin America had one third of the deaths in the world with 8% of the population. Deaths after vaccination drives have dropped to 8%.  Brazil with 617,000 deaths from coronavirus was second only to the US with 800,000 deaths. Brazil is now back to normal after a successful vaccination drive that has 66% of the population fully vaccinated, and 80% with one dose, some of the highest rates in the world, according to Our World in Data at Oxford University. In Colombia with 50 million population about 50% of people are fully vaccinated. Cases have dropped from 30,000 in June to 2000 a day and deaths from 700 daily that month to 50 a day in December 2021. In Buenos Aires, Argentina's capital, 83% of three million population are fully vaccinated, 14% have received a booster. Buenos Aires city health minister says Argentine society has an affinity for vaccination campaigns. "They rapidly accepted receiving them," he says. Yet from the point of view of new variants emerging there is a different situation in rural areas. In industrial states such as Sao Paulo 78% are fully vaccinated, yet less than 40% are fully vaccinated in poor Amazon state of Roraima.   We make it a point to honor the brave reporters in these countries who provide the reports in the WSJ, as we did earlier for NYT Stephanie Nolan's reports from South Africa and Zambia about frontline workers against Omicron in Africa.  Luciana Magalhaes in Sao Paulo, Jenny Carolina Gonzalez in Bogota, and Sylvina Frydlewsky in Buenos Aires and Kejal Vyas writing this report from San Salvador. ...

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Contrast the slow US vaccine export response with that of India, Russia, EU and China. Only in May 2021 after India's daily Covid cases were close to 400,000 a day did the US make a serious offer of vaccines to other countries in need of assistance. U.S. president Biden says that 80 million vaccine doses would be exported by the end of June 2021. The WSJ says citing Airfinity, a London research firm, as of May 10 more than 333 million doses of vaccine were produced by the US and only 3 million vaccine doses were exported. Contrast that with the European Union which has shipped 111 million doses overseas one third of its total production, Russia which has exported 27 million doses.  India has exported 66 million doses according to the Ministry of External Affairs website as of May 17, 2021. This includes 4 million doses to Brazil, 4 million to Nigeria. Within its own region Bangladesh received 10 million and Sri Lanka 1.2 million doses, Afghanistan 1 million. Mexico received about 1 million doses. In Africa the Democratic Republic of the Congo which has suffered from many epidemics including Ebola virus received 1.7 million doses, Nigeria 4 million doses, Kenya 1 million, Uganda 1 million. Of the 66 million about half of it is a direct grant assistance and Brazil, Mexico, Morocco received all vaccine as grant assistance, 70% of Bangladesh's is grant assistance. The list on the Ministry of External Affairs site of the Government of India shows 95 countries including many of the most struggling nations of Latin America and Africa, bringing hope to countries which are struggling to hold onto hope for a better life beyond the pandemic. Sending help overseas through vaccine supplies is suspended for the moment but will resume in July after India has pulled in all of its pharmaceutical manufacturing industry under a government guided effort to go all out. Never has so much help bringing much needed hope gone to so many countries of the world in the twentieth or twenty first century from a nation that is struggling to meet its own needs. The US in pursuing a US first policy of vaccinating all its citizens has not taken into account the need to bring this evolving vaccine technology into the hands of as many qualified pharmaceutical manufacturers as possible. This in a rapid response to expand manufacturing capabilities to meet world wide demand. The risks of not doing so were not taken on early- the very same way the virus spread in January to March of 2020 can be repeated as people travel around the world particularly for tourism, business family reasons. This risk takes on anew dimension of contagious mutations of the virus which are 50% more- the Indian variant being 50% more contagious by some estimates than the UK variant, which itself was estimated to be 50% more contagious than the original one.  The result a pandemic that stretches out indefinitely unless billions of doses are made in a short timetable to beat the timetable of Nature through the coronavirus. India is doing this for the first time with plans to produce billions of doses by engaging the whole of the Indian pharmaceutical manufacturing industry in the effort in a rapid response so that July to December would see 1.2 billion people vaccinated. The US effort, the European effort is left to the individual effort of pharmaceutical makers in the US and Europe, not a government guided effort to engage the entire pharmaceutical industry of the US and Europe in a rapid response timetable of 2-6 months.  ...

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A few events in the last 50 years are rewriting the rules for business, finance and economics, says the WSJ in this analysis. The admitting of China to the World Trade Organization under president Clinton in 2001 was one, another was the global financial crisis in 2009 with the selling of bad mortgages by the financial industry, the euro currency financial crisis with the bad accounting, real estate industry speculation, and lack of financial oversight in countries such as Greece, Ireland, Spain. The coronavirus pandemic is one more addition to this string of crises and events that have made the working class and middle class in US and Europe poorer and in worse shape after the recovery following World War II.  The changes indicated here are some of the surface changes- such as the shift to the suburbs for cleaner air and better living, the work at home as a serious option, the new focus on health care, wellness, exercise, nutrition and mental health, remote learning and community college as a realistic option to high tuition costs by the education industry, and a pharmaceutical industry refocused on public health and vaccines as it was in its early years before its shift into a simply profit driven industry. The underlying thread for all these changes on the surface is a deeper change in the public mind- a change that redefines what the people believe in just as happened after World War II. Rebuilding the devastated economies of Europe, America and Asia required a new vision at the time after World War II. And reconstruction could only happen with all the people involved and working for the public interest.  This also created a new hope for the future. President Biden's vision is for a new set of priorities that make child care, women's position in the economy, community college education as a right for all as a first step to opening the access to education that existed after the war in 1945. Investment in infrastructure, in building new roads, bridges and rail, water, internet connections, public services in transport, better layout of urban areas, better lives for retirees, are all part of an effort to improve quality and ease of living for all parts of society, not just those who can afford it.  This is uppermost on people's minds and administrations or governments that fail to deliver or simply talk with no action, will not have the support of ordinary working men and women in all countries. This is true for countries and regions as varied in their level of development as the US, Northern Europe, Southern Europe, Japan, India, Brazil and Mexico, and African nations. Democracy, government adminstration, technology and business structures exist for the people, to improve the ease of living, quality of life, through better health, education and public services.  ...