Scientists don’t yet know where the new coronavirus strain dubbed omicron first developed, or even whether it was incubated in humans or animals. Still, two things are clear. The yawning gap in vaccinations between rich and poor countries only increases the risk of more such variants emerging. And bridging that divide will require focusing on demand as much as supply.
High-minded pledges from rich countries and exhortations from global-health officials have barely made a dent in the problem. Almost no low-income countries are on track to meet the World Health Organization’s goal of vaccinating 40% of their populations by the end of this year. Among the 92 countries covered by the WHO’s Covax initiative, the median vaccination rate is only 14%.
Even if rich countries reserve more shots for boosters, supply shortages should no longer pose the main roadblock to improving those numbers. According to one analysis, G-7 and European Union countries together should still have more than enough excess doses by the end of 2021 to meet the needs of poorer nations. Previously pledged donations need to be shipped out much faster, as President Joe Biden’s administration has just promised to do. Wealthy nations should also follow the example of the U.S. and allow poorer ones to take their place in the delivery queue, so doses can go directly to where they’re needed most.
The more daunting challenge is illustrated by South Africa, where the omicron variant was first reported to the WHO on Nov. 24. The same day, the country turned away vaccine deliveries from Johnson & Johnson and Pfizer Inc. because of a lack of demand. As of last month, half of the countries covered by Covax were using less than 75% of their existing vaccine supply; presumably, they’d also have trouble absorbing new shipments.
Although the hurdles to converting vaccines into vaccinations in such places are complex, wealthier countries can help. Greater transparency and predictability about vaccine deliveries would allow local governments more time to prepare for inoculation campaigns. Funding, technology and transportation are needed to set up reliable, low-temperature supply chains to preserve vaccines and distribute them deep into rural areas. Through partnerships developed in the fight against HIV/AIDS and other diseases, the U.S. in particular can help train and pay the armies of vaccinators needed to put shots into arms. Countries will need technical assistance to track initial shots, make second appointments, and monitor and quickly investigate any adverse reactions.
Combined, those efforts should help developing nations reduce friction and reach those willing to be inoculated. The more difficult task, as rich countries have themselves found, is overcoming deep-seated suspicion of COVID-19 vaccines.
That effort needs to be intensely local. Wherever possible, authorities should work with community groups, particularly churches and women’s organizations, to assuage doubts about the vaccines’ safety. Public campaigns should be tailored to local conditions and delivered on the platforms, particularly social media and messaging services, where disinformation is most rife. Rising hesitancy should be monitored closely and rumors quashed quickly. Where cash incentives might help, international financing should be made available.
Finally, rich-country governments shouldn’t wait to address looming problems. They should be working with manufacturers to increase the supply of raw materials needed to produce COVID-19 therapeutics, including promising new treatments from Merck & Co. and Pfizer. Donor nations should fill the gap in funding for surveillance and tests, which need to be widely available for those pills to be useful. And they should head off an anticipated shortage in syringes that could undercut vaccination efforts in 2022.
Admittedly, if vaccines do need to be tweaked for omicron, prompting a new wave of inoculations, it’ll be hard to keep rich nations focused on these priorities. They should remember that unless far more of the world is vaccinated soon, those won’t be the last shots they’ll need.
