As COVID-19 Cases Climb Globally For 8th Week In Row – Only 1% Of Vaccines Administered Were in Low Income Countries

New COVID-19  cases climbed again globally last week for the eighth week in a row – while only 1% of the 100 million vaccine doses administered last week were in low- and middle-income countries – said senior WHO officials on Monday, citing two key barometers of pandemic policies.

Meanwhile, speaking at a WHO press conference ahead of this week’s planned White House Climate Summit, the teenage climate activist Greta Thunberg called upon global leaders to ensure that front line health workers and other high-risk groups in low- and middle-income countries are vaccinated more rapidly – saying it was morally unacceptable that younger people in affluent countries should be able to access the vaccine ahead of high-risk groups elsewhere.

“We have the tools we need to correct this great imbalance that exists around the world today in the fight against COVID-19, just with the climate crisis, Thunberg said. “Those who are the most vulnerable need to be prioritized in global problems require global solutions… But so far, on average, one in four people in high-income countries have received the coronavirus vaccine, compared with just one in 500 in low and middle-income countries,” she said.

Thunberg, whose foundation announced a 100,000 Euro donation to the WHO co-sponsored COVAX initiative, added: “It is completely unethical that high-income countries are vaccinating young and healthy people, if that happens at the expense of people in risk groups, and on the front lines in low- and middle-income countries.”

Regarding the upcoming climate summit, the pandemic has highlighted how health and climate are inextricably intertwined with deforestation and environmental degradation that causes climate change and the spillover of animal-borne diseases into human populations, Thunberg stressed.

“In the future, we will most likely experience more frequent and more devastating pandemics unless we drastically changed the way our ways and the way we treat nature,” she said.

“Today, up to 75% of all emerging diseases come from animals. As we are cutting down forests and destroying habitats, we are creating the ideal conditions for diseases to spill over from one animal to another, and then to us. And we can no longer separate the health crisis from the ecological crisis, and we cannot separate the ecological crisis from the climate crisis. It’s all interlinked.”

Youth Climate Activist Greta Thunberg speaking at WHO press conference

COVID Infections Also Increasing Among Younger People at ‘Alarming’ Rate 

Meanwhile, COVID cases were increasing among younger people aged 25-29 at an “alarming rate” Tedros said, possibly as a result of the propagation of more transmissible SARS-CoV2 variants as well as increased social mixing among younger adults. That mixing, added WHO COVID-19 lead Maria Van Kerkhove, is not only due to more socializing and pandemic fatigue, but also for work and religious reasons following the Easter holidays and Ramadan.

More than 5.2 million new cases were reported just last week, the largest so far, and the world also topped the record of 3 million deaths.  “It took nine months to reach 1 million [deaths], four months to reach 2 million and just 3 months to reach 3 million deaths. Big numbers can make us numb. But each one of these lives lost is a tragedy for families, communities and nations,” Tedros said.

COVAX Facility Facing Immediate Supply Problems Related to India Case Surge

WHO’s Bruce Aylward

The COVAX facility had, as of Monday, distributed just over 38.7 million vaccine doses in low- and middle-income countries, noted WHO senior advisor Bruce Aylward.

“The whole vaccine supply situation remains precarious, and the challenge still because of such competing demands for these doses remains a very difficult one to manage,” said Aylward.

The surge in COVAX cases in India has put constraints on COVAX access to vaccines produced by the Serum Institute of India (SII) – one of the main COVAX vaccine suppliers to date, he explained For the time being, SII has had to redirect much of its recent production to domestic cases. COVAX remains short on donations of other alternative vaccines, as well as funds to make strategic purchases.

“It all it all comes back again also to the COVAX facility having the resources it needs so that it can put the contracts in place, upfront to make sure the supplies are there, not just the supplies in terms of the vaccines, but… syringes and the other supplies, including … cold chain equipment, and sometimes very specialized cold chain equipment to get these products to people,” said Aylward.

While the African Union and the World Trade Organization last week held major conferences on the topic of expanding vaccine manufacturing in the short term the focus needs to be on the redistribution of doses being produced right now, Aylward stressed.

“The challenge is how we’re actually using the doses that are being made.  Last week, while those conferences were taking place, 100 million more doses of vaccines were administered around the world. And the issue is where they’re being administered – because … 99 million doses of vaccines last week went into high, upper middle income and some lower-middle-income countries but only 1% went to the lowest income countries.”

Aylward and other WHO officials lauded recent gestures by countries such as Sweden and Norway to donate excess vaccines that they don’t plan to use – urging other high-income countries that are currently hoarding vaccines to follow suit.

“If we have a lot more weeks, where 99% of the vaccines go to a set of countries that already have most of the vaccine, we’re not going to get out of this crisis as rapidly and efficiently and with as least, you know lives lost as possible,” Aylward noted.

Meanwhile, WHO’s Chief Scientist Soumya Swaminathan said that there remains considerable global vaccine “fill and finish” capacity that has not yet been harnessed by pharma producers capable of making larger quantities of active vaccine ingredients.  She said that a new COVID Vaccine Manufacturing Task Force, co-sponsored by WHO, COVAX, and other partners, is looking at opportunities to quickly address bottlenecks and ramp up the production of more vaccine supplies.

WHO Chief Scientist Soumya Swaminathan

“We know that there is a lot of unused fill and finish capacity globally, and therefore we need manufacturers who have the capacity to make a bulk [active vaccine ingredient] product, to link them with existing fill and finish capacities in facilities around the world,” Swaminathan said.

The Task Force is trying to help link suppliers of critical vaccine ingredients and raw materials to manufacturers, and ensure that export bans “don’t interfere with the process of vaccine manufacturing”. A longer-term goal would be to actually build more manufacturing capacity, particularly in low- and middle-income countries through technology transfer arrangements, she added.

In a thinly veiled appeal to Moderna and Pfizer, Swaminathan said that WHO is calling upon “owners of technology, particularly mRNA technology, to come forward to work with us, to share that technology, that know-how, and experience with recipient companies that will be selected according to a set of criteria that we are developing, and that will ensure not only supplies for this pandemic, but will also help with future regional health security for regions which currently do not have any vaccine manufacturing capacity.  And this obviously can be extended to vaccines for many other infectious diseases.”

On Friday, WHO issued a call for expressions of interest from small and mid-sized pharma firms, as well as from “owners of technology and intellectual property rights” to mRNA vaccines –  to support the creation of a COVID-19 mRNA vaccine technology transfer hubs, particularly in low- and middle-income countries.

“The intention is for these hubs to enable the establishment of production process at an industrial or semi-industrial level permitting training and provision of all necessary standard operating procedures for production and quality control. It is essential that the technology used is either free of intellectual property constraints in LMICs, or that such rights are made available to the technology hub and the future recipients of the technology through non-exclusive licenses to produce, export and distribute the COVID-19 vaccine in LMICs, including through the COVAX facility,” stated the WHO call.

It added that it was seeking expressions of interest from:

  1. Small/middle-sized (public or private) manufacturers of medical products (drugs, vaccines or drug substances) preferably, but not exclusively, in LMICs, which could host a COVID-19 mRNA hub and:
    • Assemble the technology up to good manufacturing practices-grade pilot lots for clinical trials;
    • Transfer the appropriate know-how and technology to existing or new manufacturers in LMICs to enable them to develop and produce COVID-19 mRNA vaccines;
  2. Owners (public or private) of technology and/or intellectual property rights. These may be academic institutions, pharmaceutical companies, non-governmental organizations, or any other entity willing to contribute these to a technology transfer hub, under the auspices of WHO, to enable the production of mRNA-based COVID-19 vaccines in LMICs.

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