More Shots Alone Won’t Win the Global War on Variants: The Editors

While speeding up vaccine donations, rich countries must also do more to get those doses into arms.

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(Bloomberg Opinion) — Covid-19 variants are racing through the developing world far faster than vaccinations. More shots are desperately needed to slow the spread of the disease — but even they won’t be enough.

The so-called delta variant in particular is tipping the pandemic into a frightening new stage. The highly transmissible strain, now infecting more than 100 countries, has upended poorer nations. Hospitals are overflowing in Indonesia, as patients’ relatives hunt desperately for oxygen cylinders. Deaths have been rising for more than a month in Africa, spiking 43% in just one week. Countries from Bangladesh to Zambia have recorded sky-high positivity rates.

The longer these outbreaks rage unchecked, the greater the danger to everyone. Newer variants are already appearing. If some turn out deadlier or more contagious, they could devastate the developing world — as well as still-large unvaccinated populations in richer countries.

The U.S. has a special responsibility to act (not to mention, as the world’s largest economy, selfish reason to prevent more disruptions to trade and global growth). At last month’s Group of Seven summit in England, President Joe Biden vowed to lead a massive effort to share vaccines with low- and middle-income countries; the group pledged to donate 870 million doses, at least half by the end of this year. Yet, thus far, the U.S. appears to have delivered only around 40 million shots. The U.K. has yet to send out any of its 100 million pledged shots, while European countries have delivered only a few million. More of these doses need to be shipped out faster, to the countries most in need.

Perhaps as soon as this fall, however, distribution and demand may pose bigger bottlenecks than supply. Already, regulatory hurdles are delaying some vaccine shipments. While most poorer countries have rushed to launch initial vaccination campaigns, and many have experience with large vaccination programs for children, it’s not clear how prepared they are to expand adult vaccination programs nationwide; unpredictable supply only compounds the problem.

Indeed, some have had to destroy doses they couldn’t administer. If projections hold true, the world could have several billion doses of high-quality Western vaccines by the end of this year. Many may go unused, even as huge swaths of the developing world remain unvaccinated.

Through its two-decade campaign to distribute HIV/AIDS drugs, the U.S. has built up unparalleled experience and relationships with public-health authorities globally. It should be leading an effort now to improve developing countries’ capacity to store and administer vaccines. Armies of vaccinators need to be hired and trained. Logistics chains need to be extended, including cold-storage facilities for powerful mRNA vaccines. Digital systems need to be set up to track supplies and monitor the vaccinated.

These efforts should be accompanied by a campaign to improve public-health communication, combat misinformation and overcome vaccine hesitancy. While there are more willing recipients than shots right now, that balance will inevitably shift, as it has in the U.S. and other developed nations. Efforts to increase confidence will have to be tailored to each country, and different regions within large countries, given the range of factors contributing to such mistrust.

Finally, developing nations need more money for testing, epidemiological investigation and control measures, as well as technical help to keep track of spreading variants. Analyzing sewage wastewater can help authorities spot outbreaks early and target limited testing resources. Low-cost technologies for genome sequencing can help track variants and identify new ones before they take off. Regional labs should be expanded to analyze samples from countries that can’t yet afford their own.

All these capabilities will not only aid in the current battle, but better prepare developing nations for future pandemics. There’s no more urgent priority.

—Editors: Nisid Hajari, Timothy Lavin.