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The great vaccine rollout and the global pecking order

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by Rajan Philips

Last Tuesday Britain became the first country to administer the first multi-nationally developed Pfizer-BioNTech coronavirus vaccine. Eight hundred thousand doses of the vaccine are being distributed among the Isle’s four nations in the first stage of the British rollout. Canada is starting its Covid-19 vaccination this week with 250,000 doses of the same vaccine; another 20 million doses are arriving next year along with over 350 million other vaccines. While welcoming the arrival of the Pfizer vaccine as “the beginning of the end of the epidemic in the UK,” Prof. Stephen Powis, medical director of the National Health Services England, has also cautioned that getting to the end itself is going to be a “marathon [and] not a sprint.” Britain has ordered 40 million doses so far and it will cover 20 million people with two shots each, 21 days apart. There are still 47 million to account for. It is a long haul.

In the US, Donald Trump is not happy that Britain got the vaccine before the US and he is even madder that he will not be able to claim credit for vaccination in America as much of it will happen after he leaves office. In any event, many of his supporters may refuse to take the vaccine because it is not mentioned in the US Constitution! Under its military “Operation Warp Speed” vaccination program, the US has issued purchase orders for 800 million doses from the world’s six leading vaccine contenders, although there is some controversy about the timing of vaccine deliveries. Last Tuesday, Trump issued a meaningless executive order that all vaccines procured by the US must be delivered to the US first before vaccines are supplied to other countries.

Russia meanwhile got ahead of both the UK and the US, launching three days before UK its nostalgically named Sputnik V vaccine in Moscow which accounts for about a quarter of Russia’s infections. For several months, China has been conducting mass trials involving millions of recipients for two of its five vaccines in development, Sinovac and Sinopharm. Beijing is yet to announce its internal vaccination program proper, but has already shipped 1.2 million doses of Sinovac to Indonesia, a nation of 274 million people. India has the world’s single largest vaccine manufacturer in the Serum Institute established in 1966, in Pune. The Institute has an annual production capacity of 500 million doses, and has production contracts with the Oxford-AstraZeneca vaccine as well as the Novavax vaccine. The first 100 million doses of Serum’s production are earmarked for use in India, while the rest will be open for distribution among developing countries.

The vaccine rollout I have described here is hardly global in that it is tilted entirely in favour of wealthy countries, and excludes much of the rest of the world, with the exception of the two giant outliers – China and India. This global vaccine anomaly is being exposed and criticized by the People’s Vaccine Alliance that includes well known civil society organizations such as Amnesty International, Frontline AIDS, and Global Justice Now. The Alliance has pointed out that wealthy countries representing only 14 per cent of the world’s population have so far reserved 53 per cent of the most promising vaccines, and thereby limited the ability of the world’s nearly 70 poor countries to vaccinate only 10% of their populations for all of 2021.

A majority of the developing countries are consigned to getting their supply from the pool of vaccines provided by the COVID-19 Vaccine Global Access (COVAX) facility, the global organization set up by the WHO to ensure “rapid, fair and equitable access to COVID-19 vaccines worldwide.” It is partnership of high-income countries and lower-income countries involving 60% of the world’s population, with the former providing for the supply of vaccines to the latter. The expectations are that the WHO will supply 20% of a developing country’s population at no cost. But the reserved quantities for COVAX, according to the People’s Vaccine Alliance, now amount to a single dose for about three people in developing countries, or 16% of the population. Even that may not be fully available in 2021. The root of the problem is too much reliance on donor charity and too little desire to tackle the structural aspects of anomaly.

 

The Pecking Order

The world’s ten leading Covid-19 vaccine contenders, including the Chinese (Sinovac) and Russian (Gamaleya) manufacturers, have a total capacity to produce eight to nine billion doses a year. The chart below illustrates the current capacity and pre-order of each vaccine candidate. Of the ten contenders, excluding the Chinese and Russian contenders, only three vaccines – Pfizer/BioNTech, Moderna and Oxford/AstraZeneca, are at the point of getting public health authorization in multiple countries. The three have a combined annual capacity under four billion doses. Novavax and Johnson & Johnson are expected to join them in 2021, and raise the capacity to six billion doses. In other words, even in any best-case scenario, it will easily take at least three to four years before a majority of the world’s peoples can receive their two shots of the Covid-19 vaccine.

 

Add to this what might be called the tragedy of the aggregate – in that while the combined global Covid-19 vaccine production capacity might exceed the world’s total demand, not every country, or not individuals within countries, would be equally positioned to receive the new vaccine without too much delay. Within the so-called high-income countries (HICs), the priority for vaccination is being given to the elderly, frontline healthcare workers, people with medical conditions, and those who are in essential services. But there is no reason-based system for distributing vaccines between different countries. The global pecking order privileges those in HICs far above the people in lesser income countries. The two charts below provide a snapshot of the per capita procurement levels (Calling the Shots); and the bulk vaccine orders placed by individual and groups of countries with different vaccine manufacturers.

 

As shown in the chart, Canada leads the pack with confirmed orders for just under 10 doses for each of its 37.7 million people. Australia and Britain are procuring just over five doses per head, while every other country or region is under three doses per head. At the bottom of the chart is COVAX, with a single dose for about three people. The bulk order chart shows 2.4 billion doses reserved for developing countries, whose estimated population, excluding China, is 3.6 billion people. Almost all of the reserved developing country supply will come from India’s Serum Institute and the Oxford/AstraZeneca and Novavax vaccines, which are considerably cheaper than Pfizer/BioNTech and Moderna.

On the supply side, “all of Moderna’s doses and 96 percent of Pfizer/BioNTech’s doses are contracted to HICs. In contrast, 64 % of Oxford/AstraZeneca’s doses are pledged to people in developing countries. But their supply can “only reach 18 per cent of the world’s population next year at most.” As well, Oxford/AstraZeneca’s deals are mostly with big developing countries like China and India, while the majority of developing countries are left to depend entirely on the COVAX facility.

 

Vaccines as global Public Good

This global pecking order and the disparity between countries are inevitable to some extent, but the question is what efforts are being made by national and international leaders to mitigate this seemingly natural gap. The signs of mitigation are not as encouraging as the rhetoric of global reset and assertions of global solidarity. The same wealthy countries that have ratcheted up vaccine procurement, are also opposing the waiver of the World Trade Organization’s rules for protecting intellectual-property rights, that is required to facilitate the production of Covid-19 vaccines in developing countries.

Led by South Africa and India, ninety-nine WTO members have called for a temporary waiver of WTO rules. The People’s Vaccine Alliance supports the waiver request, but it is being flatly rejected by the HICs, including the UK, the USA, Canada, Norway, and the EU. The HICs, which are under pressure by the pharmaceutical industry, are not supportive of structural changes, and would rather prefer a charitable avenue like COVAX. The UK is the largest funder of COVAX, and is keener about urging for more donations than supporting any rules waiver. WTO decisions are normally reached through consensus, and so a majority vote will be meaningless if the HICs are not willing to compromise.

To address, these disparities, the People’s Vaccine Alliance “is calling on all pharmaceutical corporations working on COVID-19 vaccines to openly share their technology and  intellectual property through the World Health Organization COVID-19 Technology Access Pool, so that billions more doses can be manufactured and safe and effective vaccines can be available to all who need them.” In addition, the Alliance is calling for Covid-19 vaccines to be made as “a global public good—free of charge to the public, fairly distributed and based on need.” A first step would be “to support South Africa and India’s proposal to the World Trade Organization Council to waive intellectual property rights for COVID-19 vaccines, tests and treatments until everyone is protected.”

It is indeed a pity that there should be so much global disparity in the production and distribution of Covid-19 vaccines, when all the scientific work and breakthroughs that created them have involved unprecedented international collaboration at every level. In 1955, when Dr. Jonas Salk at the University of Pittsburgh developed his successful vaccine against polio, the then generational scourge in the US and elsewhere, he was hailed as a “miracle worker,” but he declined to patent the polio vaccine, or to profit from it. He would rather let it be free for maximum global distribution. When asked, “Who owns this patent?”, Dr. Salk famously replied, “Well, the people I would say. There is no patent. Could you patent the sun?” Dr. Jonas Salk chose to walk away from a $7 billion worth patent and let his vaccine be a global public good. Why cannot Covid-19 vaccines be similarly another global public good?

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Islamophobia and the threat to democratic development

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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.

The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.

To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.

Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.

It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.

All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.

Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.

If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.

In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.

However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.

It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.

The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.

It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.

A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.

Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.

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Pakistan’s love of Sri Lanka

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By Sanjeewa Jayaweera

It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.

The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.

We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.

This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.

Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!

At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.

One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.

It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!

ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!

The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.

When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!

I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.

I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.

I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.

Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!

I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.

Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.

We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.

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Covid-19 health rules disregarded at entertainment venues?

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Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!

To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.

Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.

The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..

How can one think of social distancing while gyrating, on a dance floor, that is over crowded!

If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.

And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!

Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.

Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.

With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.

I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.

Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.

He has also stated that plainclothes officers would move around to apprehend such offenders.

Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.

He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!

I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:

“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.

“There is no science to beat common sense.”

But…do some of our folks have this thing called COMMON SENSE!

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