Outside the front entrance of the Pfizer Clinical Research Unit in New Haven, Francesca Maviglia spoke about when her mother became ill with COVID-19 shortly after getting vaccinated.
“She started having COVID symptoms a week after her second dose,” she said of her mother, who lives in Italy and got the virus in August. “And so when she texted me to tell me that she had tested positive, I took a deep breath, I reminded myself that she would be OK, and I stayed calm.”
Maviglia’s mother would have a mild infection and recover. But a friend’s mother in Morocco wasn’t as fortunate and died the same month from COVID-19 — a week before she was scheduled to receive an initial dose of a vaccine.
“[My friend] and I are from the same region of the world, we’re both from Mediterranean cultures,” Maviglia said, “but because I’m from the northern coast of the Mediterranean and she’s from the southern coast, because I’m from Europe and she’s from Africa, my mom got to survive COVID and her mom didn’t.”
Maviglia, a public health practitioner and graduate student at Yale School of Public Health, was among health care providers and activists who met in New Haven Wednesday night to highlight deadly outcomes of inequities in the global COVID-19 vaccine rollout.
They have joined health care advocates in other cities and countries in calling on highly developed nations, including the United States, and pharmaceutical companies to make COVID-19 vaccines more accessible to underserved nations.
“A number of countries, both low-income, middle-income and high-income countries, have been involved in clinical trials to test these vaccines,” said Dr. Reshma Ramachandran, a primary care physician and health services researcher at Yale.
“And despite countries volunteering their citizens for these trials in hopes of getting earlier access, they were actually pushed to the back of the line after high-income countries,” she said.
Billions of people worldwide have received a COVID-19 vaccine and now boosters, but data shows significant disparities among geographical regions.
Many countries in the Americas, Europe, Asia, the Middle East and Oceania have close to two-thirds or more of their populations vaccinated, but only about 6% of all people in Africa have received one dose, according to the Africa Centers for Disease Control and Prevention.
The emergence of the new omicron “variant of concern” last month in South Africa has brought new fears as to how the region will be impacted, and how the variant could exacerbate existing vaccine inequities.
“Because now rich nation after rich nation have decided that the way to handle omicron is to just boost ourselves, ban travel from Africa, and then we’ll be fine,” Madhu Pai, a global health expert at McGill University in Quebec, Canada, said on NPR’s All Things Considered. “That is the most myopic policy I’ve ever heard of.”
Programs like COVAX, a global sharing initiative that relies on donated vaccines from high-income countries and pharmaceutical companies, originally pledged to deliver 2 billion doses of COVID-19 vaccines to countries in need by the end of 2021.
In September, it reduced its goal to 1.4 billion. The Associated Press reports that the COVAX initiative has fallen short in meeting demand.
“Control of both the supply and the price is still in the hands of the pharmaceutical companies,” Ramachandran said. “Even though COVAX had these ambitious goals of ensuring access for low- and middle-income countries, companies didn’t come to the table until much later and with very paltry donations that are not meeting the global need.”
That’s why Maviglia said she and others want to put pressure on pharmaceutical companies and world leaders to freely share their vaccine technology and information so that underserved nations can manufacture and produce doses on their own instead of having to rely on donations.
“It’s not random, it’s not by some accident of history that countries in the global south are lacking doses to vaccinate their people at the same speed as the global north,” Maviglia said into a megaphone before a small crowd. “It’s a continuation of a system of colonialism and new colonialism that says some lives are worth more than others. It’s racism and it’s medical apartheid.”
To try to address the problem, governments in India and South Africa proposed a World Trade Organization Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver agreement last year.
It would temporarily waive intellectual property rights of the technology and “recipes” for COVID-19 vaccines and treatments so that underserved countries could manufacture and distribute doses on their own without having to compete with wealthy countries for vaccine purchases.
The Biden administration in May announced support for such a waiver, but drugmakers and other influential countries remain opposed.
Discussion of a TRIPS waiver was expected to take place at the WTO’s 12th Ministerial Conference — it was originally scheduled to start Nov. 30 but has been postponed due to the omicron variant.
