| | | | | |  | | By Carmen Paun | This week we're looking at how countries still waiting on coronavirus shots are preparing for their vaccination campaigns.
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General view of the Vaccination Cells area during a Covid-19 vaccination drill by SEDENA at 81st Infantry Battalion of the Mexican Army on Dec. 18, 2020 in Mexico City, Mexico. | Hector Vivas/Getty Images | THE WEST VACCINATES. THE REST OF THE WORLD WAITS — The world has failed the equity test. Of the 10 countries with the highest number of reported Covid cases to date , three have started vaccinations and four plan to begin within a few days. One is Russia, which has deployed its homemade vaccine despite questions about its testing. Six are rich Western countries: the United States, France, the United Kingdom, Italy, Spain and Germany. The remaining three — India, Brazil, and Turkey — are still waiting. So is the rest of the world. Yet the countries still waiting for their first shots are preparing; there is much to do. The World Health Organization has listed roughly 50 activities they should be taking care of now so they can eventually run a smooth campaign – among them, establishing a national coordinator, identifying who should be prioritized for shots, collecting data on immunizations and monitoring rumors circulating about the vaccines. Most nations are still in the early planning phases. Only six countries in the Americas, the region hit hardest by the pandemic, have come up with priority groups to be vaccinated, according to the Pan American Health Organization, which didn't name the countries. | 
Sao Paulo State Health Secretary Jean Gorinchteyn, Sao Paulo Gov. Joao Doria and Director of Butantan Institute Dimas Covas hold boxes of some of the 2 million doses of the coronavirus vaccine developed by the Chinese laboratory Sinovac in partnership with the Butantan Institute on Dec. 18, 2020 in Sao Paulo, Brazil. | Alexandre Schneider/Getty Images | Looking east: Lacking the Western vaccines, some countries are turning to Chinese and Russian-made shots. Sinovac's vaccine candidate seems to be the choice for now in Turkey and Brazil, which have been hosting phase 3 trials. Turkey may start using it outside of those trials . Brazil's Sao Paulo state could follow suit in January, after trials there showed the vaccine to be more than 50 percent efficacious. (The first two vaccines being used in the West were about 95 percent effective in clinical trials). Argentina, the hardest hit country in South America after Brazil, is planning to use Russia's Sputnik V to start vaccination this month. Its president has promised to be the first one to get it to boost confidence. In Africa, Egypt is planning to be a production hub for the continent for Sputnik V and Sinopharm's, another vaccine candidate developed in China. India plans to stick with a locally produced version of the Western-developed vaccine from AstraZeneca and Oxford University. It may see approval in the country before the end of this month, though it's unlikely to be authorized in the U.S. until at least February. The countries choosing Chinese vaccines are doing so "not because it's their first choice, but because it's their only choice," said W. Gyude Moore, senior policy fellow at the Center for Global Development and former Liberian minister of public works. Remaining questions about their testing are academic for most countries in Africa, which are afraid they will not be able to open up their economies as the developed world, with better vaccine access, moves ahead, Moore said. | 
A herd of elephants graze on Dec. 21, 2020 in plains of the Mara North Conservancy, Kenya. | Siegfried Modola/Getty Images | COVAX still kicking: But for smaller countries like his own, Moore thinks the global effort to provide vaccines to at least a fifth of the poorest countries' citizens, codenamed COVAX, is the only way to get access to a vaccine by mid-2021. There has been some skepticism that COVAX can meet that goal, but Seth Berkley, the CEO of the vaccine alliance Gavi, told reporters last week vaccines will still be coming to lower- and middle-income countries sometime in the first three months of 2021. Gavi, which leads COVAX with the WHO and the Coalition for Epidemic Preparedness Innovations, announced new deals with AstraZeneca and Johnson & Johnson. That puts it closer to securing 2 billion doses to deploy around the world in 2021. But for all its talk of a diverse portfolio of vaccines, COVAX has not yet gotten a deal with the manufacturers of the two vaccines which have received emergency use authorization in some Western countries: those produced by Pfizer/BioNtech and Moderna. The talks with them are ongoing. The WHO is expected to give the Pfizer/BioNTech vaccine an emergency use listing this month, putting it on track for a potential rollout to a small number of countries by early February, WHO chief scientist Soumya Swaminathan said Monday. WHO and UNICEF are working to identify which countries may be interested in using specific vaccines — and checking if they are ready for them, said Unicef's COVAX/ACT coordinator Gian Gandhi.
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Dag-Inge Ulstein, Norway's minister for international development. | Sturlason | WHO ACCELERATOR LEADER SAYS PHARMA COULD DO MORE — Norway's top international development official Dag-Inge Ulstein, who's helping lead the WHO's effort to distribute coronavirus vaccines, medicines and tests, thinks pharma could give more assistance in poorer countries. At the same time, Ulstein in an interview said a proposal pushed by developing countries to waive Covid-19 patent protections won't gain much traction, though he hopes drugmakers will hear the calls to expand production capacity and transfer technology. Ulstein is helping the WHO's ACT-Accelerator race to fill a $3.7 billion funding gap by the end of this year, with an additional $23.9 billion shortfall for next year. With $256 million committed so far, Norway is the accelerator's fifth biggest government contributor. Here's a transcript of our conversation, edited for length and clarity. Why is pharma's role so important here? All the good news coming into our countries should be the same good news for the poor countries. So that is why price, production and transparency need to be put on the table. There can't be profit for the least developed countries. It's actually about saving the world, in real time. They [pharmaceutical companies ] have the key. It can be solved in the boardrooms of these companies right now, and that's how it should be, actually. The same companies have done such a great job in the last months. What they actually have achieved in so few months is more that we could hope for. | 
Senior citizens sit in their cars as they receive the Pfizer/BioNTech vaccine at a drive-thru Covid-19 vaccination center in Hyde on Dec. 17, 2020 in Manchester, England. | Christopher Furlong/Getty Images | Are you supportive of the initiative by India and South Africa to ask for a patent waiver on Covid-19 medical tools from the World Trade Organization? We don't have the time to just solve the bottlenecks… It wouldn't be possible to have consensus [required for the waiver]. So that's why we actually tried to shift and see: Could we make the same results by challenging the companies? It was a very wide waiver, also including not only medicines, not only Covid-19 related technologies. That was some of the concerns from some of the other countries. So from my side, if we really want to see results, we could not just enter into some argument, spending the time discussing something that we knew would not succeed. Besides talking to companies, are you also reaching out to countries that have not yet contributed to the Accelerator, like the United States and Russia? Yes, we are calling countries and leaders and colleagues every day. There are some countries that have really stepped up – you have Canada, you have Singapore, New Zealand. We have a strong message in the G20 communique , but we haven't seen all of the money. And that should also be done now. In the end, it needs to come from the wealthier parts of the world. It's a lot of money, but it's not that much when we know how much money the same countries are losing every hour.
| | | | | "We didn't end the [Ebola outbreak in Liberia in 2015] with vaccines or a therapeutic solution. The outbreak ended simply in behavior change. But here [in the United States], you guys like freedom. This is a place where to a certain extent, it's taken to the extremes, where individual freedom trumps the collective good." — W. Gyude Moore, senior policy fellow at the Center for Global Development and former Liberian minister of public works | | | | | | 
Sen. Patrick Leahy speaks during a Senate Judiciary Committee hearing on August 5, 2020. | Carolyn Kaster, Pool/Getty Images | U.S. SPENDING DEAL BOOSTS VACCINE FUNDING, GLOBAL HEALTH — A colossal year-end government funding package , which Trump is now threatening to oppose, includes new money for global health. It also calls for better surveillance of future pandemic threats. Here's a rundown of what's in the measure: — Gavi gets $4 billion: The international vaccine alliance gets the money to buy and deliver vaccines to countries whose health systems are being overwhelmed by the pandemic, said Patrick Leahy (D-Vt.), vice chairman of the Senate Appropriations Committee. That's a big, big boost. The U.S. previously gave Gavi $290 million this year, and it had promised $1.16 billion through 2023. — $1.56 billion maintained for the Global Fund to Fight AIDS, Tuberculosis, and Malaria: Congress kept funding even for 2021, although President Donald Trump had wanted to halve it. That keeps the U.S. contributing 33 percent of the organization's funding versus the 25 percent Trump sought, according to a summary from the House Appropriations Committee. — China's pandemic response: The director of national intelligence must by late March provide a public report assessing whether and how Chinese officials may have sought to suppress information about the virus and its spread. The report should also assess whether Chinese officials sought to spread disinformation to advance national security and control global supply chains of medicines, medical supplies and other equipment. — Look into the crystal ball: The DNI should analyze the threat the pandemic poses to the U.S. over the next 18 months, the capacity of countries to combat it, and the risk to the U.S. if Covid-19 is not contained abroad. The bill also calls for an analysis of likely pandemic threats in the next decade and opportunities for establishing an effective global system for surveillance and response. — Give us a plan: The incoming Biden administration by late March should publish a report on how to mobilize international institutions to combat Covid-19.
| | | | A NEW YEAR, A NEW HUDDLE: Huddle, our daily must-read in congressional offices, will have a new author in 2021! Olivia Beavers will take the reins on Jan. 4, and she has some big plans in store. Don't miss out, subscribe to our Huddle newsletter, the essential guide to all things Capitol Hill. Subscribe today. | | | | | | | | POLITICO: Why social media hasn't been able to shut down vaccine misinformation. The Guardian: Colombia's president said undocumented Venezuelan migrants in the country won't be vaccinated against coronavirus. New York Times: In one of the world's most polluted cities, class affects pollution exposure. Associated Press: Concern among Muslims over halal status of Covid-19 vaccine. Devex : About 80 percent of Africans surveyed in 15 countries said they would take a coronavirus vaccine once it's publicly available.
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