Drawing from the 2030 Agenda for Sustainable Development (AfSD) vision to 'leave no one behind', particularly low-income countries, a research report on COVID-19 vaccines and treatments, contends that more big pharmaceutical companies need to buy into the COVAX initiative.
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a global initiative aimed at equitable access to COVID-19 vaccines led by the Global Alliance for Vaccines and Immunization, the World Health Oganization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and others.
The research: "COVID-19 vaccines and treatments nationalism: Challenges for low-income countries and the attainment of the SDGs" authored by Prof Godwell Nhamo, Dr David Chikodzi, Hlengiwe Precious Kunene and Nthivhiseni Mashula, says from the procurement and distribution of COVID-19 personal protective equipment (PPE) and ventilators to the outlook of possible vaccines and treatments, low-income countries and territories have been left behind.
"It is necessary to highlight that methods of administering and storing the vaccine may need refrigeration. Hence, vaccines may take even longer to reach the most remote parts in developing countries. There may also be a risk of contamination due to poor storage. To this end, the ideal vaccine candidate for the global south could be one that does not need special refrigeration and is administered as droplets in the mouth" the research report said.
In the research, the lead author, Prof Nhamo, chief researcher and Exxaro chair in business and climate change, University of South Africa (UNISA), asserts that the growing COVID-19 vaccines and treatments regionalism and nationalism favour the SDGs set-up, which in his research, highlights as having been agreed on because it presented a leeway for protecting national interests and manipulation from stronger nations.
In his virtual Nelson Mandela Annual Lecture address on July 18, 2020, the United Nations secretary-general, António Guterres, gave a sobering assessment regarding the state of nationalism, regionalism and the United Nations in the era of COVID-19. In his speech, Guterres highlighted that Nelson Mandela spent 27 years 'fighting the inequality that has reached crisis proportions around the world in recent decades – and that poses a growing threat to our future', yet 'COVID-19 is shining a spotlight on this injustice.'
"To this end, layers of inequality in the global economy that required urgent attention before they destroy societies were put under the 'COVID-19 X-ray'. Nothing could be hidden. COVID-19 re-ignited fault lines in global solidarity and laid in the open past centuries of inadequate health systems, huge gaps in social protection, as well as systematic and structural inequalities," Guterres said.
He stated that "As such, many regions and countries that had registered significant progress in eradicating extreme poverty under the Millennium Development Goals era were taken back many, many years in just a few months and rebuilding will not be easy".
Guterres further said, "Given that the least developed and vulnerable economies will be most affected, and in the context of the Black Lives Matter global movement following George Floyd's brutal murder at the hands of police in the USA, one can safely indicate that the lives in developing countries matter under COVID-19 views the black lives matter movement as an additional genuine sign that people are tired and have had enough of oppression and inequality, including Africa's under-representation in international institutions such as the Bretton Woods and the United Nations Security Council".
While acknowledging the fact that the world was facing the deepest recession since World War II, and the widest collapse in incomes since 1870, he estimated that more than 100 million people were likely to be pushed into extreme poverty. This kind of insight, the UN chief said, remains relevant to contextualise the ills of COVID-19 nationalism and regionalism, as the majority of the poor will not be from the rich nations.
From Guterres' perspective, researchers suggest that COVID-19 exposed many falsehoods everywhere, including: 'The lie that free markets can deliver healthcare for all; The fiction that unpaid care work is not work; The delusion that we live in a post-racist world; The myth that we are all in the same boat. …"
Guterres further points out in his lecture that 'The 26 richest people in the world hold as much wealth as half the global population'. The United Nations Chief mentions 'inequality' (SDG 10) thirty-four times in his speech. He goes further, reminding the world that the vision and promise of the United Nations is, among others, basic needs and human rights matters, healthcare (SDG 3), food (SDG 2), water and sanitation (SDG 6), education (SDG 8) and decent work (SDG 8) should not be commodities for sale to those who can afford such or, in our view as authors, go to the highest bidder.
Guterres presented what he thought would be an amicable way of resolving the inequality impulse in addressing COVID-19 between the developed global north, and the battling and underdeveloped global south. He proposed a 'New social contract and a new global deal that create equal opportunities for all, and respect the rights and freedoms of all'
Prof Nhamo states that from the UN chief's view, this will be the only way for the world to attain the targets under SDG 3 and many other targets from the 2030 AfSD.
"The global political system was put under the spotlight for its failure to deliver critical public goods like public health. Hence, COVID-19 'brought home the tragic disconnect between self-interest and the common interest; and the huge gaps in governance structures and ethical frameworks' between and among nations," Prof Nhamo said.
The research points out that in 2014, the cost of attaining the SDGs (before COVID-19) was estimated by the United Nations Conference on Trade and Development to range between $3.3 and $4.5 trillion annually for developing countries. This left a funding gap of approximately $2.5 trillion. Therefore, low-income nations are likely to suffer the most from COVID-19 as such resources are not readily available.
Access to health care remains a critical pillar in dealing with the COVID-19 pandemic and already, low-income countries have suffered from a secondary shortage of already approved drugs for malaria such as hydroxychloroquine and chloroquine that were, at one point, thought to be effective in treating COVID-19.
The World Health Organisation (WHO) estimated that up to 769,000 people in sub-Saharan Africa (SSA) could succumb to malaria as a result of the shortage, thus, double the number estimated under normal supplies of the drugs.
After COVID-19 was declared a pandemic in 2020, researches around the world kicked into action to try and get either a cure or vaccine as soon as practical. However, it was suggested that COVID-19 treatment would likely be available globally by late 2021. With this rush, the WHO director-general proposed and coordinated the four COVID-19 treatment strategy that witnessed treatment trials to determine which treatment would be effective among, one, the novel drug remdesivir that was developed by Gilead in response to Ebola, two, lopinavir and ritonavir, some antiretroviral drugs used against HIV/AIDS, three lopinavir and ritonavir, in combination with the immune system regulator, interferon β, and four, the antimalarial drug chloroquine.
Combinations of different therapies were also put on the table and these included: lopinavir and ritonavir, lopinavir and arbidol, as well as ribavirin and interferon. The use of anti-inflammatory drugs such as glucocorticoids, 1L-6antagonist, Janus kinase inhibitors, and chloroquine/hydroxychloroquine were also thrown into the hat.
As of July 15, 2020, a total of 24 COVID-19 candidate vaccines were undergoing clinical evaluation and were at different phases of clinical trials, while 140 candidate vaccines were in pre-clinical evaluation.
Of the active clinical vaccine candidates, 12 (52%) were led by public entities such as research institutes and academic institutions with the remaining 11 (48%) being led and developed by private or industry developers. Along with a suite of institutions, the researches argue that vaccination platforms such as mRNA have been utilised to treat past coronavirus pandemics.
The mRNA, is said to instruct human cells to build a wall of protein to trigger an immune response to COVID-19. Some biotech companies such as Inovio pharmaceuticals have reportedly. In the research conclusion, Prof Nhamo and co-authors, further state that "Should the preaching on true corporate citizenship be heard, the world waits to be proven wrong through reduced and not-for-profit cost manufacturing and equitable global distribution of the COVID-19 vaccines and treatments. Ultimately, the world will be shooting itself in the foot should the interests of capitalists and nationalists prevail."
Prof Nhamo further states that "This is not the time to decide who gets the COVID-19 vaccines and treatments bids first, and who pleases their shareholders the most. It is human lives at stake. More noise and action on the promotion of universal access to all upcoming COVID-19 vaccines and treatments must be heard, and those that oppose such should be held accountable."
"The right to health is slowly, but surely disappearing. What pain and loss of innocent lives, yet these also matter! The conclusion of the whole matter is that no one is safe from the risk of COVID-19 until every global citizen is covered."
With the risk of COVID-19 infections still a major threat globally, drastic non-pharmaceutical strategies to deal with the pandemic like flattening the curve included hard lockdowns, staying at home, working-from-home, isolations and quarantines, have, according to the researchers, added to the great depression.
This, they said, is likely to collapse many health care systems that were already stressed in developing countries, derailing plans to attain universal health by 2030.
The full research finding can be read on www.tandfonline.com/doi/full/10.1080/17441692.2020.1860249
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