Global Health Matters – Live Event Series

Global inequity in COVID-19 vaccination 

Co hosted with Access to Medicines Ireland, SafetyNet Primary Care, Oxfam Ireland and Concern Worldwide

• Date:  Friday -March 19th, 2021
• Time: 1-2 pm Irish Time
• Watch the full recording HERE

The fundamentals of Covid-19 vaccine access and supply globally – and reaching the most vulnerable, will be the focus of this webinar. In recent weeks, the debate has been shifting along ideological lines from one of equity to one of charity, in terms of rich countries “donating” vaccines to poorer countries.  Ongoing outbreaks of new variants of COVID-19 worldwide mean greater risk to all countries irrespective of the success of vaccine rollout programmes for individual countries. The need to address artificial vaccine scarcity is crucial in light of the hoarding by rich countries in some cases of two to five times the volumes needed for national programmes.

It is time to show global solidarity and accelerate vaccine development to increase supplies for all countries. It is crucial that rich nations support initiatives such as the World Trade Organization waiver and the World Health Organization Covid-19 Technology Access Pool to correct the imbalance of supply between the rich and poor. But it is equally important that outcomes in which vaccines are shared or donated are tied to fair pricing and accountability measures, and do not have damaging conditionalities attached.

Topics for Discussion:

In this webinar, we discussed the vaccine landscape worldwide for the most vulnerable: What does the future hold? Who will lead on the equitable roll out of vaccines worldwide? What must be done to avoid the mistakes of the past? What provisions are in place to ensure we do not leave the marginalised behind?

Moderators

• Nadine Ferris France, Executive Director, Irish Global Health Network
• Nor Nasib, Finance Officer, Irish Global Health Network

A Summary of Points Made

Dr Aisling McMahon is an Assistant Professor of Law at Maynooth University where she specialises in medical and intellectual property law. Her work is particularly interested in the role of patents within the health context, including the impacts patents can have on access to, and delivery of healthcare. Aisling has published widely within the leading international peer reviewed medical and intellectual property journals, including in the: Journal of Medical Ethics, Medical Law Review, Cambridge Quarterly of Healthcare Ethics,  and the Intellectual Property Quarterly. She is a member of Access to Medicines Ireland. 

View her contribution here

• There is a vast divide between high and low/middle income countries emerging in relation to access to COVID-19 vaccines. Due to the vast inequalities arising, we are as, WHO Director-General Dr Tedros Adhanom Ghebreyesus put it, on the ‘brink of a catastrophic moral failure’ – urgent action is needed. It is also in all our interests for everyone to have access to vaccines, as none is safe until everyone is safe.
• Currently, much of the issues around global equitable access to vaccines are caused by an ‘artificial scarcity’ in the production of vaccines. This could be alleviated by companies sharing intellectual property rights, data, and know-how around COVID-19 vaccines which would help to increase supplies everywhere.
• Two key global initiatives are being proposed to address this artificial scarcity and thus achieve global equitable access:
  • COVID-19 Technology Access Pool (CTAP) is a mechanism for the sharing of IP, data and know-how which if sufficiently supported would enable greater production of COVID-19 vaccines, diagnostics and medicines, but to date approx. 40 countries world-wide have supported it. Many including Ireland have not formally endorsed it, and this must change urgently. It is also vital companies are encouraged to share such rights and know-how in the spirit of solidarity to tackle this pandemic which is in all our interests.
  • The WTO Waiver is a proposal first put forward by South Africa and India to temporarily suspend IP rights on technologies for the prevention, containment and treatment of COVID-19. However, it has been opposed by many higher income countries/regions. It is also vital this is reconsidered to tackle the pandemic.
• Access to Medicines Ireland (AMI), has been actively working on these issues, in February 2021, AMI were invited to speak on these issues before the Oireachtas Foreign Affairs Committee in February 2021, where  the urgent need for action was highlighted. The Committee published an important report on this in March where it recommended that:
  • the Irish government formally endorse the C-TAP;
  • the Irish government advocate for C-TAP and other mechanisms to address global access to vaccines at an international level, particularly at the EU and at the UN Security Council;
  • government assistance in encouraging more pharmaceutical companies to join the C-TAP; and
  • Ireland increases financial support for the World Health Organisation’s ACT Accelerator.
• Given the threat the pandemic posed, and the inequalities which are evident it is vital that the government would adopt these recommendations as soon as possible.

Peter Kamalingin B.L – Pan Africa Program Director, Oxfam International. He is a Ugandan with 20 years’ experience in social justice struggles, development Policy analysis, humanitarian planning & Conflict management. A practicing farmer in eastern Uganda, he also promotes pan African narratives and perspective to development many of which he has represented in various regional and international fora. Peter holds an MA in International Relations (UoN, Nairobi), MA Peace & Conflict Studies (EPU, Austria), BA Political Science & Public Administration (MUK, Kampala). His favourite pastime is keeping bees, tending to nature and building people relations.

View his contribution here

• The role of countries like Ireland is to offer support to Africa’s call for debt suspension and issuance of a special drawing rights (SDRs) from IMF and Africa’s efforts to strengthen Domestic Resource Mobilisation (DRM) by curbing Illicit Financial Flows. It is also important that these countries “call out the selfish EU acts of instituting vaccine export controls at a time we need stronger global solidarity”
• While charitable vaccine doses received through COVAX are welcome and useful, it is important to note that they are not enough to address the huge needs for vaccination within the time we have to bring the disease under control. 
• It is only sharing of recipes, and the science/technology of vaccines production and suspension of patents that will enable scale up on production of vaccines to meet the huge needs in a time and before the virus mutates into new variants and becomes resistant to existing vaccines.
• G-7 leaders are urged to show their commitment to protect human rights not by charity, but by supporting South Africa and Indian proposal on temporary waiver of TRIPS  and suspension of patents. African leaders are urged to learn from the Covid-19 crisis and work together to find ways to build Africa’s capacity to meet its current and future public health needs, by avoiding unsustainable overreliance on externalised capacity and by investing in Research and Technology. Finally, Big Pharma leaders are urged to put humanity before their own profit. 

Dr Fiona O’Reilly – is CEO of Safetynet Primary Care. Fiona has devoted her career over the past 3 decades to working in the health care area, both nationally and internationally – with a focus on and passion for achieving health equity for all and bringing humanitarianism home. She has led the organisation to adapt and change to respond to the Covid-19 crisis to protect the health of marginalised groups and particularly those living in congregated settings. ​Fiona is also a founding director of the Emergency Nutrition Network (www.ennonline.net).   

View her contribution here

• Safetynet’s Covid response focussed on reduction of spread in high risk congregated settings and promoting continued access to health care for vulnerable groups.
• Health inequity was seen in Ireland with those forced to live and work in poor environs and congregated settings at higher risk of contracting the virus. Marginalised groups, such as Roma and Traveller families, had increased rates of Covid-19. Marginality and social determinants of health were drivers of spread.
• Equitable vaccination roll out in Ireland will need to ensure strategies are appropriate and acceptable to the target groups. This can be ensured by early involvement of influencers from those communities in designing tailored approaches.
• Roll out should prioritise those in high risk settings including those forced to live in congregated settings including homeless hostels, Direct Provision centres & halting sites.
• Vaccination monitoring should include ethnic identifiers so that coverage and uptake can be determined and inequity identified

Breda Gahan – is a Registered General Nurse (RGN) and Midwife (RM) in Ireland, with a Master’s in Public Health (MPH) from Liverpool School of Tropical Medicine and 30+ years field experience in Health and HIV work in various countries with Concern including Iraq (pre-Concern 2 yrs), Sudan (2 yrs), Cambodia (3 yrs) and Mozambique (3 yrs). Breda began working in HIV and AIDS as a nurse in St James’s Hospital in Dublin in the late 1980’s. She is currently Senior Health and HIV Adviser at Concern Worldwide leading on maternal, child health, and health systems support with Concern field teams.

View her contribution here

• Maximise vaccine production capacity through emergency measures i.e. waving of IPRs temporarily and donor support to COVAX and WHO CTAP.
• Access to COVID-19 vaccines should be globally allocated by need and in-country priorities agreed with Ministries of Health. 
• Governments and citizens must work together to prevent and to reject policies of prioritisation over and above front line workers and those most at risk.
• Do not leave those most at risk and vulnerable among the extreme poor behind in access to COVID-19 vaccine.
• Strengthen health systems with the delivery of COVID-19 vaccines within the national Expanded Programme of Immunization (EPI) in LDCs.

Resources

• WHO Monitoring COVID-19 Vaccination – Interim Guidance
• Open Letter to Taoiseach for urgent support of Covid-19 emergency waiver
• Dr Aisling McMahon – Global equitable access to vaccines, medicines and diagnostics for COVID-19: The role of patents as private governance
• Joint Committee on Foreign Affairs and Defence – Report on the Distribution of COVID-19 Vaccines to Developing Countries
• Majority of people in Ireland think monopoly control of Covid-19 vaccines should end to speed up supply
• HSE VACCINE APPROACH FOR VULNERABLE GROUPS in Ireland
• Concern’s ‘February 2021 – Vaccinating the most vulnerable everywhere is not a choice but a necessity’
• The Alliance2015 (Concern is a member) COVID-19 Multi—Country Research findings PDF report
• Safetynet Primary Care
• Access to Medicines Ireland
• Oxfam Ireland
• Concern Worldwide
• “Sign this European citizens’ initiative, and ensure that the European Commission does everything in its power to make anti-pandemic vaccines and treatments a global public good, freely accessible to everyone”: Sign here 
• “Tell world leaders that we cannot put a price on global immunity. The vaccine must be available to everyone, in every country, free of charge.” Sign the Oxfam Petition Here