Will part of humanity be deprived of a vaccine against a disease that affects the whole planet?
This is the fear of many NGOs and leaders about Covid-19, while millions of doses could arrive at the end of December in Europe or the United States.
Underdeveloped countries, sometimes just as affected by the pandemic, risk being worse off and counting on international solidarity.
“A lot of time has been lost but a lot of things are still being played out now.
We are clearly at a decisive moment, ”said Julia Heres Garcia, global health and gender advocacy officer at Oxfam France.
Millions of pre-orders for rich countries
For now, unsurprisingly, the countries that are taking the biggest slice of the pie are the great powers.
Canada has already pre-ordered nearly 360 million doses from seven manufacturers, or more than 9 per capita.
Australia, the United Kingdom (more than 5 doses per capita each), the European Union (3.6) and the United States (3.1) follow, according to data from the Global Health Innovation Center.
Of course, not all products will hit the market at the same time and will not necessarily all be authorized by the drug agencies, but this gives an indication of their market power.
Covax device
"There was a race for the vaccine which led to a very rapid seizure of more than half of the initial production capacities by the rich countries", squeaks Julia Heres Garcia.
“As always, there is a principle of reality that is essential.
Vaccines go first to rich countries for financial reasons and for the ability to distribute them, ”notes economist Frédéric Bizard, professor at ESCP and president of the Institute of Health.
For the future product of Pfizer / BioNTech alone, rich countries have already reserved 85% of the number of doses produced next year, according to calculations by the Center for Global Development.
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Some less developed countries have tried to enter into agreements directly with certain laboratories to order at lower prices, but generally without much success.
Another mechanism has been put in place at the international level.
The Covax program is led by the Alliance Gavi platform, the Coalition for Innovations in Epidemic Preparedness (CEPI) and the World Health Organization (WHO).
It brings together nearly 200 countries: half of them finance the purchase of vaccines, the other half, poorer, benefit from it.
The goal is for two billion doses to be distributed equitably by the end of 2021, meaning that at least 20% of the population in the least developed countries can be vaccinated.
The European Union announced on November 12 that it would participate to the tune of 500 million euros, or 100 more than initially planned.
In total, "Covax has raised 4 billion euros, but we are very far from having financed the foreseeable needs of developing countries", underlines Frédéric Bizard.
Donations, "not a long-term solution"
To complete this, we can also imagine that a country decides to redistribute part of its own doses to less developed countries.
But it is difficult to think that this can be done in the very short term, especially if the quantities supplied are limited at first.
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"Nothing is recorded on the number and the conditions, but we reserve the right, in the end, to give doses to developing countries", slips us a European source.
A track that does not necessarily arouse the enthusiasm of NGOs.
“We are of course not going to oppose donations, but we do not consider that this is a long-term solution.
We must also give the possibility of producing vaccines on a larger scale, ”Judge Julia Heres Garcia.
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The production, precisely, stumbles on questions of patents.
New meetings are scheduled at the World Trade Organization (WTO) on December 10 and 17 in order to "remove obstacles to the sharing of intellectual property," said the official.
Several NGOs believe that the current system allows the behemoths of the pharmaceutical industry to control the quantities produced by “blocking” their rivals and thus being able to increase prices.
China on the lookout in Africa
Finally, if purchasing vaccines is one thing, distributing them to people in poor countries is another.
And it promises to be just as complicated, in terms of regions where the health system is often failing.
"We will not back down from any effort to ensure affordable and equitable access (to vaccines, tests and treatments, editor's note) for all", guaranteed the G20 countries in their final declaration last Sunday.
But in the process, German Chancellor Angela Merkel said she was "worried that nothing has been done yet" in concrete terms on this plan.
"What is not organized is the whole distribution part and the question of timing," regrets MEP Pascal Canfin (ReNew Europe).
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The former elected environmentalist fears that other powers will take advantage of these delays to advance their pawns on the international scene.
“Beyond the public health and humanitarian issue, there is also vaccine diplomacy.
If we do not get ready to say to these poorer countries:
this is how we organize ourselves, in a very concrete way, to allow you to access the vaccine
, we leave room for others and especially China and to Russia who do not necessarily share the same interests or the same values, ”he fears.
"The Chinese and the Russians are going to sell them doses at an advantageous price and use vaccines as a tool of diplomatic soft power, with other counterparts in exchange", adds Frédéric Bizard.
Chinese President Xi Jinping also announced on June 17: “African countries will be among the first beneficiaries of a vaccine made in China.
"
