Question of Priority: The G20’s vaccine imperative

Dear Prime Minister Draghi, we congratulate you on your preparations for the G20 summit on October 30. We wish to bring to your attention the issue of the inequitable COVID-19 vaccine distribution plaguing our planet, and to ask you to consider the G20 meeting as an opportunity to address this inequitable distribution. Over six billion doses have been administered worldwide, but 70% of these doses were administered by only a few of the world’s 194 countries, and only 2% of people in low-income countries have received a vaccine dose. Vaccines can play a major role in ending the pandemic, but only if they are available to all, and only if we collaborate with one another as no one is safe until we are all safe. 

We believe that vaccine inequality can be ended, and that high-level action by the G20 will help immensely to do that. Now and every month until the end of the year, the richest nations, because of over-ordering, will be sitting on a vaccine stockpile of unused doses that are surplus to their requirements. Meanwhile, only 5% of Africa is fully vaccinated. Similar problems exist in large parts of Asia and Latin America. In order to reach the 70% vaccination target the world has set – the vaccination levels of high-income countries – five billion more vaccines are needed including 1.6 billion additional vaccines in Africa. Achieving this goal is within the world’s reach, should high-income countries decide to share their surplus doses immediately. 

A detailed plan can be agreed by the G20 to redistribute available vaccines and switch delivery contracts to the COVID-19 Vaccine Global Access (COVAX) facility, the international bulk-purchasing agency aimed at ensuring equitable access to vaccines globally. We urge you to press this idea on your G20 colleagues when finance and health ministers meet in Rome on October 29 and when leaders meet on October 30. 

We believe that the plan we outline below, which builds on the global vaccines summit convened by US President Joe Biden in September, can bring immediate relief to the poorest countries. First, our evidence shows that four polities – the United States, the European Union, the United Kingdom, and Canada – will be stocking by the end of this month 240 million unused vaccines. With a concrete plan agreed by the G7 countries and endorsed by the G20, and with the help of the militaries in these countries, these could be airlifted immediately to the countries most in need. Let us stress that these are unused vaccines, after we take account of the deployment of boosters in high-income countries and the vaccination of 12-15-year-olds, and they come on top of the donations that have already been agreed. Second, another 212 million vaccines can be transferred by the end of November. Third, a further airlift can be agreed for December of 150 million vaccines, with 280 million more in January and 245 million in February – adding up to a transfer of vaccines and delivery contracts for vaccines totalling 1.1 billion in the next four months. 

These doses would help low-income countries in Africa and elsewhere achieve the currently unattainable World Health Organization vaccination targets of 40% by the end of the year or very soon thereafter. Fourth, the World Bank should make available additional finance immediately to build the capacity needed to administer vaccines quickly and effectively in not only the urban but also the rural areas of low-income countries. 

We believe that if all this is agreed, the world can meet what the WHO has said is a spring date in 2022 for 70% of all adults to be vaccinated. We call your attention to the results if vaccines are not distributed to the countries in need at the rate we have proposed. Without urgent reallocation, 100 million vaccine doses will have passed their use-by date at the end of this year. If we do not act quickly, the figure could exceed 200 million by the end of January 2022. 

It would be unethical for all these vaccines to be wasted when globally, there are 10,000 COVID-19 deaths every day, many of which could have been averted. The information from a UK survey is that for the deployment of less than 100 million vaccines, 120,000 lives have already been saved, illustrating the benefits of a mass vaccination campaign in countries where a fourth wave of COVID-19 is happening and escalating numbers of lives are in danger of being lost. 

We are in touch with the African Centre for Disease Control and Prevention to assess their needs and the shortfall in vaccine supply. They say that they are still recovering from a long and hard third wave that claimed the lives of 80,000 people since the start of August. Unfortunately, the rate at which lives are being lost is increasing, not decreasing. With each new wave being worse than the previous wave, many experts fear that things will worsen when the impending fourth wave arrives - unless vaccines are swiftly provided. 

Vaccine inequity constitutes a threat to us all. Just as one cannot put out half a fire and be safe from the fire, so are we all not safe until everyone is safe. Without rapidly scaled up vaccination, fast-moving variants will continue to arise in unvaccinated regions which are bound to spread to the fully vaccinated elsewhere and undermine the vaccination progress made to date. As you know, the probability of death increases with increasing poverty. It is estimated that the failure to deliver vaccines to low-income countries will cost the world $5.3 trillion. Low-income countries will bear the brunt of these costs as they cannot begin to recover from the pandemic without far greater access to vaccines. As the G20 convenes in Rome, we hope that the assembled leaders will agree that the poorest and the most vulnerable can finally have access to the miracle of life-saving vaccines.