Three Ways the US Can Promote Equity in Ending the COVID-19 Pandemic Globally

On April 15, 2021, the U.S. will join the Global Vaccine Alliance (GAVI) and co-host the launch of the Investment Opportunity for COVAX Advance Market Commitment.

Continued inequity in COVID-19 vaccination means virus mutations occur and newer variants emerge that may be resistant to currently available vaccines. Credit: United Nations.

By Ifeanyi Nsofor
ABUJA, Apr 2 2021 – As richer western nations continue hoarding COVID-19 vaccines to the detriment of poorer nations, there is some light on the horizon. On April 15, 2021, the U.S. will join the Global Vaccine Alliance (GAVI) and co-host the launch of the Investment Opportunity for COVAX Advance Market Commitment.
The aim of the event is to raise more funds to ensure at least 1.8 million doses of COVID-19 vaccines are available to 92 low-income nations. The U.S. recently donated $4 billion to COVAX and this new leadership role is highly commendable.

“The more the virus that causes COVID-19 is out there in the world, the more opportunities it has to evolve—and to develop new ways of fighting our defenses against it. If we don’t get the vaccine out to every corner of the planet, we’ll have to live with the possibility that a much worse strain of the virus will emerge.” 
Bill Gates

However, even if all the commitments are met from the launch, only 20% of people in poorer nations would be vaccinated. Furthermore, it could take until late 2022 for that population to be vaccinated.

Continued inequity in COVID-19 vaccination means virus mutations occur and newer variants emerge that may be resistant to currently available vaccines. Therefore, it is in the interest of every nation (both rich and poor) that everyone everywhere has a fair chance of being vaccinated simultaneously.

Bill Gates alluded to this in his recent Gates Notes: “The more the virus that causes COVID-19 is out there in the world, the more opportunities it has to evolve—and to develop new ways of fighting our defenses against it. If we don’t get the vaccine out to every corner of the planet, we’ll have to live with the possibility that a much worse strain of the virus will emerge.”

Simply put, to end this pandemic, we must vaccinate everyone, everywhere.

As the COVAX investment commitment launch approaches, these are three ways the U.S. especially can ensure more equity in ending the COVID-19 pandemic globally:

First, support the push by the World Trade Organization for temporary COVID-19 vaccine patent waivers so that vaccines can be manufactured locally in Africa and other parts of Asia. Recently, the U.S. Chamber of Commerce opposed calls for the World Trade Organization to back a temporary waiver of intellectual property rights to speed coronavirus vaccine production in poor countries.

If this continues, it could take until late 2023 or even early 2024 to vaccinate all those eligible across Africa. President Joe Biden has to intervene to authorise these waivers so that vaccine production can take place simultaneously in rich and poor countries.

Local production of vaccine in African countries will also lead to reduction in logistics costs and waiting times in transporting the vaccines from the west to African countries. Egypt has concluded preclinical trial and would soon begin clinical trial for a vaccine locally.

Likewise, Johnson and Johnson pharmaceutical has pledged 400 million of their single-dose vaccine to the Africa Vaccine Acquisition Task Team. Most of the supplies would be manufactured locally by Aspen Pharma in South Africa The U.S. should support more local production across African countries to speed up COVID-19 vaccination on the continent.

Second, block capital flight via corruption from poorer nations. Africa loses an estimated $50 billion yearly due to illicit financial flows. This theft amounts to a staggering $800 billion stolen from 1970 to 2008. These funds are stolen via electronic transfers.

Surely, banks and other agencies are aware as the theft is happening. The U.S. can work with banks and national anti-corruption agencies to stop funds being stolen. We do not have to wait for funds to be stolen and then go through all manners of legal and regulatory bottlenecks to repatriate the funds.

For example, no one really knows how much Nigeria’s former military dictator, General Abacha stole from the country. Twenty-three years after his death, funds he stole are still being repatriated back to the country.

The U.S. should also impose sanctions on banks, bank executives, politicians and civil servants who aid these thefts. With $50 billion yearly, Africa will not be dependent on richer western nations to vaccinate her people. Indeed, at $10 per dose, $50 billion will buy 5 billion doses of the Johnson and Johnson Covid-19 vaccine – more than enough to vaccinate all Africans three times over.

Third, ending the pandemic is not just about vaccines. Therapeutics, personal protective equipment and other commodities are essential. Sadly, the U.S. hoarded these at the beginning of the pandemic in 2020. These hoardings must stop.

The African Union’s Africa Medical Supplies Platform (AMSP) chaired by Zimbabwean billionaire, Strive Masiyiwa has succeeded in creating a platform for linking manufacturers with African nations especially for pre-ordering of COVID-19 commodities, including vaccines. The AMSP is an innovative idea to make Africa self-sufficient in COVID-19 response. This should be supported by the U.S.

All lives are created equal. The U.S. government should deepen its global health leadership by ensuring that this COVAX launch is an opportunity to demonstrate the sanctity of lives everywhere. It is the equitable thing to do to end this global pandemic for everyone.

Dr. Ifeanyi McWilliams Nsofor is a graduate of the Liverpool School of Tropical Medicine. He is a Senior New Voices Fellow at the Aspen Institute and a Senior Atlantic Fellow for Health Equity at George Washington University. Ifeanyi is the Director Policy and Advocacy at Nigeria Health Watch.

Pandemic Accentuates Need for Caribbean Countries to Improve Food and Nutrition Security

Jaxine Scott displays some vegetables in her backyard garden at her Kingston, Jamaica home. Credit: Kate Chappell

By Kate Chappell
KINGSTON, Jamaica, Apr 2 2021 – Last year, Jaxine Scott was off work as a caregiver at a primary school as a result of the pandemic. One day, she noticed a green shoot emerging from some garlic in her fridge. She decided to plant it, and to her surprise, it thrived. “I thought ‘It looks like I have a green thumb, let me plant something else,’” Scott says. She now has a backyard garden, including cucumber, pumpkin, melon, callaloo, cantaloupe, pak choy and tomatoes. “It makes me feel good,” she says. “I can help my family members and neighbours. It has saved me money. I’m not going to stop, I’m going to continue,” she says.

Scott, 45, is just one of thousands of Jamaicans who have found an interest in gardening, both as a way to pass the time and to become more self-sufficient when it comes to food and nutrition.

This is a small yet important step for a country and region in which the trees are laden with an abundance of fruits, yet many people go hungry every day.

An October, 2020 study of eight Caribbean countries found that 40% of people surveyed experienced some form of hunger, with 42% of those saying it was moderate to severe. The survey by the College of Health Sciences at the University of Technology included 2,257 households in eight countries across the region (Jamaica, Trinidad and Tobago, Guyana, Belize, Barbados, St. Kitts and Nevis, St. Vincent and the Grenadines and Antigua and Barbuda.) Another recent study from the Caribbean Research and Policy Institute and Unicef also found that in a survey of 500 Jamaican households, 44% reported that they were experiencing food shortages, while 78% said their savings could last them four weeks or less.

Food security is a technical term referring to the availability of nutritious food, and defined by the United Nations as having “physical, social and economic access to sufficient, safe and nutritious food that meets their food preferences and dietary needs for an active and healthy life.” The World Bank reports that despite the pandemic, there is adequate supply, however the challenge lies at the national level. The risks to food security include higher prices and reduced incomes, which forces households to rely on smaller portions of less nutritious foods.

“We suspected people were cutting back on their intake, especially households where the breadwinners were losing their jobs. It has shook up some of the households quite a bit. People are cutting back on the number of meals that they were having,” says Dr. Vanessa White Barrow, the Head for the School of Allied Health and Wellness at the University of Technology’s College of Health Sciences.

The effect of this, of course, has many repercussions, including malnutrition, lack of energy, obesity as a result of consuming lower-cost but unhealthy foods and a variety of health issues like diabetes and hypertension.

“What has happened is that the nutrition divide has widened as a result of COVID,” says Prof. T. Alafia Samuels, of at the Caribbean Health Research Institute at the University of the West Indies.

“We also know that before, because of the extent that many household were dependent on processed food, people have cut back (on healthy foods) and are going for cheaper alternatives, and this has long-term health implications,” she says. This especially impacts children, who need nutritious food to grow and learn adequately. In addition, children are confined to their households, doing online learning and missing physical activity they would have had at school.

Food and nutrition insecurity are just one frightening outcome of the pandemic, which has ravaged one of the most tourism-dependent regions in the world. In Jamaica alone, a minimum of 50,000 people have been laid off from the tourism industry, a number that is likely even higher when taking into account indirect employment. An estimated 135,000 people have lost their jobs in total. The country’s real GDP for fiscal 2020/21 is expected to contract by up to 12%, according to the Bank of Jamaica, and the unemployment for Oct. 2020 was 10.7%. According to the World Bank, the percentage of people living below the poverty line was 19.3% in 2017, and while this figure had been improving, it is unlikely to continue this trajectory.

With this hardship in mind, the government has introduced a series of financial stimulus measures to reach the most vulnerable, but these are not sustainable. In addition to financial measures, the government has also focused on increasing food security, an effort that existed prior to the pandemic, but has since been ramped up.

In terms of boosting food security and assisting the farming industry, Jamaica’s Minister of Agriculture and Fisheries Floyd Green says that the government is investing JMD$1 billion this year.

Decreased market demand, in large part from the hotel and restaurant industry, has harmed the farming industry. So while at times there is an excess of supply, a lack of demand has impacted farmers and their production systems, which in turn erodes food security.

“The challenge with COVID is clearly the downturn in the market, which discourages the farmers from producing,” says Green, adding that they worry their supply will not be absorbed. With this in mind, the government created a “buy-back” program, which found new clients for farmers, which has helped.

“We saw an initial decline in production with COVID when it came in, but we went back into a growth position overall, and now year-over-year seeing growth.”

Ultimately, Green says COVID has forced people to examine their self-sufficiency. “Covid has brought back into sharp focus in the minds of people the need to be more self-sufficient when it comes to feeding ourselves.”

The need for self-sufficiency exists on a large scale as well, especially on an island that imports over US$1billion of goods annually. And while some of that cannot be avoided as it is inefficient or impossible to produce everything needed by Jamaicans, Green says there are some efforts to increase the nation’s self-sufficiency, as well as to ramp up exports, which can help to balance the import bill.

“A part of what we have been doing is to have to take a critical approach to analyzing our import bill, and what can we do what can we grow efficiently to reduce the import bill. We have a twofold approach, we don’t only focus onthe import bill, but export revenues. We have to look to raise export revenues as a small island state that wont be able to produce efficiently,” Green says.

To this end, the government is looking to encourage production of ginger, turmeric, cocoa, coffee, castor oil, and mangoes, which are all in demand because of their superior quality, he says. “ We are looking to further encourage incentive some of our farmers to go into some of these crops. What you will see now over the next three years is a determined push towards export stimulation.”

In terms of local food supply, Green says it is sufficient. The issue, however, is with a lack of purchasing power, especially of late as a result of the economic downturn. “Our challenges is to restart the economy to make sure people can get back purchasing power.”

Green mentions a backyard gardening program in which 2,500 families across the country, with a majority focus on urban areas, received a kit containing all the necessary tools to start a garden and become more self-sufficient.

This is one measure towards achieving food security, says Jamaica Agricultural Society vice-president Denton Alvaranga.

“A lot of persons are at home with a lot of time on their hands, the elderly, middle age, they are at home, children are at home, and most times, having very little to do.

It would be very useful at this time to re-emphasize the backyard gardening program,” he says. “This is very, very useful and timely when you look at it a lot of things produce can be grown locally in our backyard and a lot of people have a lot of space.”

In addition to backyard gardening, Both Samuels and Barrow-White add that government programs to identify and reach the most vulnerable communities and families will help increase food security. Samuels is currently working with Jamaican churches to develop a database to identify these people. “The plan is interventions, and we are proposing actually support them to roll out that kind of intervention that has worked in one church so they can have a systematic way to find out who are the vulnerable what needs to get them to the point. You need some kind of organization, you can’t go out there and look for people one by one,” Dr. Samuels says.


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