Inequity has marred the fight against Covid-19. This must stop

This week, I will be in joining leaders, including Prime Minister Modi and President of the European Commission, Ursula von der Leyen, at the Raisina Dialogues in India to discuss the challenges of our time and how inequity is a root and exacerbating force.

From the ongoing pandemic, to the climate catastrophe, to rising conflict that is transforming geopolitics, humanity is currently locked in a downward spiral that needs intentionality from leaders to break out of. And if we don’t tackle inequity and the danger of greedy nationalism, we’ll be missing the true lesson of the last few years.

The greatest wrong of the pandemic is how inequitable the rollout of health tools has been. In many lower-income countries, a combination of blatant greed in 2021, a runaway pandemic and disinformation that has specifically undermined a number of excellent vaccines led to more than a million preventable deaths. Waves of the virus have taken a huge toll on our heroic health workers and led to backsliding on virtually every other health challenge.

With more than 80 percent of its adult population now vaccinated, the country will be close to meeting the global target set by WHO of fully vaccinating 70 percent the population by the summer. We know that there’ll be future waves of the virus and I’ll be making the argument at the Raisina Dialogues that now is the moment to double down on sharing health tools fairly.

In lower-income countries, where the vast majority of people are still unvaccinated, there’s a real risk of surge at some point in the near future that knocks out health systems and pushes back further efforts to tackle malaria, measles and polio. To prevent this, the push now on COVID-19 should be on vaccinating the vulnerable and wider population to strengthen the wall of immunity, which has allowed rich countries to open up their economies and societies. Using India as a model, strengthening manufacturing in lower-income countries is also key to ensuring a more even distribution of health resources and mitigating the risk of rich countries hoarding supplies.

The most effective time to increase vaccine-based immunity is before an outbreak.. Therefore, the best tactic is that for any dip in COVID-19, huge effort should go into vaccinating and indeed boosting the most vulnerable and raising the general population so as to protect people and health systems from collapse. And it’s unjust that breakthrough treatments – including antivirals like Paxlovid, which was endorsed last week by WHO – are still only available in a handful of countries when we know it could save a lot of lives.

Treatment equity is just as important as vaccine equity and related to this it’s critical that people can test so that if they’re positive they can be put onto treatment early which provides optimal effectiveness.

While some will say, it’s not possible to overcome the barriers to access in low-income countries in Africa, I say that it is being done and it’s actually the only way to protect health systems in the medium- to long-term. Looking forward to President Biden hosting the Second Global Summit on COVID-19 taking place in the US, I hope all countries regardless of income levels commit to enhancing efforts to share vaccines, tests and treatments.

As well as vaccinating more people quickly, especially those that haven’t been vaccinated yet, we must look at the root causes of the challenges we faced in the first place. Manufacturing vaccines and treatments in regional hubs would make a big difference and help get these game-changing health tools to all countries quickly. It’s positive to see WHO’s mRNA hub in South Africa producing its own mRNA vaccine prototype for COVID-19 but we can’t settle for this.

Furthermore, with pharmaceutical groups unwilling to share technology or know-how in the worst pandemic in more than a century, it’s clear that new rules are needed to ensure that profit is not prioritized over short-term profit. Hope and fine words are not a strategy that delivers for people. It is critical that the World Trade Organization’s discussions on waiving intellectual property rules progress quickly and the outcome is substantive and actually improves access to COVID-19 tools.

The crisis in sharing health tools that led to millions of preventable dying is also an important background for any new Pandemic Accord so that next time we understand the likelihood for nationalistic greed and set in place systems to ensure that life-saving health tools are shared fairly and effectively.

If a fourth dose is good enough for people in rich countries, then it shouldn’t even be a debate about vaccinating people in low-income countries with their primary doses.

The pandemic is not over and our future response must be based on the principle that a life in New Delhi has equal worth to a life in New York.

We must reject the politics of convenience and embrace the politics of hard work – multilateralism is in peril as are the millions of lives that depend upon global solidarity.

Those that disagree are part of the problem.

I look forward to uniting with leaders in New Delhi, to tackle the multidimensional crisis of conflict, climate crisis and COVID3, which is driving spiking food prices and inflation and threatening overall national security. The world faces its greatest challenge since the founding of the UN after the Second World War. Historic challenges need historic leadership and time is not on our side.

The writer is co-chair of Access to COVID-19 Tools (ACT)-Accelerator