Should health planners in low-income countries prioritise Covid vaccination? Has anyone asked them? We need to support low-income countries to tackle local health priorities if we want to give global vaccination coverage a fighting chance. This requires a significant shift in our attitude to development assistance. Otherwise, we’ll be living with a Covid Groundhog Day every year.
The UK is once again slogging it out with another Covid variant. The latest, Omicron, probably originated from an only partially vaccinated country. The scenario had been foreseen by virologists since the pandemic began.
We need to act to prevent an annual cycle of pain. Only when the world is vaccinated, can we be safe from Covid mutations. Otherwise, our aging population can expect to be trapped in a Groundhog Day loop taking its toll on our leisure and service-based economy as well as our NHS.
We are responding, albeit slowly. We have a political consensus stretching from Matt Hancock to Jeremy Corbyn that supports UK spending on vaccines internationally. It’s why – in a context of eye-watering cuts to the UK aid budget – millions of vaccines have been bought and shipped by the UK government. Presumably our diplomats are also lobbying governments in low-income countries to make these costly and logistically complex projects a priority in their health plans.
But, we are missing something here. Is this what low-income countries want? Would younger African electorates want their governments to redirect time, money and people to vaccinate against Covid?
In many low-income countries, health budgets are less than £20 per person a year. The NHS pays about the same for a Pfizer booster dose here in the UK. Somalia’s government health expenditure is just £3 a person. Comparable to the cost of a single AstraZeneca shot.
Make no mistake, Covid is killing people in low-income countries. The death toll is also likely to be under-recorded. But consider that the average age in Uganda is 16.7 years old. Vulnerability to Covid is simply lower.
Low-income countries already shoulder huge health burdens. In ways we don’t see in day-to-day life in the UK. Malnutrition, HIV, malaria, diarrheal diseases and “classic” respiratory infections are much bigger killers than Covid. Tragically, these relatively cheap to manage health issues take their biggest toll on children. But the scale of these challenges has long been far greater than the resources available.
Compared to existing health challenges, Covid’s impacts are more likely to be indirect – the crushing toll on economic recession and the risk of diverting effort from existing health challenges.
Covid vaccination programmes in many African countries have been slow to start. Whilst there are notable successes in the region, covid vaccination rates are broadly low. In Nigeria, only 4.5% have had a single shot.
If we want to achieve the goal of vaccinating the world, we need to wake up to the political and public health reality of Covid in low-income countries.
Stretched health workers weren’t getting the support they needed before this pandemic. Now, the UK and others are asking for more time and work from low-income health workers to prevent Covid variants whose impact is felt most severely in middle and high-income countries.
To get out of our economic woes, we therefore need to be prepared to make radical and never before imagined investments in general health infrastructure in low-income countries.
We need to support vaccination programmes against Covid. We need to make it easier by working to liberate patents rather than insisting on protecting pharmaceutical companies’ rights to take yet more profit from vaccination.
But we cannot ask citizens in low-income countries to prioritise vaccination to protect our leisure-based economy and aging population without addressing their needs first. To do so we need to radically change the direction of overseas development assistance – boosting aid, not slashing it.
We need to be prepared to foot the bill, not just for Covid vaccines but for health and allied investments that low-income countries needed before Covid came along.
So if rich countries like the UK want to get out of Groundhog Day, we don’t just need to restore our previous commitments. We need a revolutionary shift in our attitude to overseas aid.
