PORTLAND, Oregon — Several studies have reported that low-income populations face the greatest economic and health risks that stem from the COVID-19 pandemic. Now, the disparities of the pandemic are playing out in international vaccine distribution. As new, life-saving drugs have come on the market, wealthy nations have bought up the limited available doses. This has left low-income nations, including Kenya, increasingly vulnerable to the virus. With limited finances and a muted voice on the world stage, Kenya may have to wait years before vaccinating even a portion of its population. But, there are non-governmental organizations (NGOs), including Gavi, the Vaccine Alliance and Jhpiego, that are working to vaccinate Kenya and the rest of the world’s low-income populations.
The COVID-19 Pandemic in Kenya
In the early days of the COVID-19 pandemic, it was widely believed that countries in Africa would be devastated by the virus. Health officials worried that the virus would rapidly spread in densely populated urban areas like Nairobi, Kenya. Furthermore, the world predicted that Africa’s undeveloped healthcare systems would not handle the surge of patients.
Africa experienced high rates of infection, but the death toll in many African countries remained low. For instance, researchers estimated that in Nairobi, 34-41% of the urban population have been infected with the virus. However, by the start of 2021, Kenya had only attributed around 1,700 deaths to the virus.
In recent months, Kenya’s infection and mortality rates have risen toward a new peak. On March 24, 2021, Kenya reported 1,540 new cases and 18 new deaths. This uptick has been attributed to the highly contagious South African variant of the virus, which has started spreading across the African continent and around the globe. As this recent spike threatens Kenya, there is little hope of quickly vaccinating the country.
As pharmaceutical companies began hinting at the arrival of new COVID-19 vaccines in 2020, global health authorities voiced their concerns that wealthy nations might refuse to share their life-saving drugs with the rest of the world. These fears regarding “vaccine nationalism” led to the creation of COVAX, a global vaccine exchange committed to equitable distribution, in June 2020.
Gavi, the Vaccine Alliance co-leads COVAX. The Bill and Melinda Gates Foundation started Gavi as a public-private partnership in 2000. It is devoted to vaccinating impoverished communities. In short, COVAX operates as an international marketplace through which all member nations receive their vaccine doses. COVAX has access to a vaccine stock supplied by manufacturers from which wealthy nations purchase their doses. Funds from those purchases are in turn used to supply impoverished countries with their own vaccine doses.
COVAX plans to supply lower-income nations with free vaccines for 20% of their populations. Kenya is one such country. The more countries align themselves with COVAX, the more power COVAX has to negotiate prices and purchase the necessary doses to vaccinate Kenya and the rest of the world.
However, as COVID-19 vaccines have come on the market, many wealthier nations have circumvented COVAX and bought their doses directly from the vaccine manufacturers. This has led to a situation where, on January 14, 2021, only 10 countries, including the United States, the United Kingdom and Israel, possessed more than 95% of the world’s vaccine doses. On the other hand, the entire continent of Africa received only 2% of doses.
Bilateral deals between wealthy nations and manufacturers not only reduce the global supply of vaccines but also drive up the prices as nations bid for dwindling doses, thereby excluding low-income countries like Kenya. Additionally, without the widespread backing of member nations, COVAX loses its ability to negotiate the equitable pricing and distribution of vaccines.
The Push to Vaccinate Kenya
Despite the difficulties posed by vaccine nationalism, Gavi and other NGOs are still working to vaccinate Kenya and other lower-income nations. On March 2, Kenya received more than one million doses of the AstraZeneca-Oxford vaccine through COVAX as a result of agreements made between Gavi and vaccine manufacturers. This initial shipment comprised only one-third of the more than three million doses that COVAX has promised to Kenya. It is a disparity that illustrates the struggles organizations face in vaccinating impoverished nations without widespread international support.
Another organization assisting in the effort to vaccinate Kenya is Jhpiego. Jhpiego was started at Johns Hopkins University in 1973 to provide medical equipment and expertise to low-income countries across the globe. While Jhpiego has traditionally worked with healthcare concerns such as HIV/AIDS, maternal health and cancer, it has recently committed itself to combat the COVID-19 pandemic. In Kenya, Jhpiego is working alongside Gavi to provide logistical support to Kenyan health officials in their efforts to effectively and efficiently distribute the vaccine throughout the country.
A Call for Equitable Access
On the world stage, NGOs are advocating for a more equitable distribution of vaccines. On March 5, 2021, the World Federation of Public Health Associations published a letter calling for an international vaccination scheme that prioritizes the health and safety of the world’s most vulnerable populations. Several international NGOs signed the letter, but it is clear that wealthy governments must become involved for an equitable distribution of vaccines is to become a reality.
Hopefully, world leaders will heed the message of these NGOs and push to vaccinate Kenya along with the rest of the world’s lower-income countries. By investing in the health of their lower-income neighbors, wealthy countries would not only affirm the humanity of impoverished people but also save themselves from future difficulties. As the letter warns, the persistence of the pandemic among impoverished communities will have repercussions for both the health and wealth of high-income countries as well.
– Joseph Cavanagh