--:-- [Theme music fades out]
--:-- Sean Rameswaram: Support for Today Explained comes from the FIFA World Cup, of all things. The FIFA World Cup 26 is coming to North America next summer. It is the ultimate celebration of sports and culture. You can get closer to the beautiful game with a hospitality package, closer to the action, the best seats, the best suites, closer to match day and that world-class food and that world-class entertainment, closer to the experience of a lifetime. Book a hospitality package at fifaworldcup.com slash hospitality. Terms and more at AppleCard.com.
--:-- Sean Rameswaram: But now we can look at some real numbers. And Julia Belouz has been doing just that for Vox. How's it looking, Belouz?
--:-- Julia Belouz: The short answer is not so great. So we're kind of entering this world of the vaccine haves and have-nots. In rich countries, 150 million COVID-19 vaccine doses have gone out. And in poor countries, it's around 150,000. So less than 1% of the doses that have gone out in rich countries have been distributed in poor countries. Less than 1%.
--:-- Sean Rameswaram: Yep. And it's actually only two low-income countries that have had vaccines distributed. So one is Nepal. They recently kicked off their vaccine campaign with donations from India. And then the other one is Guinea in West Africa. So they gave out around 50 doses of vaccine at the end of last year and then stopped. And so it wasn't really the start of a vaccine campaign. But the health ministry there was saying that this happened only on an experimental basis. So it wasn't the start of an official campaign.
--:-- Julia Belouz: I mean, we covered the vaccine first rolling out in the UK and then, of course, coming to the United States pretty much soon after that. It's still just a little shocking that this disparity is that drastic. Something like 150 million in rich countries to 150,000 in poor countries.
--:-- Sean Rameswaram: What's the explanation? Is it just first come, first served, highest bidder?
--:-- Julia Belouz: Highest bidder is a good way to put it. So vaccines aren't a public good, and the countries that could pay a lot got first dibs. And so last year, as we saw the pandemic playing out, rich countries started to sign these bilateral deals with vaccine manufacturers, and they scooped up a lot of the supply. And this created this global scarcity where basically, yeah, the first in line, the first with deals are starting to vaccinate their populations and the rest of the world has to wait.
--:-- Julia Belouz: But there's another problem that we should talk about. Which is? So the way this worked, countries were signing these deals with manufacturers at a time when they didn't know which vaccines would work. So they signed multiple deals covering their populations many times over. So in the case of the U.S., there's enough vaccine supply pre-purchase to cover the population twice over.
--:-- Sean Rameswaram: Back in our homeland, you know we always have to have a Canada reference. Sure. They bought more vaccine doses than any other country per capita in the world.
--:-- Julia Belouz: And this has led to this crazy disparity where 60% of the some 7 billion doses of vaccines that are available have been purchased by high-income countries, even though they're home to only 16% of the world's population.
--:-- Sean Rameswaram: It's another massive disparity story in this pandemic. But that's a little confusing because, I mean, as I know from living in the United States right now, there's a ton of people who want the vaccine but can't get it. Now thousands of people who had vaccine appointments, if they were even able to get them between websites crashing and phone lines being jammed, are now learning that their appointments are canceled. And in Canada, I've heard similar stories. With no new Pfizer deliveries provinces are trying to adjust
--:-- Julia Belouz: Make it sound like both of these countries should just have warehouses full of vaccines standing by for everybody who needs them. And it doesn't even feel like that. No, yeah, that's not happening.
--:-- Sean Rameswaram: What's happening is the vaccine manufacturers are giving the countries that made these deals first in line access. So they have the priority slots over the next year and in the years ahead. And that just means poor countries, even if they buy doses now, they're going to have to wait.
--:-- Julia Belouz: When do poor countries get the vaccine? So one of the estimates I saw was at the earliest, most countries won't even start vaccinating until 2023. 2023?
--:-- Sean Rameswaram: Yeah, so that estimate came from an analysis from the Economist Intelligence Unit. But if you think about how slowly things are rolling out, even in the rich countries, and even if things accelerate, it's going to be a while until people who are at the back of the line start to get vaccines.
--:-- Julia Belouz: I mean, I know some poorer countries have been spared by this somewhat because, say, there's less international travel in and out of those countries. But it seems kind of crazy, Balooz, that these countries aren't going to get vaccinations until 2023 or something. I mean, if this is a global problem, doesn't it need more of an immediate global solution?
--:-- Julia Belouz: Absolutely. And yeah, there's a lot of criticism on rich countries now for hoarding the vaccine supply for exactly the reason you're saying that we're going to just cause the pandemic to drag on. What we're heading toward is the vaccine have and have not scenarios where you have rich countries like the US, the UK, Israel, vaccinating their entire populations, including young people and poor countries not having anyone covered.
--:-- Sean Rameswaram: And so this will create opportunities for the virus to continue circulating globally and we know this is a hugely contagious virus. We need really high levels of herd immunity to stop it from spreading. And if we continue with the way we're going, where you have, yeah, this big disparity between richer countries and poorer countries with vaccine coverage, I don't know when this pandemic is going to end.
--:-- Julia Belouz: I can also see a scenario in which, of course, Justin Trudeau and Joe Biden and Boris out in the UK want to take care of their people first and are prioritizing their own populations. But who's going to represent poorer countries in all of this?
--:-- Julia Belouz: Well, the WHO has been speaking out against this hoarding in rich countries. I need to be blunt. The world is on the brink of a catastrophic moral failure. And the price of this failure will be paid with lives and livelihoods in the world's poorest countries.
--:-- Sean Rameswaram: And the reality is, like we see within the U.S., there's not a lot of discussion about give the vaccine to poor countries. It's mostly how do I get my mom vaccinated? How do I get a vaccine for myself?
--:-- Julia Belouz: And it obviously makes sense for political leaders not to think about people in other countries ahead of their own populations. But, yeah, we know that, again, it's a really contagious virus. And to stop the spread, we need to make sure people around the world are covered.
--:-- Julia Belouz: There is some ethical debate happening now about whether countries that have had uncontrolled spread, like they didn't even make an effort to contain their outbreaks. So the U.S., the U.K., which at one point was just considering driving toward herd immunity. They're the ones who are vaccinating at higher rates than the rest of the world.
--:-- Sean Rameswaram: And this is obviously raising some ethical dilemmas about whether it's fair that countries that tried and did a better job, that happened to be poor and not pre-purchased this advanced access, whether it's fair that they're going to now have to wait.
--:-- Julia Belouz: There is this other element here, which is that the rich countries have funded the development of these vaccines that we have on the market now. And you can argue that they should have advanced access. But again, if we want this pandemic to end, we can't leave the rest of the world behind.
--:-- Sean Rameswaram: What to do about vaccine hoarding in a minute.
--:-- Sean Rameswaram: Thank you comes from Chime. Nobody likes fees and complicated banking says Chime. And Chime gets that. Chime is a financial technology company that says they understand that every dollar counts. So when you set up direct deposit through Chime, they say you get access to fee features, such as free overdraft coverage, getting paid up to two days early with direct deposit, so much more.
--:-- Julia Belouz: Chime says with qualifying direct deposits, you can be eligible for free overdraft, up to $200 on debit card purchases and cash withdrawals. Plus, they say you don't need to worry about monthly fees or maintenance fees. You can work on your financial goals through Chime today. You can open an account in two minutes at Chime.com slash explained.
--:-- Sean Rameswaram: That's Chime.com slash explained. Chime feels like progress. Chime is a financial technology company, not a bank. Banking services and debit card provided by the Bank or Bank N.A. or Stride Bank N.A. Members FDIC. Spot me eligibility requirements and overdraft limits apply. Timing depends on submission of payment file. Fees apply at out-of-network ATMs. Bank ranking and number of ATMs according to U.S. News and World Report 2023. Chime checking account required. Not all journalism is the same. Take The Guardian. Our coverage has something unique. Fierce independence. Nobody owns us or tells us what we can and can't say. So we're free to report the whole picture.
--:-- Julia Belouz: We connect what's happening in Washington to the rest of the globe. Expose corruption wherever we find it. And give fresh perspective on everything. From wellness and soccer to culture, the climate and more. Read, watch and listen to The Guardian for free at theguardian.com.
--:-- Sean Rameswaram: Blues, before we took a break, we talked about the catastrophic moral failure here. But you also mentioned, in fairness, that a lot of the richer countries actually funded a lot of the vaccine research. When all of that funding was happening, could there have been a plan instituted to maybe make sure that the vaccines were more equitably distributed?
--:-- Julia Belouz: So we actually, we meaning the global community, actually worked on that last year. It didn't get a ton of press, but countries signed on to the biggest bilateral deal since the Paris Climate Agreement called COVAX.
--:-- Julia Belouz: COVAX. Yeah, COVAX, yep. The COVAX pillar aims to ensure that every country gets fair and equitable access to eventual COVID-19 vaccines. It does this by acting as an insurance policy. So it's an alliance of more than 190 countries, and its express purpose is to support the equitable distribution of COVID-19 vaccines in the pandemic.
--:-- Julia Belouz: So it has two parts. The first part is a purchasing pool that rich countries can buy into. And the idea is that basically if you coordinate vaccine purchasing agreements globally, you can buy in bulk, drive prices down, and poorer countries aren't priced out of the vaccine race.
--:-- Sean Rameswaram: And then the second part is a fundraising effort. So the idea is that basically richer countries would just give money to support purchases of vaccines for lower-income countries.
--:-- Julia Belouz: Sounds great on paper, and I take it it's not working?
--:-- Julia Belouz: Yeah, it's a lot harder to execute in reality, of course. And it's not quite that it's failing, but it's not working up to its ideal. All these agreements that higher-income countries signed with the vaccine manufacturers, they basically undermine the COVAX effort because basically rich countries are competing then with the poorer countries to get access to doses ahead of anything that COVAX does.
--:-- Sean Rameswaram: Then you can't have equitable distribution because, again, we have this situation where richer countries are at the front of the line. So were these richer countries signed up for COVAX and then also they're the ones responsible for it not working? Or were the richer countries never signed up to begin with?
--:-- Julia Belouz: The first. So not everyone signed up at once. And only with Biden coming in did the U.S. announce that they would sign on. One of my sources, Lawrence Goston at at Georgetown put it really nicely. He said, you know, countries joined COVAX so that they could proclaim they were good global citizens, but at the same time robbed it of its lifeblood, which is obviously vaccine doses.
--:-- Julia Belouz: It seemed like many countries wanted to have it both ways. So the vaccination portion of COVAX isn't going according to plan. How about the fundraising part of it?
--:-- Julia Belouz: So the fundraising is also falling behind. So COVAX depends on donations from higher income countries and many rich countries aren't funding COVAX to the level it needs to be funded to. The U.S. has given zero dollars to COVAX.
--:-- Sean Rameswaram: So there's a lot of room there as well for improvement. Is COVAX still alive or is this dream just like dead?
--:-- Julia Belouz: No, it absolutely alive. And they're plugging away valiantly. And they recently announced an agreement with Pfizer for up to 40 million doses of the COVID vaccine and that they also expect to distribute even more doses of the AstraZeneca vaccine. But nothing's really happened yet, so they've said they're going to try to do this in the first quarter of 2021.
--:-- Sean Rameswaram: And I guess the optimistic side says, yes, I really hope that they get it right and that these doses start to go out to poor countries around the world. But we're seeing how slow the rollouts are in the countries that signed deals a long time ago. So whether they actually are able to get all these vaccines out in the first quarter remains to be seen.
--:-- Julia Belouz: Is part of the problem with something like COVAX that there's just no enforcement arm? It's just sort of honor system?
--:-- Sean Rameswaram: If you use the analogy of the Paris Climate Accord, like countries are just agreeing to do something, but what they actually do in reality is often quite different.
--:-- Julia Belouz: Are there alternatives here to making sure that there's better global vaccine distribution than something like COVAX?
--:-- Julia Belouz: Yeah, so there are alternatives. So the nonprofit Oxfam is saying, you know, countries should build these regional vaccine production hubs to start to turn out vaccines at a lower price in the places where they're needed and where production costs are lower.
--:-- Julia Belouz: So basically, yeah, bringing the production to countries where the vaccines are in short supply. So that's one possibility. The vaccines we already have approved in the U.S. and in Europe, the AstraZeneca vaccine, Moderna, Pfizer, they are partnering in some cases with other pharmaceutical companies even to speed up just parts of their production.
--:-- Sean Rameswaram: But I think the major point is that it's just not happening quickly enough. We're in a pandemic. We're already at the point of almost half a million deaths in the U.S. alone. And the pandemic continues to burn on and in some cases accelerate with the new variants.
--:-- Julia Belouz: And so I think what people who are calling for action are upset about is that we need this to happen a lot faster than what we're seeing right now. And these solutions that, you know, necessitate building up facilities in poorer countries or these partnerships that may eventually result in better vaccination around the world. These don't sound like things that will address this anytime soon.
--:-- Sean Rameswaram: What can be done right now to address what the WHO is calling a catastrophic moral failure?
--:-- Julia Belouz: The other thing that can be done is just the simple donating of vaccines. So basically rich countries stop hoarding. Instead of creating this situation where you have even low-risk people within their countries vaccinated, they start to donate vaccines after their high-risk groups are vaccinated. And then they give the excess supply to COVAX, which could then distribute it to other countries that are part of the partnership.
--:-- Sean Rameswaram: What we're seeing basically is that that's not even part of the conversation. But actually, there is one exception globally where we're seeing real leadership on this. Which is it? Is it one of those Scandinavian countries?
--:-- Julia Belouz: It's Norway. So they've been a global outlier. They also hoarded in some sense. They pre-purchased enough vaccine supply for something like three times their population. But then they decided to start giving the vaccines away in parallel with the vaccine rollout that's happening in their country.
--:-- Julia Belouz: And I asked the Minister of International Development in Norway how and why they were doing that. And they said they simply determined it was both ethical and in their self-interest to do the rollout that way.
--:-- Sean Rameswaram: So the difference between Norway and the rest of the world is Norway has leadership that said, hey, it'd be pretty unfair if we just hoarded all these vaccines. Exactly. That basically comes down to that.
--:-- Julia Belouz: What Norway is talking about is the reality. This is a virus that if it's a threat somewhere, it's a threat everywhere.
--:-- Sean Rameswaram: Julia Belouz is a senior health correspondent at Vox. You can read her reporting on the vaccine and the pandemic at vox.com.
--:-- Julia Belouz: Thank you.
