Vaccine doses should go to where they are needed, not only to where they can be afforded

 By Hossam Elsharkawi, Regional Director, Middle East & North Africa, International Federation of Red Cross Red Crescent Societies

I recently visited Iraq. My visit was a sample of what inequality means in real life.

I went with the Iraqi Red Crescent colleagues to Hamidiya one hour drive from Baghdad to see first-hand the work of the Red Cross and Red Crescent network. I met people who don’t have access to clean water, health care services, or masks to keep them safe from COVID-19. When I asked a mother attending a COVID-19 awareness session why she is not wearing a mask, she replied: “The cost of a single disposable mask is 40 cents per piece. We are a family of five. I can’t afford it. I prefer to spend this money on food.”

It is just not acceptable that in the 21st century, people still have to choose between spending their few coins on food or on health.

I observed first-hand how the Iraqi Red Crescent and other organizations have done great work to fill the enormous gaps in water, sanitation, health, and livelihood. Having said that, the needs remain still immense and unmet.

What I saw in Iraq is everyday life for millions of people. Not only in Iraq but in many other countries in the Middle East and North Africa as well.

Rich? You Live!

In our region, the striking reality is that if you are rich, your chances of surviving COVID-19 are higher than the poor. Simply because you can pay the cost of medication and hospitalization if needed. If you are rich, you have water and soap to clean your hands and you can afford masks and alcohol-based hand rubs. You can stay at home during quarantine because you have enough savings to sustain your expenditure. The poor don’t have any of that.

The inequalities caused by COVID-19 continue dividing us between The Rich and The Poor. World Health Organization (WHO) described it well: “Over 39 million vaccine doses had been given in 49 richer states⁠ — but one poor nation had only 25 doses.”

While legally, each nation has the right to purchase as many millions of vaccines as they want, ethically this is not acceptable. Powerful nations that lead the road to Human Rights Charter, should rethink their commitments towards protecting the most vulnerable, especially during a global public health crisis.

Countries in the Middle East and North Africa are experiencing the highest rise in COVID-19 infections since the pandemic started. In some countries, health systems are approaching a breaking point, while in others they have largely collapsed. Millions of vulnerable people are at higher risk of being infected with COVID-19. If the recent trend in vaccine distribution continues, those people would be at the bottom of the list, if ever they will be vaccinated.

Vaccine Nationalism

I understand the impulse to protect one’s citizens first before worrying about other countries. But the reality is that we need the immunity of our neighbors too to be truly protected and safe. This applies to individuals as well as countries.

“Vaccine nationalism” may keep some people safe in the short term, but it will only prolong the suffering in the long term.

We urge all governments to support the COVAX facility which, in our estimates, represents the best approach for ensuring that all countries can access the vaccines. COVAX is part of a global collaboration aiming to make sure that vulnerable people in all corners of the world will get access to COVID-19 vaccines, regardless of their wealth. It is our best hope for making sure that vaccine doses go to where they are needed, not just where they can be afforded.

We cannot end this pandemic if the communities and the countries in greatest need of support are left behind in the rush to deliver safe vaccines to the wealthiest and most powerful nations.

Mistrust Risk to Become Deeper

This pandemic has created a feeling of mistrust. The most obvious example of mistrust we have seen has been the unwillingness of many people all around the world to follow basic public health advice such as wearing facemasks, practicing physical distancing, and voluntarily self-isolating when having symptoms.

If the inequitable distribution of the vaccine continues, the mistrust will be deeper and even more difficult to deal with. Each one of us has a role to play to make sure that the most vulnerable people get the vaccine before the healthy rich ones.

Until then, we at the Red Cross and Red Crescent, will be with the communities, in Iraq and everywhere else, building trust in the global good and shared humanity.

We will continue advocating for a fair and equitable distribution of a COVID-19 vaccine through the multi-national COVAX mechanism.

During a pandemic, acting ethically and with strong values rooted in dignity and respect for all is not an option. It is a must. And it is in our humanity.

Dr. Hossam Elsharkawi has over 30 years of professional experience in the humanitarian world, spanning assignments in more than 35 countries, comprising volunteer and professional work with many Red Cross and Red Crescent National Societies, ICRC, and IFRC. He was previously Vice President of Health in Emergencies, at the Canadian Red Cross, where he led the preparedness and response for complex humanitarian emergencies. Previously, Dr. Elsharkawi worked with the World Health Organization to develop guidance for medical teams responding to health emergencies in armed conflict and insecure environments.