The Great Pandemic Divide

Byron Black

IO – As the United States continues to progress towards vaccinating enough people to reach herd immunity in the coming months, masking and social distancing requirements being relaxed, and Americans starting to come back to work and vacation, one could easily fall under the impression that the end of the worst pandemic in a century is just around the corner.

In the developing world, however, a different and tragic story is unfolding.

In India, a second wave is engulfing and ravaging the entire country. More than 20 million cases have been recorded so far, reported daily cases are averaging 350,000 and, given the rapid rate of weekly increases, some epidemiologists are predicting a million Indians will be infected on a daily basis before the second most populous nation in the world starts sees this newest surge start to subside. Meanwhile, given the severe limitations of India’s public health system to handle so many patients, the final death toll for India could end up being of catastrophic proportions.

Unfortunately these numbers-which are based on government statistics–are probably far off the actual numbers. According to the Institute for Health Metrics and Evaluation, an American public health think tank based in Seattle, the actual number of daily infections could be more than 14 million. Even more sobering news comes from the Financial Times, a UK-based daily newspaper which recently reported that comparisons between local news in the Indian press and official numbers suggests that the actual death count could be ten times higher than we are being led to believe.

Other parts of the developing world could be headed for similarly devasting outcomes. In fact, there is nothing unique about India with the exception of its scale due to its relatively large population. Across South America, for example, in countries such as Brazil, Argentina, Peru and Uruguay, death rates on a per capita basis exceed those of India, and daily infections per million people (with the exception of Peru) are higher than those being reported in India, as well.

The main problem facing the developing world is, very simply, its lack of access to vaccinations. During the early stages of the pandemic, rich countries pre-ordered the vast majority of vaccine supplies being prepared by big pharmaceutical companies. The result: until now nearly 90 percent of the global vaccine supply has found its way into the hands of the world’s richest countries, and only 0.2 percent in the poorer regions in the world, such as in Africa.

Such a stark divide is compounded even further by governments failing to enforce and in some cases having a blantant disregard for social distancing rules. This is best exemplified by Jair Bolsonaro’s Brazil, where its 430,000 deaths are second only to the United States, and with its vaccination rollout having reached less than 10 percent of the population, its crisis is far from over.

As richer countries start to reach herd immunity, with the United States taking the lead as it expects 70 percent of Americans to have been jabbed before the end of July, there is an urgent need to find ways to get vaccinations in countries were there is a shortfall. US President Joe Biden has proposed a waiver on intellectual property

claims on vaccines, but this is not enough. The World Trade Organization, which is the forum where such a waiver would be enacted, may not get around to voting on a waiver until December. This is a case of doing far too little and not bringing enough vaccine relief before its too late.

Public health experts are saying that the only way for getting the billions of doses needed in vaccine-poor countries is for rich countries to stop stockpiling boosters. Many of these countries have bought enough doses to cover their populations many times over to mitigate the risk that they will needed. But such a policy– while it makes sense from a political viewpoint–could easily backfire.

Nobody, not even the United States, can afford to be complacent. Not only is there a risk of new India-type scenarios being played out in countries considered as being high-risk, such as Mexico, Argentina and Turkey. Epidemiologists are issuing warnings that as long as Covid-19 continues to spread in the developing world, there is an increased risk of new, deadlier and more vaccine-resistant mutations coming to the surface. If that were to happen, it would be a major setback for everybody, including high-income countries that seemingly have had the situation under control.