At a Covid-19 summit hosted by the U.S. President two weeks ago, donors came up far short of the US$15 billion that the World Health Organization says is needed to contain the pandemic globally. A few countries and contributors pledged about $3 billion, and Joe Biden himself could only promise $200 million from the United States, with the U.S. Congress failing to move on his request for $5 billion. There’s meanwhile a stark discrepancy in vaccinations between rich and poor countries: Fewer than 20 percent of Africa’s population has received a single vaccine dose, while vaccination rates top 80 percent in most high-income countries. The Lancet, an influential peer-reviewed British medical journal, has gone so far as to describe the gap in vaccination rates as “vaccine apartheid,” a phrase now adopted by The New York Times. But unvaccinated populations in some parts of the world mean the risk of dangerous new Covid variants that could threaten the world as a whole. Why isn’t global vaccination more of a priority?

James Love is the director of Knowledge Ecology International, a nonprofit research foundation that supports intellectual-property transfers in biotechnology. Love says attitudes toward Covid-19 have changed in the West among the public and political leaders; they simply don’t see vaccination now with the same urgency that they did a year ago. And there are other obstacles. One is a near-total absence of testing data to show which of the many available vaccines are the most cost-effective—an especially important calculation when funding is scarce. Another is that many pharmaceutical companies don’t want to share their vaccine trade secrets with producers in developing countries. But, Love says, the biggest obstacle preventing people in poorer countries from getting inoculated remains a lack of money. As leaders in developing countries face limited budgets and an array of other serious health-care issues, it’s a challenge for them to weigh Covid vaccination against their competing concerns.


Michael Bluhm: Why couldn’t the recent summit raise more money for global vaccination?

James Love: The initial pitch was to vaccinate the whole world with two doses. Now it’s to vaccinate the whole world with two doses every year. That plays out differently.

First, the world was convinced that no one’s safe until everyone’s safe. I don’t think people believe that anymore. People don’t think you’re going to make everyone safe. They don’t think you’re going to have zero Covid. They’re not idiots. They understand that a lot of people aren’t taking the vaccines. They know that even people who are vaccinated are getting Covid. This is what voters are thinking, and political leaders have to pay attention to that.

There’s donor fatigue, not only related to Covid-19—and not just in America. The U.K. is cutting back on development spending. It’s harder to get replenishments for the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which is an older, highly regarded project. When countries look at what they’re going to spend their money on, Covid isn’t the only thing. They’re thinking about the reconstruction of Ukraine.

Xiangkun Zhu

Bluhm: And thinking differently about the pandemic?

Love: Yes. At first, there was a tendency to think that the point of vaccination was to keep you from getting Covid. And if enough people took the vaccines, you could get rid of Covid because you’d have herd immunity. Over time, the stories we were getting about the effectiveness of vaccines in preventing infection changed. Israel began to report that the Pfizer vaccine wasn’t very effective in stopping people from getting the Delta variant. Omicron was effective at evading all the vaccines.

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