A group of countries in the world has started the vaccination race against the COVID-19 coronavirus. England, the USA, Russia, and China are part of the group of countries that began the approval of vaccines and have also begun mass vaccination in their population at risk: people over 65 years of age, health personnel and people vulnerable to a chronic disease. Is it a right of the world population to have access to such vaccination? What will happen in countries like Peru?
England began vaccination against COVID-19 on December 8, 2020, after approving the vaccine from the company Pfizer / BioNTech (of German-North American origin, hereinafter Pfizer) on December 2, 2020. After England, Other countries have followed, including Latin American countries. On Friday night, December 18, the Moderna laboratory (of North American origin) also received its approval in the United States and immediately began its distribution to start vaccination in that country and in other countries around the world. In the same sense, in Russia and China their respective vaccines have been approved and their mass vaccination has begun.
What about the other countries of the world? Each country has moved its negotiation and purchase team seeking to have access to said vaccines, first, by approving them by the competent public entity and, second, by purchasing and distributing them in its population at risk. Do all the countries of the world have this negotiating and purchasing power? It seems not, and the best example is that countries like Peru, even with purchasing power, have not been able to confirm to date (12-22-2020), some of the vaccines in application.
The most complex thing is that the vaccines approved and that are being applied in the world require a particular refrigeration for their conservation. In the case of the Pfizer vaccine, it requires -70 degrees Celsius cooling, while the Moderna vaccine requires -20 degrees Celsius cooling. Countries like Peru do not have a cold chain system of -70 degrees Celsius, and if it has a cold chain system of -20 degrees Celsius, it does not reach rural areas. In short, vaccines can only be applied in urban areas of the world prepared for their conservation with ultra-cold chains, and with the capacity to manage and distribute personnel and resources.
The good news, however, is that on December 18 the World Health Organization (WHO) released the news that poor countries will also have access to vaccines. This access would be given through the alliance of private-public entities and a group of nations of the world, called COVAX: the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator. According to the news, 2 billion doses of vaccines have been reserved for countries with poor or medium economies in the world (see WHO online, https://news.un.org/es/story/2020/12/1485842).
Although COVAX’s leading partner is an international organization called GAVI (a global Vaccine Alliance), in turn led by a family foundation, the Bill and Melinda Gates Foundation, it is a concrete alternative for democratization of the application of the Vaccine. Also in this alliance is the United Nations Children’s Fund (UNICEF), which would be responsible for distributing the vaccine around the world. We understand that UNICEF, with its experience in vaccinating children in different countries of the world, would be implementing in alliance with each interested country systems of super cold chains for the distribution and application of vaccines.
Given this context, it is important to note that the global right to COVID-19 vaccines is shaping up. While there is no specific authority or written standard, these are built on the needs and global participation of stakeholder groups, vaccine manufacturing laboratories, donor nations, and foundations. The economic explanation is simple: if we manage to overcome the pandemic, through a worldwide vaccination, the global economy will recover and provide a greater benefit to the capital economic system. Otherwise, the pandemic context would be generating a new world order.
Regardless of whether we agree with these intentions or interests, it should be recognized that global vaccination will not become a reality in 2021. Given the impossibility of producing two or five vaccine laboratories for the world population (estimated at 7.7 billion), and since many vaccine projects in other laboratories are behind schedule, ensuring the vaccine for most of the world’s population is still a dream. It is possible to aim at vaccinating at least the world’s population at risk. This would be the challenge of the year 2021.
What to do from Peru?
In principle, from countries like Peru it is convenient to be integrated into the COVAX alliance. The Pan American Health Organization (PAHO) has promised that 10 poor countries (among which Peru is not found) will receive the vaccine proportionally free, while the other countries will be able to join the alliance and the proportional benefit of the vaccine assuming the corresponding payment (see for example https://news.un.org/es/story/2020/12/1485712).
It is also advisable to continue supporting invention initiatives in national laboratories. If we do not develop a national capacity, our dependence on transnational laboratories will continue, repeating the circle of exclusion in which we find ourselves. If there is a risk of other pandemics, even more so, invention in vaccines is essential.
It is also advisable to continue developing a preventive capacity in the diverse and complex population of the country. This means attacking the vulnerability that we have as a country. It is not just a matter of issuing orders from Lima to control social isolation, but of initiating a transformation of the extreme inequalities suffered by fellow citizens of shantytowns and popular neighborhoods, and of peasant and native communities, which do not have healthy and access to essential sanitation services.
Finally, it is convenient to take part of the global order to show more strongly our concern as a State in the equitable production and distribution of vaccines in the world. A private-public project, as COVAX is initially, with a merely distributor role of a minimum percentage of vaccines is not enough, but it is essential that the countries of the world share knowledge, production, and distribution of vaccines equitably. If the pandemic is a global risk, its solution must also be global. The risk against humanity must be faced with the equitable participation of all States and social groups representing this humanity.
Lima, December 19, 20 and 22, 2020.
[1] Professor at the Pontificia Universidad Católica del Perú and the Universidad Nacional Mayor de San Marcos. Lawyer, Magister in Social Sciences and PhD in Laws. The author appreciates the comments of Imelda Campos Ferreyra and Ana, Richard and Leonidas Peña Jumpa.