Science
Vaccine inequality deepening, at home, and across the world
Summary
The WHO-backed program is facing supply constraints, exacerbating the difficulties faced by the poor countries in accessing vaccines. Within the country, the gap between vaccine leaders and laggards among states is growing.The World Health Organization-backed Covax initiative was aimed at ensuring that poor countries would be able to access vaccines easily. However, the reality has been quite different. Data published by Unicef shows that of the 50 countries that have received the most number of vaccines through the initiative, five have a GDP of over $20,000 per capita (India’s by comparison is $1,905). These are South Korea, Saudi Arabia, Canada, UK and Australia. These five countries have received about 4.8 million vaccines.
So far, Covax has delivered 136 million vaccines to 135 countries. This includes 16 million doses to 24 countries that would be categorized as low income by World Bank criteria, 114 million vaccines to 90 middle-income countries, and 6 million to 21 high-income countries. However, adjusted for population, while the high-income countries in this set got 2.4 doses per 100 people, the low-income ones 24 received only 2.2 doses. The middle-income countries got 2.8 doses.
This inequality exists even as Covax struggles to meet its initial goal of vaccinating more than 20% of its member-nations’ population with one dose. Middle- and lower-income countries were prioritized. Yet, among the 114 countries in these two sets, only 13 countries -- all of them small island nations -- have met the target. Some such as Nigeria, where only 2% of the population has received one dose, face a potentially severe third wave.
Himachal Leads
Covax’s vaccine shortfall has been partly due to the export controls imposed by the Indian government on Indian manufacturers of covid-19 vaccines. This led the Serum Institute of India, its biggest supplier, to halt its shipments until the end of the year. With increased supply, India, which has vaccinated 24% of its population with at least one dose, administered 3.8 doses a day in the past seven days. Yet, this pace is inadequate to cover the entire adult population by year end.
Among states with over 5 million population, Himachal Pradesh continues to lead in vaccine coverage, having given 629 doses per 1,000 people. Delhi (509), Kerala (488), and Uttarakhand (481) follow. The laggards, Bihar and Uttar Pradesh, have doubled their coverage in the last month. At the same time, their gap with Himachal Pradesh has widened. For example, Bihar increased its doses per 1,000 people from 109 on 22 June to 173 on 22 July. Himachal jumped from 378 to 629 during this time.
NE Surge
As India eases its restrictions, there are more pockets where infections are rising. 15 states and union territories registered an increase in new cases this week as opposed to 8 last week. Among them, Kerala, Manipur, Mizoram and Nagaland have shown an increase in each of the past three weeks. In all, 67 districts from 19 states and union territories have witnessed an increase in cases registered in each of the last two weeks. Kerala’s Malappuram reported over 14,669 cases, the highest for a district.
North-eastern states continue to see high caseloads. Among the top 10 districts showing the steepest incline this week, 8 belong to this region. Tamenglong in Manipur reported 193 cases this week, up from 105 last week and 44 two weeks back. Similarly, Kohima in Nagaland, saw a sharp rise from 168 cases last week to 270 cases this week.
Recounting Deaths
The number of deaths in India increased this week, partly due to a reconciliation exercise by the Maharashtra government, which added 3,500 deaths to the toll. In the process, Ahmadnagar, Nagpur, and Nashik districts recorded more deaths, 517, 637, and 593 deaths respectively this week, up from last week’s 60, 13, and 58.
Two districts in Odisha – Khordha and Sundargarh – remain a cause of concern as weekly deaths there have not decreased since the first week of June. This week, both their numbers doubled to 151 and 48 respectively. Khordha has vaccinated 50% of its population with at least one dose, while Sundargarh has managed 23%, marginally lower than the national average of 24%.
Some states are seeing signs of recovery. Gujarat, Jharkhand, and Madhya Pradesh reported less than 10 deaths each in the last seven days. But, as the pandemic has shown often, tides can change rapidly.
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