The contrast could not be starker. Here in the UK, 3,000 clubbers in Liverpool danced to indoor DJ sets as part of a pilot to trial the safety of mass events as the country gradually reopens. In cities such as Delhi, people with Covid struggle to stay alive as family members desperately try to find a hospital bed in a health system that has collapsed under the strain of India’s second wave. As experts have warned for months, the pandemic is evolving into a tale of two health crises. Richer countries such as the US and UK have suffered dreadful death tolls, but are making such speedy progress in vaccinating their populations that the end of this nightmare seems to lie just around the corner. For low- and middle-income countries, it is only getting worse.

a group of people standing outside of a building: Photograph: Vishal Bhatnagar/Shutterstock

© Provided by The Guardian
Photograph: Vishal Bhatnagar/Shutterstock

New analysis for the Observer this weekend shows that the burden of Covid-19 deaths is shifting towards poor and lower-middle-income countries. India and Brazil are in the midst of a catastrophic second wave, which is fast spreading to their neighbours Nepal, Bangladesh, Peru and Colombia. The main difference is, of course, in vaccination, the only route out of the pandemic. More than a billion vaccine doses have been administered globally, but around four in five of those have gone to high- and upper-middle-income countries, with just 0.2% sent to low-income countries. In the UK, more than 34 million adults – 65% of those aged over 18 – have received their first dose; in India and Brazil, just 9.2% and 13.8% respectively of their populations; in the world’s poorest countries, it is around one in 500.

a group of people standing in the snow: A cremation in Jaipur, India, on Friday. Yesterday, India recorded a record 401,000 new cases of Covid-19.

© Photograph: Vishal Bhatnagar/Shutterstock
A cremation in Jaipur, India, on Friday. Yesterday, India recorded a record 401,000 new cases of Covid-19.

The biggest risk to the UK is that a vaccine-resistant variant that develops elsewhere generates a third wave here

Global efforts to redistribute vaccines more equitably have fallen far short of what is needed to adequately suppress the virus. The original ambition of the Covax programme was far too modest: to ensure at least 20% of the population of each country – prioritising health workers and the clinically vulnerable – were vaccinated by the end of the year. But progress against that goal has also proved very slow: only one in five of the Oxford/AstraZeneca doses that Covax estimated would be supplied to countries by May has actually been distributed. India is a major vaccine producer for the global south and its own Covid crisis will further reduce supply for the poorest countries.

Rich countries with plentiful vaccine supplies such as the UK – we have ordered 500m doses in total – can and must step up their donations. The ethical imperative could not be stronger. Here, we already enjoy the greatest liberation: no longer having to live with constantly worrying about loved ones who are clinically vulnerable to the virus. Life is slowly moving back to something approaching normal. Across the global south, countries with fragile healthcare systems and without the economic resources to tolerate lockdowns face months, possibly years, of waves of this virus sweeping through their populations, claiming hundreds of thousands of lives. If high-income countries step up their efforts to distribute vaccines, many of these deaths could be avoided.

Quite aside from the ethical imperative, it is also in the self-interest of the UK to bring about as speedy a halt to the pandemic as possible. As the virus spreads in other countries, it mutates, risking the emergence of more transmissible, deadly and vaccine-resistant strains. Existing vaccines are already less effective against some variants. The low capacity many countries have to trace variants will make it almost impossible to track their spread. The biggest risk to the UK is that a vaccine-resistant variant that develops elsewhere generates a third wave here, leading to more deaths and economic hardship. In the words of the former prime minister Gordon Brown, “nobody is safe until everybody is safe”.

Related: Britain’s aid cuts: what’s been announced so far

There are several proposals on the table. More than 100 countries, including India and South Africa, are pushing for the World Trade Organization to suspend patent rules for vaccines during the pandemic. Brown is leading an effort to persuade the G7 nations to commit to a $60bn programme of vaccine and healthcare funding for low-income countries at their summit in mid-June. One thing is clear: all wealthy countries must agree urgent collective action to ensure more equitable access to vaccines, to safeguard their own citizens as well as vulnerable populations around the world.

But where the UK once led, it has become a terrible example for the rest of the world. It is true that we are one of the larger financial donors to the Covax programme, but that donation has been dwarfed by Boris Johnson’s decision to break his 2019 manifesto commitment to maintain international aid spending. Instead, he has cut it by more than £4bn a year. This will harm the global fight against Covid and prolong the pandemic: vital coronavirus research programmes, including one tracking coronavirus mutations in India, have had their funding cut by 70% and funding for water, sanitation and hygiene programmes – so critical in controlling Covid – has fallen by 80%. The cuts will lead to the avoidable deaths of children; funding for polio eradication has been cut by 95%, funding for family planning services by 85% and funding for girls’ education has already been cut by 40% over four years.

The cruelty of it is unfathomable: the savings are little more than a rounding error in the government’s annual budget, yet will cause immeasurable hardship and suffering across the global south. Covid-19 is only the latest health emergency to show how interconnected the world is. If countries such as Britain fail to step up, not just on vaccine distribution, but on international aid more broadly, it is not only the world’s poorest countries that will pay the price.

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