Shortages in supply of COVID-19 vaccines, coupled with vaccine nationalism, means the vast majority of people in conflict and crisis-affected contexts – and in low-income and many middle-income countries – will not be able to access a COVID-19 vaccine in 2021, and possibly for multiple years ahead. COVAX – the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income – currently expects the vaccines to reach at most 20% of populations across low and lower-middle income contexts, with the reality likely much lower.
The pandemic and its aftershocks, however, will not end until everyone is accounted for and able to be vaccinated. This requires equitable vaccine distribution across both high and low-income countries, including for refugees and internally displaced people, the number of which [exceeded 80 million in 2020, resulting in a tremendous amount of people who lack international protections and adequate access to health systems. As many of these populations can be mobile, additional risks of COVID-19 spread will occur unless they are included in vaccination efforts.
Other concerns exist around the cold storage currently required for many of the COVID-19 vaccines. This demands investments to strengthen health systems and supply chains to ensure doses can effectively reach places affected by conflict or in areas lacking electricity or specialized equipment.
Mesfin Teklu Tessema, senior health director for the International Rescue Committee, said:
“To ensure no one is left behind, investments must be made immediately to strengthen health systems. This includes shoring up supply chains, allocating sustainable and adequate financing, and empowering frontline and community health workers, who can deliver care directly to those in need within their local settings. To do this, we urge high-income countries to increase their investments to both the COVAX facility and broader humanitarian assistance that remains every bit as essential, especially given the severity of COVID-19‘s secondary impacts.
We also encourage high-income governments to share COVID-19-related technology, know-how and intellectual property, so that other countries can manufacture these life-saving vaccines through their own facilities. As a global public good, COVID-19 vaccines should be made affordable for low-income countries and distributed in an equitable manner that prioritizes frontline health workers and high-risk populations, inclusive of refugees and displaced communities. Lastly, strengthening the supply side and availability of vaccines must occur alongside efforts to build demand for vaccines. Any campaign must aim to create trust and involve local communities in planning processes.”
While the global community prepares for equitable distribution of COVID-19 vaccines, there is also an urgent need to ensure these efforts are not done at the expense of continued investment in basic routine immunizations. There is a real threat of vaccine-preventable disease outbreaks like measles because of COVID-19-related disruptions to routine immunization. This is especially true in fragile and conflict-affected contexts which account for 44% of all children who miss out on access to basic vaccines.
To address this, the International Rescue Committee (IRC) recently joined forces with Gavi, the vaccine alliance, in a partnership aimed at delivering vaccines to the most vulnerable within the Horn of Africa and the Sahel, regions prone to diverse crises from food insecurity and disease outbreak to conflict. Coupled with its engagement in the COVAX Facility and continued efforts to strengthen health systems, the IRC aims to ensure an end to vaccine-preventable diseases and death in fragile contexts — including from COVID-19.