We can’t afford inaction. The funds needed are a fraction of the trillions Covid is costing us
This June, President Biden will fly into Britain to attend his first summit of the world’s richest nations. The routine meetings of the G7 – made up of the UK, Canada, France, Germany, Italy, Japan, the United States and the European Union – come and go, and are quickly forgotten, but this time around there is an opportunity not to be wasted. The principal item on the agenda should be health: the mass vaccination of the world.
As things stand, affluent countries accounting for 18% of the world’s population have bought 4.6bn doses – 60% of confirmed orders. About 780m vaccines have been administered to date, but less than 1% of the population of sub-Saharan Africa have been injected. Immunising the west but only a fraction of the developing world is already fuelling allegations of “vaccine apartheid”, and will leave Covid-19 spreading, mutating and threatening the lives and livelihoods of us all for years to come.
Vaccine diplomacy, whereby nations selectively donate vaccines to friendly allies, is little more than “pinprick” diplomacy, because only the favoured few will be Covid-free. So to reach the greatest number of people in the shortest time across the widest geography, the G7 must lead a herculean mobilisation to bring together the proven skills of global pharmaceutical and logistic companies, national militaries, and local health workers.
Home to the major vaccine developers, the G7 countries are in the best position to agree to transfer vaccine technology to low-income countries. The temporary waiver of patents proposed by the People’s Vaccine Alliance will help Africa create its own manufacturing facilities and end months of vaccine nationalism.
The bigger barrier ahead will not be the shortage of vaccines, however, but the shortage of money to pay for them. We need to spend now to save lives, and we need to spend tomorrow to carry on vaccinating each year until the disease no longer claims lives. And this will require at least $30bn (£22bn) a year, a bill no one so far seems willing to fully underwrite.
The traditional international crisis response – the G7 passing round the begging bowl – will not yield the funds on the scale needed. The global equivalent of a charity fundraiser is no substitute for countries agreeing an equitable sharing of the burden. Lives should not be at the mercy of uncertain and often erratic patterns of giving. And so it is imperative we move on from this history of unpredictable funding and the predictable loss of life.
We cannot afford to not act. The funds needed are a fraction of the trillions Covid is costing us. They are less than 2% of Biden’s $1.9tn American Rescue Plan Act. Indeed, it would benefit the US or Europe to underwrite the first $30bn – not as an act of charity, but as self-insurance to protect national interests. If the G7 came together in June to fund mass vaccination, by 2025 their economies would be at least $500bn better off, according to the Eurasia Group.
In 2017, anticipating this need for global coordination in any future pandemic, the public-private partnership ACT-Accelerator was formed to organise, fund and distribute vital medical supplies, led by Norway and World Health Organization director-general Tedros Adhanom Ghebreyesus. Last year, to its great credit, it set up Covax to pay for the immediate vaccination of 20% of the developing world. According to current forecasting, it expects as many as 1.7bn doses to be available to 92 countries by the end of 2021, a 26% coverage.
But understandably, African leaders want 60% coverage now and 70-80% over time, on a par with the minimum most western countries think necessary to achieve herd immunity. Yet at the very moment when international development aid is needed most, Covid and national politics have conspired to cut bilateral aid commitments by 30% last year from $108bn to $79bn. Donations from charitable and corporate institutions can cover, at best, only 10% of the shortfall.
The World Bank and multilateral development banks can offer an additional $10bn a year more without undermining their triple-A investment status. But they also need to fund their climate emergency, education, social protection, and infrastructure responsibilities, which have mushroomed as a result of the pandemic.
Special drawing rights – the creation through the International Monetary Fund of $650bn of new international money – is indeed one welcome way forward, even if transferring this money in loans from the richest to the poorest countries will involve complex negotiations on who pays what. But on its own, this one-off intervention cannot guarantee the dedicated and sustained year-to-year financing that the vaccination programme will need.
So it falls to the richest countries to trigger two additional sources of funding required until Covid is eradicated. In the 1960s, the international community approved a special levy on its members to fund smallpox eradication. Currently, UN peacekeeping operations and $1bn of WHO contributions are covered by similar levies based on a nation’s ability to pay as measured by its national income, debts owed and levels of wealth and poverty.
A more equitable burden-sharing would also weigh the differential gains to richer countries from the resumption of trade and the special privileges of G7 and G20 membership. Under such a formula, the US might contribute about 25% of the vaccination fund, and the UK, France, Germany, Italy and Japan between 4% and 7% each, so the poorest countries are exempt. Here the G7 is critical: its members should declare that they will contribute their full share, totalling 60%. If they did so, China, Russia, Scandinavia and the oil states would feel bound to follow.
But even then, we must make our aid money go further so that we can sustain an annual vaccination programme. The International Finance Facility for Immunisation has raised $8bn to fund vaccinations in low-income countries on the strength of aid agencies covering the interest repayments on their borrowings. They should be asked to raise another $8bn. And a coalition of richer countries could offer financial guarantees that could then be leveraged up by the multilateral development banks into a special vaccination facility. With $2bn in guarantees, backed up by a fraction of that in grants, such a fund could generate resources for vaccines at least four times the size of the guarantees.
The costs may still be in billions, but the benefit will be in trillions. If in advance of the G7 meeting, the western public and developing country leaders can mobilise the same moral force and urgency that inspired Live Aid in the 1980s and Make Poverty History in 2005, we can end our reliance on the begging bowl, establish the global apparatus to deal with this pandemic and other global crises to come, and reunite our fractured world.
All Rights Reserved for Gordon Brown