As Ebola raged around her clinic in Kyangike, Democratic Republic of Congo, Giselle Katunda knew it wasn't the availability of a vaccine alone that would protect her as a health worker.
It was the personal protective equipment and the training she received in how to use it. It was the newly-constructed handwashing stations that, like many others, brought her clinic its first safe source of water. It was temperature monitoring and infection prevention instruction and contact tracing and a host of other interventions that, together, make vaccines most effective.
Now comes the danger of the novel coronavirus pandemic. The availability of a vaccine against COVID-19 and its variants is the part of the iceberg we see. There is much lurking underneath we must address.
Of course, the first challenge is to convince people in wealthier nations that our well-being is very much tied to the well-being of our poorer neighbors. “The emergence of variant strains of the coronavirus that could end up being more resistant to the existing vaccines is a reminder that as long as the coronavirus is raging unchecked somewhere in the world, it is a potential threat everywhere in the world,” World Health Organization Director-General Tedros Adhanom Ghebreyesus told a special meeting in Geneva this week. "Not only does this me-first approach [to vaccines] leave the world's poorest and most vulnerable people at risk — it's also self-defeating."
The me-first approach has applied to virtually every other resource blessing wealthy nations, including the provision of the health services. The UN’s goal of achieving universal healthcare coverage by 2030 isn’t impeded by the pandemic alone. Barriers in education, facilities, government support, cultural attitudes, logistics and more keep access to health services — including vaccines — out of reach for millions of neighbors in need, because they are born poor.
The availability of treatments for wealthier nations at the expense of poorer neighbors is nothing new: polio, HIV and AIDS, tuberculosis, malaria...the list continues of maladies many of us rarely think about, but remain a very real threat for anyone living in post-colonial lands.
It will take a lot to make vaccines widely available in lower- and middle-income countries: trained health workers, access to scientific understanding, better data for decision making, sanitation and, of course, the logistical chains necessary to get vaccines into communities already beleaguered by challenges in health services provision.
The WHO’s Dr. Ghebreyesus got right to the point: "The world is on the brink of a catastrophic moral failure." Time is of the essence, for the vaccine to be made available along with all the other measures it will take to ensure the measures to deliver the shot itself remain effective.