Cover story: COVID-19 Update

In second COVID wave, Asia and Latin America suffer acute shortage of vaccines, health sectors overwhelmed

Print edition : May 07, 2021

An aerial view of the graves of COVID-19 victims at the Nossa Senhora Aparecida cemetery in Manaus, Brazil on April 15. Photo: Michael DANTAS/AFP

The long wait to refill oxygen tanks in Caracas, Venezuela on April 14. Photo: Manaure Quintero/Bloomberg

As the pandemic rages across the world and nations of the global South continue to face several hurdles, billionaires add to their wealth and military spending increases.

The Asia-Pacific region has emerged as the epicentre of the latest COVID-19 pandemic surge. More than 40 per cent of the half a million cases being reported daily are from Asia. By the end of the second week of April, India had the dubious distinction of overtaking Brazil as the country reporting the greatest number of infections. More than half the infections in Asia had occurred in India.

In many countries, including India, the number of COVID-19 deaths is being underreported. In many Asian and African countries, vaccinations have barely begun. After the latest and most serious COVID-19 wave so far, very few countries have ordered a lockdown. China had successfully implemented a strict lockdown and in the process stopped the spread of the virus within months. The British Medical Journal has described the current pandemic policies of the governments in the United States, the United Kingdom and India as “social murder”.

In Turkey, despite the quadrupling of active cases since March, the government has been able to vaccinate only 8.7 percent of the country’s population. There are reports of a rise in the numbers of children under intensive care as a result of the pandemic. The government has even lifted social distancing measures while non-essential workers are allowed to continue with their jobs. A statement from the Turkish Medical Association said: “There is no national, scientifically based struggle against the pandemic. Insisting on wrong health policies is social murder.”

Interestingly, billionaires all over the world have added $5.1 trillion to their wealth as their governments followed “herd immunity” policies last year. Military spending has also increased globally while the health sectors in most of the countries affected by the pandemic are being neglected. In 2020, India spent only $8 billion on its health sector while splurging $66 billion on the military. Turkey spent $19 billion on its military.
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A few Asian countries have shown the rest of the world the way to tackle the pandemic by implementing strict lockdowns when needed and adhering to a social distancing policy until the pandemic subsides globally. China has reported only 3,270 cases and two deaths so far this year. Vietnam reported 1,174 cases in 2021, with no deaths. Taiwan had 246 cases with three deaths this year. Only 5,009 COVID-19 deaths have been reported among China’s 1.4 billion people since COVID-19 was first identified in the city of Wuhan. In comparison, countries belonging to the Western alliance, including the U.S. and the European Union (E.U.), with a population of over 941 million, have so far recorded over 1.4 million COVID-19 deaths. Meanwhile, the World Health Organisation’s (WHO) COVAX scheme to help the nations of the global South is facing many hurdles, the major one being the acute shortage of vaccines. India, which has the reputation of being the “pharmacy to the world”, was expected to play a crucial role in the production of vaccines after the pandemic struck more than a year ago.

India has one of the biggest vaccine-producing capacities in the world. After India started its vaccination drive in March, Prime Minister Narendra Modi announced the government’s “vaccine friendship” initiative with great fanfare and started shipping over 60 million doses of vaccines to over 76 nations. Most of the vaccines were delivered under the COVAX mechanism. Among the beneficiaries were not only India’s neighbours in South Asia but also many countries, big and small, in Latin America and Africa.

There was also an element of rivalry with China in the ongoing vaccine diplomacy. India rushed its domestically produced vaccine to Paraguay, the only Latin American country which still has diplomatic relations with Taiwan and which China was unwilling to supply its vaccines to for obvious reasons. The government of Taiwan claimed that India had sent vaccines to Paraguay on its request.

Brazil and Covaxin

Brazilian President Jair Bolsonaro, who openly voiced his scepticism about the efficacy of the Chinese vaccines, had specifically asked for vaccines produced in India and signed an agreement to export 20 million doses of the indigenously produced Covaxin. Brazil had also placed orders for 20 million doses of the AstraZeneca vaccines manufactured by the Serum Institute of India (SII) in January.

India has so far been able to provide only 4 million doses. The SII has not been able to fulfil many of its contracts, including with the U.K., for the supply of the corona vaccine that was patented in that country.

The Brazilian health authorities overruled the federal government and refused permission for the import of Covaxin stating that the product did not meet good manufacturing practice (GMP) requirements. The efficacy rate for the Covaxin has still not been published after the third phase of trials.
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Bolsonaro had openly advertised his preference for the AstraZeneca vaccine manufactured in India over vaccines manufactured in China. Earlier, Bolsonaro had ordered a ban on importing vaccines from China even as the pandemic was sweeping the country. Brazil has recorded the highest mortality rate in Latin America and the federal government is far from getting a grip over the situation. Many prominent politicians in Brazil representing the broad political spectrum have accused Bolsonaro of presiding over a “genocide” owing to his wilful neglect of the pandemic.

Most countries in Latin America have been using Chinese and Russian vaccines as the West is preoccupied in procuring and hoarding supplies for its own citizens. During the Quadrilateral Security Dialogue in March, leaders of the U.S, India, Japan and Australia had made the grandiose pledge to supply one billion vaccines to the people of the Asia-Pacific region. Right now, only the U.S. has the capacity to export vaccines, but as things stand, it is not even willing to help out its neighbour and closest allies at this juncture. Speaking at the Raisina Security Dialogue, Modi insisted that India would continue with its vaccine diplomacy despite the shortfall in domestic supply.

Chinese vaccines

China has provided more vaccine doses to the developing world than any other country. Even in South Asia, it is China which leads the way. In early April, a top Chinese official did admit that the efficacy levels of vaccines manufactured in the country and outside are not as high as desirable. Gao Fu, the director of the Chinese Centre of Disease Control and Prevention, acknowledged that the vaccines currently available “do not have very high levels of protection rates”.

Medical experts have said that any vaccine that is even 50 per cent effective will be useful in preventing the spread of the pandemic. Tedros Adhanom Ghebreyesus, director general, WHO, said in the second week of April that one in four people in high-income countries had received a vaccine dose. In comparison, only one in five hundred people in low-income countries had received their first dose of the vaccine.

China currently has five vaccines in use for its immunisation programmes, including a one-shot vaccine from a company called CanSino. Vaccines made by Sinovac, a private company, and the state-owned firm Sinopharm, make up the bulk of Chinese vaccines being supplied to the rest of the world. Many countries such as Pakistan and countries under sanctions like Iran are dependent on Chinese vaccines. Mexico, Turkey, Indonesia, Serbia and Hungary are some of the other countries receiving vaccines made in China.

Slovakia & Sputnik V

Russia’s Sputnik V vaccine has also had widespread acceptance. In fact, many European countries, including a few E.U. members, have opted for it. At the same time, vested interests have been working overtime to politicise and tarnish the reputation of the vaccine. The most interesting case is that of the Slovak Republic, where Prime Minister Igor Matovic resigned in the midst of a controversy surrounding the deal he had signed to purchase the Sputnik V vaccine. The right-wing opposition had objected to the country opting for the Russian vaccine despite being one of the worst-hit by the pandemic in the region.

One of the centre-right parties in the four-party coalition running the country said that the purchase of Russian vaccine would cast doubts on the country’s pro-Western political orientation. An opposition leader even described the Russian vaccine as a “hybrid war tool”. In the end, the Finance Minister and the Prime Minister swapped places, and the Health minister was made the scapegoat and had to resign. Russia has demanded that the Slovak Republic return its vaccines after a senior health official cast aspersions on its efficacy. Since the controversy erupted, other countries, including Germany and India, have decided to go in for the Russian vaccine.
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Britain’s AstraZeneca vaccine also seems to have become a victim of politics. In mid-April, many E.U. countries announced that they would no longer be importing the Oxford vaccine. Denmark went a step further and officially banned its import. It was observed that in very rare cases, less than one in a million, the AstraZeneca jab has resulted in serious instances of blood-clotting. There were reports that the Pfizer vaccine, too, had serious side-effects in rare cases. But the E.U. establishment is clearly unhappy with the U.K. for being initially niggardly in sending the vaccine to its former partners despite written commitments. The U.K.’s priority was to first vaccinate its own people.

To further complicate the global vaccine drive, the one-shot vaccine by Johnson and Johnson is also under scrutiny, also for rare instances of clotting. Many countries have suspended its use. South Africa, which is experiencing a devastating third wave, had pinned much hope on this vaccine. AstraZeneca, which the government had initially ordered, proved not very effective against the South African variant of COVID-19. The South African government then secured 30 million doses of the Johnson and Johnson vaccine and another 30 million of the two-shot Pfizer vaccine.

In mid April, the South African Health Minister, Zweli Mkhize, announced that the government was temporarily suspending the administration of the Johnson and Johnson vaccine, which is the only one being administered in the country right now. The government said that the vaccinations would resume after investigations into the cases of blood-clotting after the Johnson and Johnson vaccine was administered, concluded. Mkhize said: “Science must be respected at all times, although this may mean disruptions in our plans.” But South Africa, like most countries in the world, does not have the luxury of choosing from a basket of alternative vaccines.

Countries under U.S. sanctions

Countries under illegal U.S sanctions such as Iran, Cuba, North Korea and Venezuela have an additional burden to bear in pandemic times. The Joe Biden administration has been as unrelenting as its predecessor on the issue of sanctions. Iran was badly hit by the first COVID wave last year and has been suffering since then. The long-running U.S. sanctions have had an adverse impact on the country’s health system anyway, with essential drugs off the shelf for more than a decade. Since the pandemic began, Iran has received only a few 1,00,000 doses of the vaccine from China, Russia and South Korea. The latest surge has led to the hospitalisation of 21,000 Iranians by the first week of April. There is no space in public hospitals. Like in India, those in need of intensive care are seen sleeping on the floors of various hospitals in Teheran and other major cities.

Iranian President Hassan Rouhani has said that he is not in a position to order a lockdown after years of suffering due to the U.S. sanctions. Rouhani said: “The easiest would be to stop everything. But after that, the people facing hunger and poverty and unemployment would go to the streets.”
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Venezuela has signed an agreement with Cuba to produce two million doses per month of the “Abdala” vaccine produced by Cuba. Venezuelan President Nicolas Maduro announced in the second week of April that his government had secured funds to fully pay for the vaccines, but did not reveal the source of funding for fear of the impact of the U.S. sanctions law on the purchases. Because of sanctions, Venezuela is lagging behind its neighbours, Brazil and Colombia, in vaccination figures. Venezuela has also received vaccines from the COVAX-sharing mechanism.

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