The emergence of new variants of omicron and the desperate and possibly futile attempts to stop it in the world remind people that scientists have been warning for months that as long as most parts of the world lack vaccines, the coronavirus will be rampant.

The accumulation of limited COVID-19 vaccines in rich countries—creating virtual vaccine deserts in many poorer countries—not only means that parts of the world are at risk of shortages; it threatens the entire planet.

This is because the more the disease spreads among unvaccinated people, the more likely it is to mutate and become more dangerous, thereby prolonging the pandemic for everyone.

“The virus is a ruthless opportunist, and the unfairness that characterizes the global response is now deeply entrenched,” said Dr. Richard Hatchett, CEO of CEPI, one of the organizations behind the COVAX vaccine sharing program supported by the United Nations.

Perhaps no inequality is more pronounced than in Africa, where fewer than 7% of the population are vaccinated. Last week, South African scientists notified the World Health Organization of the new omicron variant, although it may never be clear where it originally originated. Researchers are now eager to determine whether it is more contagious or can evade current vaccines.

COVAX should avoid this inequality-but the program is severely lacking in injections and has abandoned its original 2 billion dose target.

Even if it were to achieve the reduction target of 1.4 billion doses distributed by the end of 2021, it would have to deliver more than 25 million doses per day. On the contrary, according to the Associated Press’s analysis of shipments, since the beginning of October, the average daily number has only exceeded 4 million, and in some days it was even less than 1 million.

Shipments have increased in recent days, but they are far from reaching the required quantity.

At the same time, richer countries often overdose vaccines, and many countries are now providing booster shots-WHO discourages this practice, because each booster shot is basically one dose, for those who have never been vaccinated. It is useless for people who have passed the first stitch. Although the United Nations health agency has called on countries to announce a moratorium on intensified injections before the end of the year, more than 60 countries are now implementing these injections.

Dr. Osman Dar, head of the One Health Project of the Chatham Institute, said: “It emphasizes that if the global inequality in fighting disease and poor health is not addressed seriously, everyone will face continuous and Fundamental risk.” Tank.

Anna Marriott, Oxfam’s health policy manager, said that after being placed at the back of the vaccine cohort by wealthy countries, COVAX was restricted from the beginning.

“The COVAX team may provide vaccines as quickly as possible, but they cannot provide vaccines they didn’t get,” Marriott said.

According to calculations by the International Monetary Fund from mid-November, only 13% of COVAX contracted vaccines and 12% of pledged donations have actually been delivered. According to the Vaccine Alliance called Gavi, about one-third of the vaccines distributed by COVAX are donated. The initiative is now partly a clearing house for these donated doses, and it was set up to avoid this.

Last week, COVAX issued a press release praising the European Union’s commitment to deliver 100 million vaccines to Africa by the end of the year-but in fact only 1/20 of the vaccines are on planes.

When asked about the logistical challenges of distributing the other 94 million doses of vaccine in just six weeks, COVAX’s managing director Aurelia Nguyen insisted that “arrangements have been made to transfer a large number of doses between now and the end of the year.”

She said in a statement that the problem is to ensure that “local conditions are suitable for administration.”

In the meeting minutes released before the executive meeting this week, Gavi worried that the idea that rich countries dump old or less vaccines to poor countries might undermine the entire project. On Monday, in a joint statement with the WHO and the African Union, it cautioned that “to date, most donations are temporary, with little notice, and a short shelf life.”

The anger over dose dumping is already very real. In Malawi and South Sudan, tens of thousands of expired doses were destroyed.

But according to some experts, the problem is not just getting vaccines into poorer countries. Dr. Angela Wakhweya, CARE’s senior director of health equity and rights, said that COVAX “has failed to deliver vaccines on the tarmac (airports) to people.”

For example, the Congolese authorities returned all their COVAX shipments this summer when they realized that they could not administer the drug before it expired.

In the “Risk Management” report on COVAX, Gavi warned that the “malabsorption” of vaccines in developing countries may lead to “waste” of certain doses. One problem is logistics-just getting the dose in the right country/region at the right time. But it is also important that national health systems, which are often underfunded, are able to distribute vaccines, syringes and other necessary equipment where they are most needed. The third problem is to persuade people who sometimes hesitate to get vaccinated.

However, Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, disputed the distribution issue, saying that the only obstacle to immunization in poor countries is supply.

Most of the COVAX doses distributed so far are vaccines from AstraZeneca, which have not yet been approved in the United States, and when the vaccine is associated with rare blood clots, its poor launch in Europe has fueled anti-vaccine sentiment. Vaccines used mainly in the United States and most of Europe—manufactured by Pfizer-BioNTech and Moderna—are only available in small quantities through COVAX.

The United States, which has been banning overseas sales of vaccines and exporting key ingredients for several months, has donated a total of 275 million doses of vaccine, more than any other country, but the deadline for most of the Biden administration’s 1.1 billion dose pledge is 2022 September. The alliance usually allows vaccines produced in the group to be sold anywhere in the world, and has actually delivered one third of its promised 500 million doses.

Efforts to increase global production outside of selected manufacturers have stalled, and many activists and scientists blame it on pharmaceutical companies’ opposition to abandoning the intellectual property rights of lucrative vaccines.

COVAX’s failure to provide enough vaccines anywhere close to enough has made some people wonder whether it’s worth fighting for vaccines, because so far, the epidemic has not destroyed Africa as many people initially feared – and often It is the most serious among the richer countries. This is a strategy that few public health officials would approve of.

“I think the real thing that Africa can do to shame the world is to stop demanding vaccines,” said Christian Happi, a Nigerian virologist who is a member of the CEPI Scientific Advisory Board. “Vaccines have not arrived yet, anyway, we may not need them like the West.”