Vaccine inequality is an ethical failure – history will not be kind to the leaders who refused to act

The choices of a few will decide whether or not we face further deadly waves of Covid

Only 11 per cent of the whole population in Africa has received two shots (AP)

World health leaders are making an urgent call for $16bn (£11.8bn), telling us that if 2022 is to become the year when we finally bring Covid-19 fully under control, they need to spend on testing, treatments, vaccines and PPE. They say that without this funding, we have no chance of meeting the global Covid targets of vaccinating 70 per cent of the world’s population.

Since the turn of the year, Covid cases have reached their highest level yet – more than 10 million reported in the first 40 days of 2022 – and despite the successful manufacture of 12 billion vaccines, enough to fully immunise every adult in the world, the gap between the vaccinated rich and the unvaccinated poor is not narrowing but still continues to grow.

Only 11 per cent of the whole population in Africa has received two shots, and in low-income countries, the number is still just 5 per cent. While nearly 70 per cent of vaccines have been administered in high – and upper-middle-income countries, only 1 per cent have been allocated for low-income countries. The gap in testing is even worse. To date, 0.4 per cent of tests have been administered in low-income countries, while nearly 80 per cent of all tests have been administered in richer countries.

It is a myth that our global health organisations – whether the World Health Organisation (WHO), GAVI, the Global Fund, vaccines coordinator COVAX or ACT-Accelerator who are responsible for equitable access to Covid tests and treatments and desperately need the $16.8bn (£12.4bn) – cannot deliver.

When funds have been made available, Covax has supplied 144 countries with more than 1.13 billion vaccines, and ACT-Accelerator has funded over 148 million Covid tests. What is missing is not the will, nor the capacity to deliver, but the finance to do so.

This miserliness is an ethical failure, the richest countries abandoning their moral obligation to help the poorest. It is an economic failure, with the loss of $5tn (£3.7tn) in output by 2023. And, most of all, it is epidemiological failure – because the disease will continue to spread and mutate. And it will continue to surprise us with new variations that cannot be assumed to be less lethal than the last, because we failed to invest in testing and vaccination, and we therefore remain ill-prepared.

There are many ways to raise this money: through the International Monetary Fund (IMF) and World Bank, through special drawing rights (SDRs), or through innovative financing such as a finance facility for health. But, above all, countries should now agree to the fair share formula proposed by Norway and South Africa. Modelled on the way we fund UN peacekeeping through assessed contributions, and the International Monetary Fund and World Bank through quotas, it is the fairest way to allocate the burden between countries.

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The US and the European Union would each pay around 25 per cent of the bill, with other G20 members and smaller high-income countries contributing the rest. Already Norway and Germany have signed up to pay and share.

Now it falls upon President Biden and European Commission president Ursula Von der Leyen and prime ministers Mario Draghi of Italy, the UK’s Boris Johnson and French president Emmanuel Macron to show their leadership. Their actions will decide whether or not we face further deadly waves of Covid and will determine the fate of millions beyond their shores, many of whom live in countries they never think of, in villages not on their maps.

They will either be remembered as the leaders who brought Covid under control by vaccinating the world, or they will suffer the condemnation of history, vilified for creating an even more unequal and divided world. History will not be kind to our leaders if they fail, but millions will hail them as heroes if they succeed.