Our response to COVID-19 cannot be one-size-fits-all | Corona pandemic
Today we can say that we are entering a new phase of the COVID-19 pandemic, with many of the countries hardest hit by the virus – such as the UK – having vaccinated enough of their vulnerable patients and health staff to withstand the worst pressures. on their health systems, even as the virus continues to circulate widely. With over a billion vaccines a month, there should in theory be enough for everyone.
However, there is a problem with the distribution of the vaccines – some people who need them urgently, such as health professionals or people who are at risk of developing a serious form of the disease because of their age or because they suffer from other diseases, do not. have no access to it.
Yet the solution proposed by the UN, which calls for “vaccines in the arms of 40 percent of people in all countries — and 70 percent by mid-2022” by the end of this year, is too simplistic. A one-size-fits-all solution that ignores local epidemiological and political conditions is misguided and even threatens to divert efforts from where they are most needed.
What we need to see are locally adapted approaches that cater to the unique characteristics of each outbreak and the people it threatens. They also need to consider the full range of tools we now have at our disposal – and that doesn’t just mean vaccines.
Doctors Without Borders (Medecins Sans Frontieres, or Doctors Without Borders) has worked in one way or another to respond to COVID-19 in nearly all 80 countries where we work. In some of those countries where we’ve worked on case management and vaccination, we’re now stopping responding. This is either because, as in France, the vaccination rate is now very high; or as is the case in Peru, as authorities are able to manage the response despite the ongoing outbreak in the country. In other countries we have never really started, like in Niger, because the country sees very few serious cases of the virus.
However, in some regions where we operate, we are still seeing wave after wave of COVID-19, with very high incidences of severe forms of the disease, very low vaccination rates and little local capacity to control the outbreaks. This is especially true in some parts of Asia and the Middle East: Afghanistan, Iraq and Yemen all remain hard hit, and here we continue to treat patients who have developed the most severe forms of the disease. Many of them die because it is difficult to access the right care in time due to the seriously deteriorating state of the health care systems in those countries.
It will be difficult to get high vaccination coverage in these countries, even if we solve the vaccine supply problem, due to the lack of a well-functioning health care system, the uncertainty associated with conflict and the rejection of vaccines by some of the population. However, it is precisely because of these challenges that we must focus our efforts on these countries, with urgent action from the UN, the World Health Organization (WHO) and other international organizations needed to take holistic measures.
This means ensuring that rich countries with reserve doses set up large and predictable donation schedules for vaccines that aren’t close to their expiration date; investing in vaccination infrastructure by building permanent vaccine centers and funding staff training and salaries; fund the massive expansion of testing so people know when they are sick; ensure that the new antiviral treatments currently on the market are widely available at affordable prices, and fund the widespread availability of oxygen therapies – and pay the salaries of medical personnel to administer them – to those people who develop severe forms of the virus.
The formidable challenge of introducing these packages — a challenge MSF itself is grappling with — is exactly why a global vaccination effort targeting a unified level of vaccine coverage would require a lot of wasted effort and resources. Anyone who wants a vaccine should have access to it, but there is a huge difference between guaranteeing the availability of vaccines in all countries and running massive campaigns in all countries. By undertaking too much of the latter, we risk misallocating time and resources to countries relatively unaffected by the pandemic, thereby not using them where they are needed most in the fight against COVID-19 and other pressing issues. health issues.
The development of the vaccines we can use against COVID-19 is one of the fastest in medical history, but we must be clear about what we can achieve with them: they protect against serious illness and death, but are far less effective at stop the transmission. We will not eradicate this disease with the vaccines we currently have. That’s why we need to focus on getting vaccines to people most at risk of getting seriously ill or dying in the places most affected by the virus, rather than pursuing unattainable ideas for global eradication.
To save as many lives as possible, we don’t need a slogan promising an unattainable goal, but a series of smart and locally adapted measures. Only then will we address the uneven progress of the pandemic around the world, the myriad of different outbreaks that different people are experiencing in different locations, and the inequality that continues to hinder poorer countries’ ability to save the lives of their people.
The views expressed in this article are those of the author and do not necessarily reflect the editorial position of Al Jazeera.