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The U.S. Is Among Other Countries Pushing For Global Vaccine Equity


What will it take to vaccinate 70% of the world's population within a year? President Biden promised to help meet that goal this week.


PRESIDENT JOE BIDEN: We're going to lead with the power of our example, and we're not going to stop. But the only way to get this done is for everyone, everywhere - is for all of us to step up, which I'm confident you will.

INSKEEP: OK. Now the United States and European nations are already in the neighborhood of that 70% goal, give or take. But other nations are far below. In low-income countries, fewer than 10% of people have been vaccinated and in Africa, fewer than 4%. So though the United States has promised to donate many more vaccines, a lot of work remains, and we have called a person who's trying to do it.

Dr. Bruce Aylward is an epidemiologist and senior adviser at the World Health Organization. He is also running a part of the WHO that is coordinating the international effort to fast-track vaccines. Welcome to the program, sir.

BRUCE AYLWARD: Thank you, Steve.

INSKEEP: How does the help that you have been promised compare to the help that you need?

AYLWARD: Steve, this is such an important development - the promises and the summit that President Biden held yesterday, right? It's a crucial timing, one year into this thing. It brings a political dimension to solving problems that money alone can't solve. That is access to the vaccines. And the other important thing, Steve, that you didn't mention in the intro there was it was about more than just vaccines. It was also about saving lives with oxygen and testing - right? - the whole package. So this is - was a really important development yesterday, gets us part of the way there.

INSKEEP: Can you help us understand how vast the disparity is here? I just ran out some numbers. Maybe we're around...


INSKEEP: ...Three-quarters of America's vaccinated, depending on whether you're just counting adults or just counting kids, but a lot of people vaccinated compared to 4% in Africa. What does that mean in real terms?

AYLWARD: Yeah, it's a staggering difference, first of all, Steve. If you look at the global numbers, 40% of people in the world have had at least one dose. In Africa and low-income countries outside of Africa, that's less than 4% - so a tenfold difference. And what does it mean? It means people are dying who shouldn't be dying. It means health care workers are getting infected that shouldn't be. It means the societies are dragging. It means economies can't reopen, and we're going to lose trillions. That's what that disparity means in real terms.

INSKEEP: I want to ask another question because when I look at these global COVID maps, I actually see a lot of countries that seem to be doing a lot better than the United States, which is in the midst of a terrible delta surge. Is that a little deceptive? Are things much deadlier in other countries simply because they - we don't - can't tell it or can't measure it because they don't have as much testing?

AYLWARD: Absolutely. So we talk always about this equity gap in vaccines. And it's real - right? - 40 times higher rate of vaccination right now in the highest-income countries versus the lowest. So that's part of it. But if you look at testing, Steve, we have a 100 to 200-fold difference in the level of testing. So in sub-Saharan Africa, very, you know, just marginal testing going on. So we need a big step up in that to help protect people and to help understand how the vaccines will be rolled out and the impact they'll have. And we're having those same gaps in oxygen, all the critical tools. And again, why yesterday was so important - because it was about vaccinate the world, save lives now, roll out all of these tools and get that political piece in place, which is going to be crucial for something at this scale.

INSKEEP: Let me ask a stark question here. The FDA here in the United States has just approved additional Pfizer shots for high-risk people and everybody over 65. More such announcements may be coming. When you think about this in real terms, when someone gets a third shot in the United States, does that mean someone in Asia or Africa does not get any shot at all?

AYLWARD: Every time we look at a dose of vaccine, we have to say, right now we're in scarcity with a life-saving intervention. We have to say, is this having the biggest possible impact it could have? And what we know is if someone isn't vaccinated, it has a really big impact. If they're already vaccinated, it has a marginal impact. The one exception, of course, Steve, are those populations like the immunocompromised who may not have been protected with the one or two doses they got at the beginning. They definitely need another dose. But we need to make sure doses are going into people anywhere in the world who need it. It's good for them. It's good for America. It's good for everyone.

INSKEEP: Are you comfortable with the decisions the United States has made up to now, giving increasing numbers of people access to a third shot?

AYLWARD: I think what the U.S. is trying to do is be very careful about this to make sure that they can support the global effort as much as possible while doing what they think is crucial for their population. Right? They're not saying boosters for the whole population. They're not saying boosters for whoever wants them. What they're trying to look at is, who do we think is essential to help protect in our society and at the same time played a big role in the global rollout? Every country's got to make the tough decisions themselves, Steve. We're just trying to help lay out what a global roadmap has to look like.

INSKEEP: Needless to say, ultimately, what you want is a few billion extra doses of vaccine. What, if anything, is holding back sufficient manufacturing of vaccines at this point?

AYLWARD: Yeah. Steve, it's not what we want; it's what the world has to have. We have got to get this thing under control. We've got to get societies open, economies open, the global interconnected economy moving again. We've got to stop variants from emerging, which means we've got to vaccinate people everywhere. It's not a want to have; it's a have to have for everyone. What's holding us back? It's not vaccine production at this moment. One-point-five billion doses of vaccine will be made this month in the world.


AYLWARD: And Steve, we need 2 billion - less than 2 billion to get the low, low-middle-income countries over 40%. So that means if we pause the high - you know, the vaccinated places, five weeks, you're there. You know, we've got to get the right doses.

INSKEEP: Are you saying there is sufficient manufacturing capacity or that you're getting close? What are you saying about capacity?

AYLWARD: So what I'm saying, Steve, is this is a solvable problem. We're making 1.5 billion doses a month, which means between now and the end of the year, we should be able to take enough of that out of that 1.5 billion to supply the places that need it because the high-income countries - India, upper middle income, they're vaccinating at a billion doses a month, which means there's enough of a differential to cover the world. We have to get the vaccine going where it's needed.

INSKEEP: Dr. Bruce Aylward is a senior adviser at the World Health Organization and joined us via Skype. Thanks, sir.

AYLWARD: Thank you, Steve. Transcript provided by NPR, Copyright NPR.