Inequality in vaccine coverage between low-income countries and high income countries is extreme. Estimates show that between 1.6 and 2 million people die from vaccine-preventable diseases every year around the world, with the vast majority of these deaths occurring in Africa and low-income countries. With the world already fissured by deep-rooted vaccine inequality, there is now concern that the funding model of the WHO might have the world in a state of unreadiness for Covid-19.
Since the beginning of the pandemic in December 2019, over fifty non-governmental organisations (NGOs) have written letters to the WHO executive board stating that international evaluation panels that appraised Covid-19 found out that WHO has inadequate and irregular financing which is in need of modification.
Part of the letter submitted to the board notes that frequent forewarnings to reinforce barricades against pandemics had been disregarded, “leaving the world dreadfully ill-prepared almost two years ago for the tsunami of suffering to come……The funding problems of the WHO are not new, but rather have been playing out over decades. They are symptomatic of an overall failure to invest sufficiently in global public health. This must stop now.”
The health body has always been in a financial quagmire. It is well documented that WHO is not well furnished with funds and is monetarily restricted. Sixteen percent of all of WHO’s finances come from governments’ membership dues. The rest of the health agency’s finances derive from voluntary contributions, which makes the health body vulnerable to being influenced and arm twisted by rich nations.
A medical practitioner who spoke to this publication on condition of anonymity indicated that until and unless WHO has a robust and sustainable financing model, the health agency will remain subject to political influence of its donors, especially America which is the biggest funder for the WHO.
“The reason former president Donald Trump announced the withdrawal of the United States of America from WHO was because they suspected that the health agency was colluding with the Chinese government since the beginning of the pandemic,” he says. This move was reversed by President Joe Biden after he defeated the former.
Although the COVAX facility has a well-intended objective to ensure fair and equitable access to vaccines for all 190 participating economies using an allocation framework formulated by WHO, the initiative is struggling to meet its targets. This has affected smaller nations such as Botswana and many developing countries.
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and the World Health Organisation. But approximately two years into the pandemic, it has not succeeded in achieving its intended target because of over-dependence on a few manufacturers and fund shortage.
The global vaccine distribution programme is in itself heavily flawed. It has seen just 16 percent of the world’s population locking up 60 percent of the global vaccine supply. Beset with delays and reservations over its ability to deliver on its targets, the COVAX initiative once touted as the “only truly global solution” to the raging Covid-19 pandemic has found itself significantly in short of funds and hindered by vaccine hoarding in high-income countries.
Whilst regional organs such as the African Union (AU) have reiterated the need for a fast and even-handed distribution of Covid-19 vaccines, there are still major hindrances as some countries are using their financial muscle to secure hundreds of millions of doses at the expense of poor nations.
A medical practitioner who spoke to this publication indicated that already there is increasing global divide which is widening between rich nations that are way ahead in vaccinating their populations against Covid-19 and poor countries that are experiencing a third wave and also running out of vaccines.
Although the WHO Director General Dr Tedros Adhanom Ghebreyesus says there is need to turn the tide quickly to ensure that poorer nations get enough vaccines for their populations, the situation on the ground seems to say otherwise.
Although some countries have fully vaccinated a large amount of their population, many others especially those which rely on the COVAX facility have barely reached the halfway mark and are relying on donations from China and other western countries.
In November 2021, WHO member states, including Botswana, came up with a set of recommendations for sustainable financing. Some of the recommendations include the increase in assessed contributions from member states to 50 per cent of the base budget by 2029. If it becomes policy, this would double most of the members’ contributions. Among other things, experts have been calling for the betterment in transparency with regards to budget setting.
While the phrase “No one is safe until everyone is safe” has become a motto for global health institutions such as WHO, there is need for a funding formula that will sustain the health agency’s capacities to fight this pandemic and future health disasters.
