It seems like a long time ago now — and a whirlwind of pandemic, and non pandemic-related events have happened since — but just over a year ago a British grandmother was the first person in the world to receive a vaccine against COVID-19.

It was a historic moment. And the lucky recipient was 90-year-old Margaret Keenan from Coventry.

The news signalled that the UK was off to a good start on delivering vaccines and getting protected against the virus that had swept the world 10 months before.  And thanks to an incredibly efficient vaccine rollout delivered by the National Health Service — one of the only areas of the UK’s pandemic response that was praised in an otherwise damning report published in October — the vast majority of eligible Brits, 81%, are double vaccinated a year on. A rollout for the booster jab, or third vaccination shot, is now rapidly taking place as well.

But throughout the year public health experts and campaigners have repeatedly warned that while wealthy countries such as the UK focus on their own populations, the COVID-19 virus will continue to spread around the world, mutating into new variants against which the available vaccines could be less effective.

In stark contrast to the approximately 90% of Brits who’ve had at least one vaccination, only 11% of the whole population of Africa have received one vaccination shot, according to the Africa Centres for Disease Control and Prevention (Africa CDC). Only 7% of people in low-income countries globally have received at least one dose of the life-saving vaccine.

The latest problems with the new very infectious Omicron variant spreading across the world are a case in point. Vaccine inequality means the pandemic is prolonged everywhere — as unprotected areas still see high rates of infection giving plenty of chances for the virus to change and become the next variant.

The extreme differences in vaccine roll-outs globally have put ending the pandemic out of sight. As Phumzile Mlambo-Ngcuka, a South African politician and former Executive Director of UN Women, wrote in the Independent on Tuesday: “Imagine if from the start of the pandemic, world leaders had found the same urgency to guarantee equitable vaccine access for the world as they have had for enacting knee-jerk measures like travel bans. Where might we be today?”

So what has the UK done in response to the issue of vaccine inequality globally? Well, let’s just say it could do a lot better. Here’s what has happened this year.

The UK Shared Surplus Doses — But Too Slowly

In February the global vaccine sharing facility COVAX started rolling out vaccines to low-income countries — prioritising protecting frontline health workers and vulnerable people — but it got off to a slow start. By the end of May, while its goal was to have distributed 170 million doses, it had only distributed 76 million. In August the facility revised down how many it would be likely to deliver by the end of this year from 2 billion to 1.425 billion.

The facility was set up by the World Health Organisation (WHO), Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness (CEPI), and it pools donations of surplus vaccines shared by countries that ordered more doses than their population needs. It can also order its own doses and is funded by governments, philanthropic organisations, and business donations to do so — with the UK contributing £250 million from its aid budget to the organisation in January 2021.

In a speech, Prime Minister Boris Johnson pledged in February that the UK would share “the majority of any future surplus vaccines” to low-income countries.

The UK, which has a population of 66 million, has by now ordered a total of 650 million doses, almost 10 times its population, of eight different vaccines. So there is enough for every adult to get three doses with plenty spare.

Back in February it had already ordered 400 million, so there were still excess doses then too.

If the UK and other wealthy countries had shared more of their excess doses straight away that would have helped boost the COVAX scheme. However, it wasn’t until the end of July, over four months later, that the UK government finally shipped any surplus doses — 5 million were sent to COVAX and 4 million were sent directly to a selection of countries.

The shipment was the first batch of 100 million surplus doses that the UK promised to share, with 30 million due before the end of 2021, and the remainder sent by June 2022.

As of Dec. 6, 2021, 26.2 million Oxford-AstraZeneca doses had been delivered to COVAX by the UK, according to the House of Commons library. According to a government announcement on Oct. 31, the donation scheme was on track to hit 30.6 million shared by the end of this year.

The UK has contributed financially to COVAX as well as shared some doses — and that’s a good thing — but campaigners including Global Citizen have called on all high-income countries to share more and act faster. Global Citizen is calling on G20 countries to together share 2 billion doses by the end of 2021, rather than the 1 billion the group plans to share by next June.

Marie Rumsby, Global Citizen’s UK Country Director, said in July when the UK sent its first batch: “It’s great that they have started sharing vaccines now — and those 9 million will make a huge difference to those who receive them — but we need more urgency.”

“We need one billion vaccine doses shared by G7 countries by September, and two billion by the end of the year,” Rumsby added. “So 9 million is just a drop in the ocean."

Worryingly, an analysis in the Telegraph has found that even with the comparably lower doses that have been pledged, the UK will need to double its rate of donation each month in 2022 to actually hit its own targets.

The UK Has Thrown Away Excess Doses

The consequences of being slow to act on sharing vaccines has had another troubling outcome — wasted doses.

A report by the Independent on Nov. 15 revealed, using Freedom of Information requests, that over 600,000 AstraZeneca doses in the UK had been thrown away because they had expired.

That’s because of a change in policy that took place in May that the AstraZeneca vaccine would no longer be offered to younger people because of concerns about very rare blood-clotting. But instead of donating the excess doses on time to COVAX or directly to low-income countries, the doses were wasted.

Victorine de Milliano, a UK policy advisor for the health nonprofit Medicins Sans Frontières, told the newspaper: “In a time when vaccines and other COVID-19 medical tools are scarce and some countries have inoculated less than 1% of their population, this level of wastage is painful to see."

An analysis by the NGO Oxfam published in September suggests the figure might be the tip of the iceberg. They predict that, together, the G7 countries (seven of the largest economies in the world) will waste up to 100 million vaccine doses due to expiry by the end of this year. 

The UK Blocked an IP Waiver for COVID-19 Vaccines 

Another solution that has been put forward to help get more vaccines more quickly to countries that need them, has been loosening patent restrictions so that countries can start making vaccines themselves. That would mean the World Trade Organisation (WTO) agreeing to waive the patents on the COVID-19 vaccine formula, allowing other organisations and companies to use the formula to produce vaccines.

In order for this to happen the WTO would have to waive a piece of law called the TRIPS agreement. It sounds complicated but don’t worry — Global Citizen has explained the details of it here.

The pharmaceutical companies that first launched these vaccines want to protect their intellectual property — so there has been resistance to these suggestions and a debate over how such a process could take place. 

The big plus side of a waiver, however, would be that countries could produce their own vaccines and not have to rely on a slow drip of donations to get their population protected, something that campaigners, including Global Citizen, advocate would be the fairest way to go. 

It’s not just health advocates and anti-poverty campaigners who support a TRIPS waiver. Countries including South Africa, India,the US, and France have all argued that intellectual property rights on COVID-19 vaccines should be waived to boost global manufacture.

What about the UK though? Sadly, Britain is not on board and it needs to be for this to happen. British trade officials have argued the intellectual property system has “played a positive role” in enabling the country’s response to the pandemic and, along with countries including Norway, Germany, and Switzerland, the UK has blocked proposals for a TRIPS waiver at WTO meetings.

If the UK was given “promoting vaccine equity and ending the pandemic” as a school project for 2021, we’d give a “D”. Not quite a fail, but not a passable C grade either. Let’s aim for a higher grade and a lot more effort in 2022. Join us in taking action here to help urge world leaders to take the action needed to end the pandemic for everyone, everywhere.

Advocacy

Defeat Poverty

What Has the UK Done to Support Vaccine Equity in 2021? Not Enough.

By Helen Lock