Tony Blair Institute: Vaccine inequity threatens global ‘Great Divide’ in 2022 – with Africa left behind

PUBLISHED: Thu, 04 Nov 2021 09:39:31 GMT
Tony Blair Institute
A health worker preparing to extract a dose of vaccine from a vial.
Photo via Flicker.

New report warns of economic impact and increased risk of regional and global instability and calls for urgent action

A new report from the Tony Blair Institute warns that Africa’s lack of Covid-19 vaccines and the inequity between Africa and richer continents and countries the emergence of a ‘Great Divide’ in 2022, with serious implications for health outcomes, economic progress and political stability, both in Africa and globally. The report, ‘Africa Without Vaccines: Inequity Sets the World On Course for a Great Divide’, warns of divergent paths for Africa and for high- and middle-income countries with ample access to vaccine supplies in 2022.

High- and middle-income countries will be able to protect large swathes of people from illness in 2022. Bolstered by substantial fiscal support, these countries are on course to safely re-engage in economic and social activity in 2022, returning to a pre-pandemic normalcy in which Covid-19 might be managed like the seasonal flu.

While African countries will also be opening up to economic and social activity in 2022, the lack of access to vaccines means Covid-19 will continue to circulate more widely, requiring new lockdowns and stricter public health measures to contain outbreaks and safeguard health systems from collapse. These measures, and restrictions on travel from countries with low vaccination coverage, will hamper Africa’s recovery, impacting the short- and long-term economic and social outlook.

This divergent recovery will impact both Africa and the global community, with increased risk of:

  • more potent new variants developing and spreading globally;
  • greater instability in Africa and increased migration from Africa;
  • greater inequality and reduced global resilience to existential threats, such as climate change and another pandemic; and
  • sluggish growth in Africa dampening the long-term global economic outlook. 

Obstacles to Accessing Vaccines: Setting Course for a Great Divide

The report sets out the obstacles to vaccine access – widening gaps between Africa’s vaccine requirements and the number of vaccines supplied; challenging production forecasts; and the development of ‘Vaccine Apartheid’ – which have led to the African continent having the lowest Covid-19 vaccination coverage rates in the world, and global vaccine inequity:

  • 55% of Europe is fully vaccinated and the region with the second lowest coverage has eight times as many fully vaccinated people as Africa.
  • Despite accounting for nearly one fifth of the global population, Africa has administered just 2.7% of total doses.
  • Of the approximately 1 bn doses pledged by the G7 in June to low- and middle-income countries over the next year, only around 150 million had been fulfilled by early October. Africa had received about 40m of those donations. The Airfinity model suggests that G7 countries could in fact have redistributed 500m doses to date.

The impact of vaccine inequity on Africa in 2022

The report outlines the likely impact of vaccine inequity on Africa in 2022:

  • Undoing health progress – In 2022 and beyond we are likely to see a resurgence of diseases the world has worked hard to eradicate. Just 12 months of Covid-19 response has already eliminated 12 years of progress in the global fight against tuberculosis, according to a study by the StopTB Partnership, with critical outreach and services set aside, resulting in a 20% drop in diagnosis and treatment worldwide. But the biggest long-running risk posed by Covid-19 is on routine immunisation drives. According to the WHO, more than one-third of countries are still reporting disruptions to immunisation services.
  • Escalating Poverty and Food Insecurity – The World Bank estimates the pandemic-related economic crisis may push as many as 11m Nigerians into poverty by 2022, signalling a poverty rate of more than 50% for its 200m people. Food insecurity is a growing concern across the continent as prices rise as a result of global shortages, oil price rises due to growing demand from the reopening of advanced economies and currency depreciations which import costs. Global food prices in August were up 33% year-on-year, with emerging markets worst affected. African governments and the global community should prepare for a surge in humanitarian crises across the continent due to a depressed economic recovery. 
  • Weak Growth – Modelling by the Economist Intelligence Unit predicts that developing economies will bear the brunt of output shortfalls because of global vaccine inequity. Countries that are unable to achieve at least 60 per cent vaccination coverage by mid-2022 will suffer $2.3 trillion in GDP losses by 2025. With around $230 billion in cumulative projected shortfalls, Sub-Saharan Africa will experience the highest losses in terms of GDP share, totalling 3% of the region’s 2022 to 2025 output forecast.
  • Increasing Debt, Declining Investment – Weak growth rates will compound negative shocks to fiscal balances and debt positions. Before the pandemic, debt taken on by many African countries was already reaching unsustainable levels. Policy measures required to respond to the pandemic have pushed even more nations into debt distress, with governments having difficulties servicing debt. Many countries in Africa will have to cut back on development-critical spending in order to continue responding to the pandemic while avoiding a loan defaults, making them even more reliant on foreign assistance.
  • Restricted Travel and Tourism – The fiscal outlook will be depressed by the continuing reduction in tourism revenues. The services sector, which had been growing rapidly and accounted for approximately 55% of Africa’s GDP in 2016, will see a slower recovery than others, largely because of continuing restrictions and hesitancy around cross-border travel.
  • A Learning Deficit –  In 2022, as the continent continues to move to control new waves of transmission through lockdowns, instead of mass vaccinations, domestic and global educational disparities will widen between the wealthy and poor. The education of millions of young Africans is at stake, as well as the future of the region.

The impact of vaccine inequity on Africa in 2022

The report warns that the consequences of such a divergent recovery will not only impact Africa, but the global community too:  

  • Risk of new variants – With Covid-19 continuing to spread among unvaccinated populations, there will be a constant risk of potentially more potent variants developing. As we have seen with the global impact of the Delta variant, new variants are a risk to vaccination efforts everywhere, threatening to undo the scientific and public-health progress of the past 18 months. It is in the interest of high-income countries to ensure the world is vaccinated as soon as possible to prevent the development of dangerous mutations.
  • Risk of instability in Africa and increased migration – Sustained health and economic insecurity in Africa could heighten domestic unrest and increase opportunities for extremism. As some states lag behind in addressing economic challenges and social frustrations arise from the pandemic, governance-related challenges from terrorist groups may increase. Several terrorist groups are already exploiting the pandemic. Instability could even drive new waves of migration.
  • Risk of greater inequality and reduced global resilience to existential threats – A Great Divide is likely to deepen gaps between wealthy and poor countries, increasing global instability, generating economic uncertainty and sowing geopolitical tensions. With this outcome, the world will be even more ill-equipped to address other pressing existential issues, such as the climate crisis or another pandemic.
  • Risk to the global economy – All these factors – from variants to growing extremism – could drive up instability in Africa, with negative consequences for the global economy, as uncertainty diminishes consumer confidence and holds back investment. The economic impact of the Great Divide will be most acutely felt in Africa, but its sluggish recovery and growing instability will dampen the long-term global economic outlook.  

The report says that there is still time to change course and avoid this ‘Great Divide’, but action must be taken immediately and both high-income countries and African governments have roles to play. It makes a number of recommendations for urgent action, including:

  1. Countries must urgently fulfil their commitment tosharing excess doses and step aside in the supply queue so COVAX can be prioritised.
  2. Countries need to remove export restrictions and other trade barriers on Covid-19 vaccines and inputs involved in their production.
  3. Travel restrictions not founded on scientific evidence need to be lifted.
  4. The G7 and G20 should endorse a comprehensive financial-assistance package for Africa and allow governments on the continent to decide how this money is best deployed.
  5. Governments of high-income countries need to scale up support for vaccine manufacturing in Africa and strengthen vertical and horizontal linkages.
  6. Countries must build up institutional strength for vaccine rollout and crisis response, including agile government systems, structures and skills.

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