Ensuring Equitable Access to COVID-19 Vaccines in Contexts Affected by Conflict and Insecurity - Security Council Open VTC

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17-Feb-2021 02:24:18
Secretary-General calls vaccine equity biggest moral test for global community, as Security Council considers equitable availability of doses.

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Addressing the equitable distribution of vaccines against the coronavirus in the Security Council today, United Nations Secretary-General António Guterres proposed the creation of an emergency task force by the G20 countries to prepare and help implement a global immunization plan.

“The rollout of COVID-19 vaccines is generating hope,” he told the 15-member Council’s video conferencing meeting. “At this critical moment, vaccine equity is the biggest moral test before the global community.”

Today’s meeting was organized to discuss the role of the Security Council, Member States and the United Nations in ensuring that vaccines are made available equitably in places affected by conflict and insecurity.

The Secretary-General pointed out that the coronavirus continues its merciless march across the world — upending lives, destroying economies and undermining the Sustainable Development Goals — while exacerbating all the factors that drive instability and hindering global efforts to implement Security Council resolution 2532 (2020) on conflict prevention and resolution.

Noting that progress on vaccinations has been wildly uneven and unfair, with just 10 countries having administered 75 percent of all vaccines, he emphasized that more than 130 countries have not received a single dose. “If the virus is allowed to spread like wildfire in the global South, it will mutate again and again,” he warned. “This can prolong the pandemic significantly, enabling the virus to come back to plague the global North.”

Recalling the creation of the COVAX facility — the one global tool to procure and deliver vaccines to low- and middle-income countries — he stressed the urgent need for a global vaccination plan to bring together all those with the required power, scientific expertise and production, and financial capacities.

The Group of 20 (G20) is well placed to establish an emergency task force to prepare such a plan and coordinate its implementation and financing, he continued. Such a task force should include all countries with a capacity to develop vaccines or to produce them if licenses are available, as well as the World Health Organization (WHO), relevant technical organizations and international financial institutions.

He said the task force would have the capacity to mobilize the pharmaceutical companies and key industry and logistics actors, expressing his readiness to galvanize the entire United Nations system in support of such an effort. The Group of Seven (G7) meeting later this week can create the momentum to mobilize the necessary financial resources, he added, declaring: “Together, we can ensure sufficient supply, fair distribution and vaccine confidence.”

Henrietta Fore, Executive Director of the United Nations Children’s Fund (UNICEF), said the only way out of the pandemic is to ensure access to vaccines for everyone, including those living under conflict conditions. COVID-19 has altered responses already compounded by conflict, and basic services must reach all, she said, citing examples of strategies by UNICEF and its partners for doing so. Using existing vaccination infrastructure, efforts are focused on reaching groups in need, entailing steps to engage with and build trust in communities, and help Governments recruit health workers where they are most needed. Aiming to procure 2 billion doses before the end of 2021, in addition to 2 billion doses of other vaccines, the strategies also consider conflict situations and aim to serve hard-to-reach groups, she said. As such, COVAX has set aside vaccine stocks to reach those outside national vaccination programmes, including refugees, she reported. Calling for the Council’s help, she emphasized that a global ceasefire is needed for the duration of the vaccine delivery period. “We cannot allow the fight against this one deadly disease to lose ground in the fight against others,” she stressed. “This historic effort deserves historic support.”

Seth Berkley, Chief Executive Officer of Gavi, the Vaccine Alliance, said vaccines work against poverty and conflict by giving children the same life chances, when access is equitable. Sadly, there is a correlation between conflict and underperformance in immunization, he added. Gavi-supported countries that are not suffering fragility reach 81 per cent of children with a third dose of vaccine on average, while in countries affected by conflict, that drops to 65 per cent. That is further compounded by challenges to the provision of health care in conflict and fragile settings, where access and infrastructure are disrupted or restricted when most needed, further exacerbating deprivations and inequalities, and driving displacement, he noted.

In response, Gavi’s “Fragility, Emergencies and Refugees” policy provides greater funding of health systems and flexibilities to eligible partners and countries, he continued. Broadly, the response to the challenge of today builds on Gavi’s work in countries affected by fragility and conflict, as well as its long-standing support for the stockpiles against diseases of epidemic potential, like Ebola and yellow fever, he explained. They are funded by Gavi and managed by the International Coordination Group on Vaccine Provision. However, it is not just the vaccine, he cautioned, but also the supply chain system, the bravery and professionalism of the health workforce, and of development and humanitarian actors, which is totally essential. “Vaccines don’t deliver themselves,” he pointed out.

Explaining that investing in vaccines for COVID-19 and other diseases is a fundamental pillar of global health security, he declared: “A health budget is a defence budget.” COVAX and its goal of equitable access is critical to ending the acute phase of the pandemic, and goes hand in hand with access to diagnostics, therapeutics, supply chains and health systems innovations. The “first resort” in covering all high-risk groups, irrespective of their legal status, is including them in national vaccine plans, he emphasized, asking the Security Council to reinforce that message so that available doses are distributed to ensure truly equitable access, in accordance with humanitarian principles and upholding State obligations towards populations within their territory.

Noting that COVAX has secured 2.3 billion doses in advance commitments and options for 190 economies in 2021, he said at least 1.3 billion doses are reserved but not yet fully paid for with donor funding. They are meant for 92 lower-income countries eligible for the COVAX Advance Market Commitment, which could increase to a further 1.8 billion doses that could be delivered with additional financing, he explained.

He went on to underline the fundamental importance of making vaccines available and the Security Council playing its political role in enabling supplies to move into conflict-affected settings through neutral humanitarian actors, in accordance with international law. Global health security is key to economic and human security, progress and stability, he emphasized, describing COVID-19 as the biggest stress test of the multilateral system in decades. “We must get this one right.”

Jagan Chapagain, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC), said the pandemic has laid bare fragile health systems and the need for a collective response. Expressing regret that the briefing comes just days after a new Ebola outbreak in Guinea, he said the parallels between the two — both in terms of the destructive nature of mistrust and the transformative capacity of creating trust — are profound, he added, explaining that, when communities do not understand health interventions, they will not accept them and are likely to see them as threatening. That can lead to violence, he cautioned, recalling that it occurred many times during previous Ebola outbreaks and even more during the coronavirus pandemic. “Mistrust kills,” he said, emphasizing that trust is undermined when science is not only ignored, but derided. The decision to wear masks becomes controversial and the Internet is filled with absurd rumours, he said, adding that, whereas a crisis is not the ideal time to rebuild trust, it can be done.

He went on to underline the importance of listening to and acting on what communities say. Citing an example from an Ebola outbreak in the Democratic Republic of the Congo, he said initial attempts to bury victims were met with hostility. IFRC reached out to communities and listened, he added, noting that it trained 800 volunteers to gather feedback and adapted strategies for burials and local engagement. Those steps resulted in a sharp drop in burial refusals, from 80 per cent to 8 per cent by the end of the outbreak. Similarly, mistrust has consistently undermined COVID-19 response efforts, he said, emphasizing that earning community trust remains crucial, especially in light of the historically high levels of vaccine hesitancy during the current immunization phase. “As we learned during Ebola, people trust us for our actions, they look at what we do, and they judge us for what we do not do,” he said. “They see, clearly, the current high levels of vaccine inequity and inequality; they see the unfairness, for example, in the fact that less than 1 per cent of vaccine doses globally have been administered in the 32 countries facing severe or very severe humanitarian crises.”

Fair, equitable vaccine distribution is essential to building trust and for maintaining international peace and preventing violence, he continued. Just as efforts to ensure that all countries can access vaccines, “we also need to make sure that those vaccines reach the arms of all the people who need them”. National vaccination efforts must integrate underserved, alienated or isolated communities, including those in areas not under Government control, as well as detainees, internally displaced persons and refugees, he stressed. Strong involvement in vaccination activities by IFRC and impartial local organizations can help to ensure that these “last mile” communities are not left behind, as can be seen in the countless lives saved in Afghanistan, Central African Republic and Pakistan, he said, adding that unparalleled access into “last mile” communities can just as easily channel COVID-19 inoculations, while maintaining critical routine vaccinations.

The campaign launched in January to help vaccinate 500 million people arose from that reach and from the trust of its membership at the most local level, he continued. Member States can include national Red Cross and Red Crescent societies in all phases of immunization planning and delivery to gain insight into community misconceptions and misgivings. Attention is also needed to protect health workers, he stressed, recalling the 850 documented incidents of violence against them in 2020. “We have a collective responsibility to care for those who care for us,” he said, paying tribute to workers and volunteers, while underlining that efforts to protect them must respect international humanitarian law.

In the ensuing discussion, ministers and delegates discussed how to ensure that vaccination programmes do not leave people in conflict and fragile settings behind. They also explored ways in which to overcome the main barriers to vaccine delivery in such situations, including control over some areas by armed groups, logistical challenges, funding flows and the safety of health workers. Further, Council members considered ways in which to address misinformation leading to vaccine hesitancy, while drawing lessons from past and ongoing immunization campaigns.

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Secretary-General’s Remarks
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