Swelling numbers 

Although Asia-Pacific countries host the vast majority of more than 80 million forcibly displaced people around the globe, they have benefited from only a fraction of the world’s COVID-19 innoculations, according to the agency. 

Concern over the situation in the region continues to rise as the number of cases has surged to the largest increase globally.  

UNHCR stressed that the pandemic will only be defeated when vaccinations are available everywhere “on an equitable basis”. 

Struggling with surges 

Over this period, some 38 million COVID-19 cases have been recorded along with more than half a million deaths, devastating many already fragile health systems in the region.  

“The lack of hospital beds, oxygen supplies, limited intensive care unit (ICU) capacities and scarce health facilities and services have worsened outcomes for those infected with COVID-19, particularly in India and Nepal”, said Mr. Mahecic. 

Moreover, the highly infectious variant of the virus which first emerged in India “threatens to rapidly spread in the sub-region”, including among refugee populations, he added. 

Particularly vulnerable 

Amidst overcrowded settings, limited water and inadequate sanitation facilities, refugees remain especially at risk of COVID-19. 

In Cox’s Bazar, Bangladesh, where almost 900,000 Rohingya refugees are living in the single largest and most densely populated cluster of refugee camps in the world, the number of cases has jumped considerably in the last two months, UNHCR emphasized.  

“As of 31 May, there have been over 1,188 cases confirmed among the refugee population, with more than half of these cases recorded in May alone”, the agency’s spokesperson told journalists. 

“We have also seen a worrying increase in the number of COVID-19 cases among refugees and asylum-seekers in Nepal, Iran, Pakistan, Thailand, Malaysia and Indonesia”, he said.  

Shots on the move 

While efforts are underway to mitigate the spread of the coronavirus, preventive measures must be complemented with intensified vaccinations. 

Although some refugees, including in Nepal, have received their first jab with COVAX-provided supplies, not a single vaccine has been administered to Rohingya refugees in Bangladesh. 

The scarcity of supplies in the country means that some of the world’s most vulnerable people remain susceptible to the virus. 

“UNHCR is adding its voice to the calls for countries with surplus doses to donate to COVAX, and for manufacturers to boost supplies to the COVAX facility”, said Mr. Mahecic. 

Included in its regular budget, UNHCR’s total financial requirements for COVID include $455 million in supplementary needs and $469 million in COVID-related activities.  

To date, including projected contributions, UNHCR has received $252.8 million or only 27 per cent of these requirements.

“When a woman has lost a lot of blood during childbirth and may need to be transferred to a bigger medical facility, she first needs to be stabilized where she is before being driven out of that place. Timely delivery of blood can be lifesaving. A drone can be sent to deliver the blood so that the patient is stabilized,” says Lorato Mokganya, Chief Health Officer in the Ministry of Health and Wellness. 

In an effort to curb the country’s preventable maternal deaths and overcome geographical barriers this innovative initiative will revolutionize the delivery of essential medical supplies and services across Botswana.   

“Timeliness in attending to women who experience pregnancy and childbirth-related complications is paramount, especially in remote and hard-to-reach areas,” says Dimane Mpoeleng, Computer Science Lecturer at the Botswana International University of Science and Technology (BIUST). 

The leading causes of maternal deaths in Botswana are excessive bleeding, complications after abortion and hypertensive disorders during pregnancy.  

However, the last-mile delivery of lifesaving medical products and supplies can be challenging in this large and sparsely populated country with long distances between lower and higher-level facilities. This is heightened in hard-to-reach places where there may be a shortage of vehicles, inaccessible roads, and inefficient supply chain systems.   

Drones for Health 

In May, the university, the government and the  United Nations Population Fund (UNFPA) joined forces to launch Botswana’s first drone delivery project, called “Drones For Health. With this initiative, Botswana also became the first country in southern Africa and third on the African continent, after Ghana and Rwanda, to pilot drone technology for health care support. 

Drones are expected to drastically reduce the delivery time from hours to minutes, improving the delivery of obstetric emergency supplies and thus saving more lives. 

Beatrice Mutali, UNFPA Botswana Country Director, believes the project is a game-changer, which will not only improve the maternal health situation in Botswana, but also transform the entire health system for the country. 

“At UNFPA, we envision a world where no woman dies while giving a life, and this initiative promises to alleviate the problem of maternal deaths in Botswana,” Ms. Mutali says, stressing that innovation is an indispensable engine to bring transformative change for women, girls, and young people.  

For example, women at rural facilities such as Mogapi Health Centre, which serves a population of over 3,000, will benefit immensely from the speed and efficiency that the newly launched drone technology will bring to the health sector.  

According to Dr. Mpoeleng, the project leader of Drones For Health, each battery-powered flying aerodrone has a delivery distance of 100 kilometers and can carry up to 2 kilogrammes of cargo.  

Four villages were chosen for the pilot project. The drones will be automatically programmed for takeoff and landing and can carry back another load of supplies. Community members in the pilot areas supported the project by building all drone landing pads at the designated health posts. 

In 2017, Botswana set a national maternal mortality ratio target of 71 deaths per 100,000 live births by 2025 reducing to 54 deaths by 2030 in order to achieve Sustainable Development Goal (SDG) 3. If the current maternal death trend continues, Botswana is likely not to meet the SDG target. 

Speaking at the launch, the Minister of Health and Wellness, Dr. Edwin Gorataone Dikoloti said, “The need to invest in innovative options to bridge the long distances, reduce current transportation costs, overcome road infrastructure challenges, and improve timely availability of essential emergency obstetric care drugs, commodities and supplies is therefore urgent.” 

A 2017 report on maternal mortality rate shows that a significant proportion of maternal deaths in Botswana are preventable.  

“Now more than ever, innovation is critical to achieving the ‘leaving no one behind’ goal. And with innovation come powerful partnerships, hence our work with the university and ministries. We believe that today’s problems and changing context call for harnessing innovations that can provide breakthrough solutions that deliver sexual and reproductive health for all,” UNFPA’s Country Director says. 

“We’re holding the door open for pharmaceutical companies that have become household names, although too few households have benefited from the life-saving tools they have developed”, he said.  

“They control the IP that can save lives today, end this pandemic soon and prevent future epidemics from spiraling out of control and undermining health, economies and national security”. 

Vaccine inequity unacceptable

C-TAP was established a year ago by the President of Costa Rica, Carlos Alvarado Quesada, and more than 40 Heads of State, together with WHO. 

President Alvarado Quesado, who also addressed journalists, underlined the need to protect everyone, everywhere. 

“It is not acceptable that more than 50 per cent of the globally available vaccines were used in only five countries that account for 50 per cent of global GDP. Shamefully, low-income countries have received only 0.3 [per cent] of the world’s doses”, he said. 

Tedros explained that contributing to C-TAP  will allow qualified producers across the world to manufacture products against COVID-19.  

If fully functional, it could lead to increased supply for countries and the global vaccine solidarity initiative, COVAX. 

Study into COVID-19 origins ‘poisoned by politics’ 

Investigations into the origins of COVID-19 are being “poisoned by politics”, a senior WHO official said on Friday. 

Dr. Michael Ryan, Executive Director, was responding to a journalist’s question regarding a lack of progress on the launch of a second phase following an international expert mission to China in January. 

Preliminary results, announced in February, found the novel coronavirus was “extremely unlikely” to have come from a lab, but perhaps jumped from animals to humans. 

Dr. Ryan noted that there have been increased media reports about the investigation in recent days “with terribly little actual news, or evidence, or new material”, which he found disturbing. 

“We would, though, like for everyone out there to separate, if they can, the politics of this issue from the science. This whole process is being poisoned by politics”, he said. 

Dr. Ryan added that countries and entities are free to pursue their own theories of origin. 

“Putting WHO in a position like it has been put in is very unfair to the science we are trying to carry out. And it puts us as an organization, frankly in an impossible position to deliver the answers that the world wants”, he said. 

“So, we would ask that we separate the science from the politics and let us get on with finding the answers that we need in a proper, positive atmosphere where we can find the science to drive the solutions, through a process that is driven by solidarity, as Dr. Tedros always says”. 

Scale-up production 

“It is absolutely essential to double the production of vaccines, and there are different mechanisms that are needed for that…but we absolutely must have an equitable distribution, and we are far from having it”, he said. 

“We have seen vaccine nationalism, hoarding of vaccines, many countries buying three or four times the volume of their population. And on the other hand, we see enormous difficulty in supplying vaccines to the Global South. And this is a tragedy that we need to avoid at all cost”. 

Earlier this week, the head of the World Health Organization (WHO) described the ongoing vaccine crisis as “a scandalous inequity”.  When asked his opinion about the situation, the Secretary-General responded, “it’s exactly that”. 

Risk of inequity 

Just 10 countries have received 75 per cent of all vaccines administered so far, he said, while 0.3 per cent have gone to lower-income nations, with the African continent receiving just one per cent. 

The Secretary-General highlighted the risk inequity poses in the face of a virus that spreads and mutates, noting “this is a race against time”.

He warned that either vaccination becomes much quicker and more equitable, and thus able to prevent “a possible dramatic mutation”  that is immune to vaccines, or countries which have inoculated their populations “might discover that those vaccines will serve no purpose because the mutations in the Global South will undermine the vaccination campaign in the Global North.” 

Fully support COVAX 

At the recent G20 Health Summit, vaccine producers committed to delivering one billion doses to poorer countries. While welcoming the development, the Secretary-General said it was far from enough. 

Mr. Guterres stressed the need to fully fund and supply the global vaccine equity initiative, COVAX.  He noted that one of its main manufacturers, the Serum Institute of India, has had to cut back supply due to the surge in cases in the country, while deliveries from other contractors have been later than expected. 

He urged countries to channel their excess vaccines through COVAX, “instead of a geo-strategic competition, with several powerful countries giving vaccines to their friends, or trying to compete with each other to see who gains more influence, thanks to the vaccines”. 

The Secretary-General also reiterated his proposal for a G20-led Task Force that would work with pharmaceutical companies, and other stakeholders, on providing vaccines for all people, everywhere.

The UN chief recognized the many lives that have been saved: “To have you leading this meeting is a guarantee of success because what our partnership has always represented is indeed the very symbol of the values we represent”. 

Vaccine equity to prevent ‘further havoc’ 

Having delivered safe and effective vaccines in record time, science has shone a light for some parts of the world. 

However, despite the World Health Organization’s (WHO) authorization for 13 vaccines and the “incredible success” of rollouts in more than 170 countries, Mr. Guterres bemoaned “a large and growing vaccine gap between rich and poor countries”. 

“Just ten countries have administered more than 75 per cent of all vaccine doses. In poorer countries, even health workers and people with underlying conditions cannot access them”, he said, adding, “this is not only unjust, it’s self-defeating and dangerous – to everyone”. 

Fast, equitable vaccination is the only way “to prevent new and more dangerous variants from emerging and wreaking further havoc”, in rich and poor countries alike, said Mr. Guterres. 

Global vaccination plan 

He said a global vaccination plan was needed, beginning with a G20 Task Force comprised of countries with vaccine production and manufacturing capacities, the WHO and Access to COVID-19 Tools (ACT) partners, as well as international financial institutions.  

“I am ready to mobilize the entire United Nations System to support this effort, but we need political will to move forward”, he said. 

To this end, Mr. Guterres highlighted that the private sector could leverage its influence and expertise, use its communication channels to share accurate information and donate its service and resources, to encourage innoculation. 

While this sector has been “central to every breakthrough” throughout the pandemic, he reminded that it achieved this by collaborating with countries, communities and the public sectors. 

“By working together, we can vaccinate the world, end the pandemic, and kick-start a strong recovery”, the Secretary-General concluded. 

Surge in South Asia threatens COVAX initiative  

In a further development, WHO, GAVI the vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) issued a joint statement warning against “patchy achievements made so far”. 

While cases of COVID-19 are declining in some countries, South Asia is suffering a traumatic surge. And because vaccine access is important to stem the tide, “we must focus on ensuring countries who have not benefitted from these life-saving tools do so now, and with urgency”, the statement said. 

Although COVAX, the global mechanism for equitable access to COVID-19 vaccines, has proven itself time and again, the harrowing surge in India has severely impacted its supply to the point that by the end of June it will face a 190-million-dose shortfall. 

Up against ‘catastrophic’ consequences 

Although more vaccine doses will be available later this year, the statement said, “if we do not address the current, urgent shortfall the consequences could be catastrophic”. 

At the World Health Assembly last Friday, governments recognized the political and financial urgency of supporting COVAX with doses and dollars.  

“It is now imperative…to secure full funding for COVAX and more vaccines – right now – for lower income countries at the Advance Market Commitment Summit on 2 June”, read the statement. 

Ambitious solutions 

For COVAX to deliver on the promise of global equitable access, the partners called for the immediate funding of the Gavi COVAX Advance Market Commitment (AMC), the mechanism that allows COVAX to provide doses to lower income economies; sharing of doses; and freeing up of supply chains by removing trade barriers, export control measures, and other restrictive barriers. 

“Now more than ever, at the peak of the pandemic, we need ambitious, global solutions. When it comes to worldwide vaccine distribution, COVAX is the only initiative capable of rising to the challenge of this moment”, the statement spelled out. 

While understandable that some countries wish to inoculate all their citizens, by donating vaccines to COVAX alongside domestic vaccination programmes, at-risk populations globally can be protected, which is “instrumental to ending the acute phase of the pandemic, curbing the rise and threat of variants, and accelerating a return to normality”. 

Since COVAX was established in mid-2020, it has had the support and resources of 192 of the world’s economies, enabling it to deliver an unprecedented global rollout.  

“It’s time to finish the job”, the statement concluded.