COVID-19 Virtual Press conference transcript - 7 October 2021
Overview
00:00:04
MH Hello, everybody. This is Margaret Harris in Geneva, welcoming you today, Thursday October 10th, to this week's WHO global press briefing on COVID-19, focusing today on the strategy needed to vaccinate the world against this disease. This is a very special event as we have with us today Mr Antonio Guterres, the United Nations Secretary-General, who will, with our WHO Director-General, Dr Tedros Adhanom Ghebreyesus, outline what we need to do to get the world vaccinated against COVID-19 by the middle of 2022.
This is a big moment and this is a big topic so I will ask you all to keep your questions to COVID-19, focusing on these really important issues we need to discuss today. We also have in the room and online our usual experts, Dr Mike Ryan, Executive Director, World Health Emergencies Programme, Dr Maria Van Kerkhove, Technical Lead for COVID-19, Dr Bruce Aylward, who is the Lead for the Act Accelerator, Dr Kate O'Brien, Director of Immunisation, Vaccines and Biologicals, and Ms Tanya Czeneski, who is the Technical Lead for the Vaccine Strategy. Dr Soumya Swaminathan will be joining us as well.
As usual our interpreters will be providing simultaneous interpretation in the six official UN languages plus Hindi and Portuguese and I thank you all in advance for that. Now without further ado I will hand over to Dr Tedros for his opening remarks. Dr Tedros, you have the floor.
00:01:51
TAG Thank you. Thank you, Margaret. Dear Secretary-General, good morning, good afternoon and good evening. At this press conference almost exactly one year ago I said that the world was eagerly anticipating the results of trials of vaccines against COVID-19. I also said that once we had a vaccine we must use it effectively by making sure it's available to all countries equitably.
The development and approval of vaccines in record time took us to the summit of scientific achievement. Now we stand on the precipice of failure if we don't make the benefits of science available to all people in all countries right now.
More than 6.4 billion vaccine doses have now been administered globally and almost one-third of the world's population is fully vaccinated against COVID-19 but those numbers mask a horrifying inequity.
High and upper-middle-income countries have used 75% of all vaccines produced so far. Low-income countries have received less than 0.5% of the world's vaccines. In Africa less than 5% of people are fully vaccinated.
00:03:27
As you know, earlier this year WHO set a target for all countries to vaccinate 10% of their populations by the end of September. 56 countries didn't make it through no fault of their own.
Today WHO is launching the strategy to achieve global COVID-19 vaccination by mid 2022. The strategy outlines the road we must all take together to achieve our targets of vaccinating 40% of the population of every country by the end of this year and 70% by the middle of next year.
Achieving these targets will require at least 11 billion vaccine doses. This is not a supply problem. It is an allocation problem. By the end of September almost 6.5 billion doses had already been administered worldwide.
With global vaccine production now at nearly 1.5 billion doses per month there is enough supply to achieve our targets provided they're distributed equitably.
Contracts are in place for the remaining five billion doses but it's critical that those doses go where they are needed most with priority given to older people, health workers and other at-risk groups.
00:05:03
We can only achieve our targets if the countries and companies that control vaccine supply put contracts for COVAX and the African Vaccine Acquisition Trust, AVAT, first for deliveries and donated doses.
We have the tools to bring the pandemic under control if we use them properly and share them fairly and we must remember that vaccines are a powerful tool but not the only one. All countries must continue with a comprehensive risk-based approach of public health and social measures in combination with equitable vaccination.
Vaccine equity will accelerate the end of the pandemic. Achieving WHO's vaccine equity targets will substantially increase population immunity globally, protect health systems, enable economies to fully restart and reduce the risk of new variants emerging.
00:06:03
Today I'm delighted to be joined by the United Nations Secretary-General, Antonio Guterres, who, like us, has long called for global vaccine equity. Secretary-General, thank you for your support and advocacy throughout the pandemic and also your special focus on vaccine equity. Welcome and you have the floor.
AG Thank you very much, dear Tedros. Ladies and gentlemen of the press, vaccine inequity is the best ally of the COVID-19 pandemic. It's allowing variants to develop and run wild, condemning the world to millions more deaths and prolonging an economic slowdown that could cost trillions of dollars.
I've long been pushing for a global vaccination plan to reach everyone everywhere sooner rather than later, a plan that I suggest should be implemented by an emergency task force made up of present and potential vaccine production countries, with [unclear] organisation, COVAX partners, international financial institutions working with the pharmaceutical companies to guarantee the production of enough doses and their equitable distribution.
Unfortunately I have not been heard. Yet instead of global co-ordinated action to get vaccines where they are needed most we have seen vaccine hoarding, vaccine nationalism and vaccine diplomacy.
00:07:35
We of course welcome efforts by countries to get vaccines to more places but the plethora of global, regional and bilateral initiatives has failed to deliver. It has not got us anywhere close to the first benchmark of 10% vaccination in all countries by the end of September, as Dr Tedros just said. This even though the number of doses required comes to less than one week of global manufacturing output.
That is why I'm very pleased to join Dr Tedros today to launch the global COVID-19 vaccination strategy. This is a costed, co-ordinated and credible path out of the COVID-19 pandemic for everyone, everywhere.
This detailed plan of action drawn up by the World Health Organization is designed vaccines, as was said, into the arms of 40% of people in all countries by the end of this year and 70% by the middle of 2022.
It is based on a thorough scientific analysis of the evolving pandemic, the effectiveness of vaccines, the cost of procuring and delivering them and global demand and supply.
00:08:45
Through sharing, swaps, technological transfers and other priority actions it is possible to reduce deaths and minimise suffering, prevent health systems from being overwhelmed, resume social and economic activities and reduce the risk of dangerous new variants.
It is up to member states to do their part, to come together, doing everything that is needed for this strategy to succeed and the entire United Nations system is mobilised around supporting governments to end this pandemic, from health and humanitarian workers to logistics and operational experts and communications specialists, through our verified campaign to fight the plague of vaccine misinformation.
With vaccine production now at nearly 1.5 billion doses per month we can reach 40% of people in all countries by year's end if we can mobilise some $8 billion to ensure their distribution is equitable.
Because crucially the success of this plan requires equitable distribution and without a co-ordinated, equitable approach a reduction of cases in any one country will not be sustained over time.
00:10:02
For everyone's sake we must urgently bring all countries to a high level of vaccination coverage. G20 countries have frequently spoken of their desire to get the world vaccinated. Their meeting later this month will be an opportunity to deliver.
I urge all global stakeholders to step up, mobilise their resources and turn this strategy into a reality. I wish WHO the best success in all the efforts it has been making to ensure that we are able to defeat the COVID-19 pandemic.
Thank you very much, Dr Tedros. Thank you very much, ladies and gentlemen of the press.
TAG Thank you. Thank you so much, Secretary-General, for your leadership and, as you said, this plan can only succeed with everyone's co-operation. We call on all countries to update their national COVID-19 vaccination targets and plans, to guide manufacturing investment and vaccine distribution.
We call on countries with high vaccine coverage to swap delivery schedules with COVAX and AVAT and to fulfil their dose-sharing pledges immediately. We call on vaccine-producing countries to allow free cross-border flow of finished vaccines and raw materials and to enable sharing of know-how, technology and licences.
00:11:34
We call on vaccine manufacturers to prioritise and fulfil contracts with COVAX and AVAT as a matter of urgency, to be more transparent on what's going where and to share know-how and non-exclusive licences to enable all regions to increase manufacturing capacity.
We call on civil society, community organisations and the private sector to continue to advocate locally, nationally and globally for equitable access not just to vaccines but also to tests and treatments.
We call on all countries to ensure they have the capacities in place to use all doses as rapidly and efficiently as possible. And we call on global and regional multilateral development banks to support countries to more rapidly access the capital they need to fund vaccine delivery programmes.
Finally although equitable distribution of vaccines will help to end the pandemic its effects will continue to be felt for many years, especially for the people who have been infected and will continue to suffer from the effects of post-COVID-19 condition, also known as long COVID.
00:12:59
Yesterday after a global consultation with patients and experts WHO published a clinical case definition for post-COVID-19 condition. The definition says that post-COVID-19 condition usually occurs three months from the onset of COVID-19 with symptoms that last for at least two months and which cannot be explained by an alternative diagnosis.
Some patients have reported symptoms of post-COVID-19 condition for much longer than two months. Common symptoms include fatigue, shortness of breath, cognitive dysfunction and others that have an impact on everyday functioning.
This standardised definition will help clinicians to identify patients more easily and provide them the appropriate care and is crucial for advancing recognition and research. WHO encourages all national authorities, policymakers and clinicians to adopt this definition. Margaret, back to you.
00:14:11
MH Thank you, Dr Tedros and Mr Secretary-General. Now I'll open the floor for questions and, as I said, this is really about the strategy, this is about COVID so I will ask you to confine your questions to those topics.
Also the Secretary-General has got limited time so we will send the questions to him first. We've already got some people who've indicated that they have questions for the Secretary-General and the first one is Sherwin Brice-Peace from the South African Broadcasting Corporation. Can you unmute yourself, Sherwin, and ask your question.
SH Thanks very much. Can you hear me?
MH Very well. Please go ahead.
SH Thank you. Dr Tedros, Secretary-General, in October 2020 the global death toll was around 1.3 million, the month at which South Africa and India presented their proposal for a TRIPS IP waiver at the World Trade Organization.
A year later that death toll is exceeding five million. Amnesty International says vaccine pharma companies are fuelling an unprecedented human rights crisis through their refusal to waive intellectual property rights and share vaccine technology.
00:15:25
At what point will officials like the Director-General, like the Secretary-General be able to say pharmaceutical companies and countries blocking or stalling efforts towards a waiver are now directly responsible for continued deaths?
Because there's a strong case to be made that it's no longer COVID-19 that's killing people but a lack of access to these life-saving immunisations.
AG This is the most tragic [?], that unfortunately to fight the COVID-19 pandemic leadership and power are not aligned. WHO, the whole UN system has shown leadership but we have no power. We have no power to determine the things that you have just mentioned.
We have no power to force companies to license or to make countries accept that the TRIPS will not apply. We cannot force countries to organise their vaccination programmes in order to take into account also the vaccination programmes of other countries.
00:16:35
The power is in the countries that produce vaccines or mass-produce them and in the companies and that is why I've been saying since the beginning that they need to come together and to make sure that there is a vaccination plan for everybody everywhere.
In the absence of that effort by those that have power WHO and UN, showing leadership, are presenting a strategy which would allow us to vaccinate 40% of people everywhere by the end of this year and 70% by June next year.
If those that were not able to come together to assume command with their power, to make equitable distribution of vaccines... I hope that they will be able to come together to take the steps that are necessary for this strategy to be effectively implemented.
It is clear for me that this is a case in which the well-being of humankind and the dramatic situation of the global economy would require not business as usual but exceptional rules, exceptional norms and exceptional measures in order to be able to defeat COVID.
Each day COVID goes on people are dying and economies are not able to recover and there is a dramatic increase of suffering all over the world.
00:18:17
MH Thank you, Mr Secretary-General. Dr Tedros will add.
TAG Thank you so much. I agree with what the Secretary-General says and I would like to add a bit. As you know, the TRIPS waiver was meant to be used during emergency situations like this one.
As everybody also knows, this pandemic is unprecedented. You can't just call it an emergency. This is a serious and unprecedented condition that happened more than 100 years since the 1918 flu pandemic.
So the question is, if we cannot use it now during this unprecedented situation when do we use the TRIPS waiver or the IP, the intellectual property waiver? You can even ask, why do we even have this IP waiver in the provisions in the first place if we're not going to use it in such conditions?
00:19:40
I think manufacturers and governments should really ask themselves this question. As Secretary-General said, we cannot force manufacturers and countries but we can challenge and pose these questions, to check for themselves.
In our discussions with the manufacturing industries and some governments who don't support the IP waiver they tell us that even if IP is waived it wouldn't help. Our response is, instead of saying it wouldn't help why don't you try it, why do you protect it if it doesn't help so let's waive it and try.
The excuse that comes with this is that it cannot work without technology transfer even if the IP is waived. But as you know, naturally what happens is when IP is waived since the knowledge is in the minds of people those who know or have the knowledge could migrate to help others who can produce those vaccines.
When it's legalised people would be encouraged to migrate to apply the same thing in other places. Or not full migration but they can work part-time so they can support in as many places as possible so the vaccine could be produced in as many places as possible so that increased production could bring equity.
Everybody knows this but those who know the technology would still stay with those who own the technology because it's illegal to go and work for others and transfer technology illegally.
00:21:52
But I think going into details of this argument may not even help. The issue is the situation we're in is unprecedented and this IP waiver is meant for such conditions and we have to use everything at hand, all means at hand to fight this pandemic.
So still the UN at large and WHO support all means including IP waivers to increase local production of vaccines so there is equitable distribution of vaccines. When we say this it's not because we have problems with the private sector. We support the private sector.
We appreciate the private sector actually for developing these vaccines in record time and incentives should be given to the private sector. These incentives can be provided when IP waiver is done from governments who can provide incentives.
But at the same time the IP waiver could be for a limited period of time, not more than two to three years and for select products. It could be vaccines and maybe specific to a couple or three vaccines in order to prevent any precedents that may affect the private sector for the long term if that's the fear.
00:23:38
The IP waiver could be controlled so it's possible and I fully agree with Secretary-General but we cannot force anyone. But we believe that governments and manufacturers have the obligation to really co-operate because when they co-operate it will help economically, the world will open up because it will help us to end the pandemic. And it's also morally the right thing to do. Thank you so much.
MH Thank you, Dr Tedros and Mr Guterres. The next question is from Pamela Falk from CNBC. Pamela, please unmute yourself and ask your question.
PA Dr Harris, thank you very much for the questions. Pamela Falk from CBS News, based at the United Nations. My question is for the Secretary-General. You said you want to mobilise $8 billion and both you and Dr Tedros say the rich countries and the private sector have not done enough.
Many countries say they have given what they can and COVAX has had quite a bit of success. The malaria vaccine - congratulations - moved forward with a lot of private foundation money and individuals'.
00:25:13
If you can't get these IP waivers or countries to give as much as you want what is your fear for variants or the next major pandemic? What is your worst-case scenario? Thank you so much.
AG We need to avoid that worst-case scenario but one thing is clear. If we let the virus spread like wildfire in the global south, in the African continent and other parts of the global south we know that variants will emerge and we know that there is a risk that those variants might become resistant to vaccines, which means we have the risk if we let this lack of equity go on and we allow the virus to go on spreading like wildfire in the global south.
There is the risk that one day - and that day could be very soon - there will be not the delta, it will be another variant that would be able to resist vaccines and all the vaccination efforts made in developed countries who vaccinated the whole of their populations one, two or three times will fall apart and these people will not be protected.
00:26:34
So not to have equitable distribution of vaccines is not only a question of being immoral. It is also a question of being stupid.
MH Thank you, Mr Secretary-General, and apologies to Pamela for getting your outlet... That was Pamela from CBS. The next question we have is from Belisa Godenho from W Media, Portugal. Belisa, please unmute yourself and ask your question. I believe it's for the Secretary-General.
BE Thank you. Belisa Godenho from W Magazine Media in Portugal. I have a question for the Secretary-General of the United Nations, Antonio Guterres. I would like to know if, in his opinion, climate change could be related to the COVID pandemic and if for a more effective fight against COVID at the global level countries should not think about health in its connection with the environment and adopt more sustainable measures in parallel with administration of vaccinations. Thank you.
AG In relation to this communication. Is it possible for our...?
It is obvious that COVID is creating enormous difficulties in the economy and societies everywhere and obviously those difficulties increase the debt of countries, making countries in able to make the investments that are necessary. All these difficulties are undermining the capacity of developing countries to be able to respond to climate change, to make the investments necessary to reduce emissions and for adaptation and resilience in their societies.
00:28:48
So it's essential that developed countries implement the commitment made in order to provide $100 billion per year for developing countries, both for the reduction of emissions but - and we ask for 50% to go for the investments necessary to build resilience for infrastructure, for communities, the so-called adaptation.
So we need to make an additional effort in relation to support to developing states to fight climate change. We need an additional effort to compensate for the dramatic negative impact of COVID in their economies and their societies.
MH Thank you very much, Mr Secretary-General. Now I understand the Secretary-General has very kindly given us more time than he had and we will have to leave but we will continue this press conference.
00:29:49
The next journalist on the line is Majid Glai from Rudol Media Network, Iraq. Majid, please unmute yourself and ask your question.
MA Thank you so much. Thank you for the opportunity. I would like to ask about the risk of lack of access especially when it comes to the vaccine in conflict zones and refugee camps as we all know that in most of those conflict zones like Syria and even somewhere like Ethiopia there is a problem with lack of medical access.
Is there any special effort to make sure that the refugees and people in conflict zones get adequate vaccine and not be deprived because of their situation? Thank you.
MH Thank you. Excellent question. We've got quite a few experts on that and Dr Bruce Aylward will lead with his answer.
BA Yes, thank you very much for raising this, Majid. It's such a crucial issue, as the Director-General and the Secretary-General emphasised. We can't get out of this crisis unless we vaccinate and make available the tools to tackle COVID to populations everywhere.
00:31:11
This includes of course as a global community populations in fragile and conflict-affected settings in particular. So right from the very outset when we first developed the planning tools, let's say, for the roll-out of vaccination the populations in these areas were given a special recognition and in working with countries and groups that were working in such areas we began right from the very beginning to make sure their national vaccine deployment plans accounted for and had special strategies for accessing populations in fragile, conflict-affected situations.
As you'll be aware, there's been a lot of experience in building access into such areas through campaigns like the polio eradication campaigns, measles campaigns and others.
So there's a wealth of knowledge, of experience, of partnerships that have been established to work with the communities and in some cases governments or others as appropriate to reach these areas.
Sometimes many of those systems break down and national plans don't always cover all of the population. Sometimes the refugee and other populations can overwhelm a country's ability to help.
00:32:29
So in that regard the COVAX facility has put in place a special, what we call, humanitarian buffer which makes additional vaccine available for groups working in such areas to be able to ensure that there is a route to vaccines that can be accessed through the inter-agency standing committee and other mechanisms to be able to ensure vaccine's available for all populations.
It's been a challenge. There are particular challenges to operating and vaccinating those areas, especially with vaccines that are under emergency use listing. But working with a number of donors, working with a number of manufacturers we're slowly working our way through those challenges.
MH Dr Ryan will add something.
MR Just a reminder to our member states that our member states remain primarily responsible for including refugees, migrants and other vulnerable populations within their national plans for COVID-19 vaccination. The humanitarian buffer is specifically put there to deal with those very specific situations in which governments may lack access to populations in certain parts of a given territory or where there are special circumstances.
00:33:45
We do thank those governments and so many of you have done it, have included refugees, migrants, other vulnerable populations within national plans and many of you have put in place special arrangements for those populations to get access to vaccine.
We thank those of you who have done that, in addition to the millions of refugees who are hosted and, I might add, mainly in countries of the south who have taken in millions and millions of refugees over the last number of years.
The vast majority of refugees on this planet are being hosted in countries who can barely afford to support their own populations and again we thank those countries who are doing that and we thank them once more for having made provision for refugees and migrants within their planning.
As I said, I very much support Bruce's statement regarding the UN system, the IASC and the special arrangements for the humanitarian buffer.
00:34:46
MH Thank you very much, Dr Ryan and Dr Aylward. The next question goes to Irene Hartman from Argentina from Claren newspaper, Argentina. Irene, please unmute yourself and ask a question.
IR Hello. Do you hear me okay?
MH Yes, we can hear you fine. Go ahead.
IR Thank you so much. I would like to ask you about Sputnik vaccine, what is the status of approval of this vaccine. In Argentina we are very worried because 23% of the population is vaccinated with this vaccine and it seems that we won't be able to travel freely to many countries so it's very important to know the status of this approval, please. Thank you so much.
MH Dr Mariangela Simao, who's Assistant Director-General for Access to Medicines, will answer your question.
MS Thank you very much for the question and I'm happy to do a quick update. The Gamalaya vaccine, which is the Sputnik V, has started the process with WHO earlier in the year and the process was put on hold due to the lack of some legal procedures.
00:36:11
I'm happy to say that in discussions with the Russian Government or in negotiations with the Russian Government this problem is about to be sorted out. As soon as the legal procedures are finished we are able to restart the process.
There still will be issues around complete information on the dossier that has to be provided by the applicants on the Russian direct investment front and there are also issues regarding the finalisation of the inspections in the different manufacturers in Russia. But I'm happy to say that the process is about to be restarted.
MH Thank you very much. Dr Aylward's got something to add.
BA Yes, it's on the second part of what you mentioned, Irene, and that was the importance of recognising vaccines for international travel. WHO is still deeply concerned that vaccines that have been proven efficacious, have been approved by WHO through the emergency use listing procedure that Mariangela just spoke to are not being recognised in all countries.
00:37:26
Again we're calling on all countries to ensure the recognition of vaccines proven to be efficacious and safe and certainly that meet WHO emergency use listing criteria.
MH Thank you so much, Dr Aylward. Do you want to add something, Dr O'Brien?
KOB Just to add to what Bruce was commenting on, I think we have to recognise why it's a problem that those vaccines that are WHO emergency use listed are by some countries not being recognised.
The first thing is to say that again COVID vaccines are not a vaccine that is required under IHR for travel so we want to reinforce that that is not a requirement for travel, notwithstanding that there may be some differences about quarantine measures or other things if people are travelling with or without having been vaccinated.
But the other reason that it's such an important issue is that it's pushing people to be vaccinated with more doses than they would otherwise be recommended to receive if the vaccines that they've already received that are WHO EULed are not recognised.
00:38:46
This again is not something that we should be doing in the face of constrained supply and inadequate supply at this point in countries where people are receiving and seeking out vaccines that they otherwise wouldn't need for the purpose of their own protection and their own vaccine status.
I think these are some of the reasons why this is such a critical issue and again calling on all countries to recognise the WHO EULed vaccines which have met the criteria of efficacy, safety and quality manufacturing.
MH Thank you so much for all those answers. The next question - we'll still stay in Latin America - goes to Bianca Reuthier from Il Globo in Brazil.
BI Hi, Margaret. Can you hear me?
MH We can hear you very well, Bianca.
BI Thanks a lot. It's again on the topic of the negotiations at the World Trade Organization about the IP waiver. What do you expect from Brazil in this negotiation? In 2007, if I'm not wrong, with an anti-IV drug Brazil was a key player and now what do you expect? Now should Brazil be doing more?
00:40:21
MH Thank you for the question. Dr Aylward will begin.
BA Thank you so much, Bianca. As the Director-General and the Secretary-General reinforced in their opening comments or response to an earlier question, we're not looking to individual countries to do things, we're looking for countries collectively to work together to solve this problem.
There are many countries that have got experience dealing with IP and waivers, compulsory licensing, etc, Brazil being just one of them. But what we expect of all countries is to bring that experience to the table to find the collective solutions to make sure as many companies with the capacities, the experience to be able to be making these vaccines have the opportunity to do it and nothing is holding them back.
Remember, if we look a the map today of vaccination around the world we've got a big ring of green with a big splotch of red in the middle of it and that splotch of red is in the areas of the world where there is no manufacturing capacity or there is manufacturing capacity but they don't have access to the IP, to the technology, to the know-how to be able to make these vaccines.
00:41:36
I think nine months ago, as the Director-General emphasises all the time, there was a great promise that these vaccines would be rolled out equitably. That hasn't happened and now we're at a point where we have got to look at, how do we ensure every region is safe as we go forward, as these viruses evolve.
That's the reason WHO has been working so hard to put in place hubs, new MRNA and other vaccine production hubs in areas that are underserved to help solve this problem. But the more rapidly that they have access to the IP, to the technology, the know-how the more quickly they will be able to help solve this problem.
That requires - to your point, Bianca - all countries working together in the WTO to make sure that IP's available. Those with experience, like ones you've mentioned, particularly important in this conversation.
00:42:30
MH Dr Mariangela will join and then after that Dr Swaminathan.
MS Very quickly just to say that there are other alternative mechanisms also that WHO has put in place like the COVID Technology Access Pool, CTAP and Brazil is one of the countries that supported this initiative that was led by Costa Rica. That aims to pull together the voluntary licensing through a public mechanism like the medicines patent pool and also to provide a platform for sharing of technology, sharing of knowledge.
So this is another way that we are also looking for the voluntary mechanisms which also work under the patent system, intellectual property system that's managed by the TRIPS council at the WTO. Thank you.
SS Just to add on this topic and as the Director-General and Dr Aylward mentioned, in addition to the process for the TRIPS waiver at the WHO, which we hope will be positive and successful, we've also put in place a mechanism for multilateral technology transfer hubs, the first one having been set up in South Africa.
The concept here is that starting with MRNA technology - but the same concept will be applied to other technologies like viral vectors and subunit proteins - the know-how is developed, is brought to this technology hub, is protected there, there is manufacturing that starts happening and at the same time this place also serves as a training centre for teams from other parts of the world to come and get trained on this technology and then to go back and set it up in their own countries.
PAHO, the regional office, has taken a proactive role along with the countries of the region and a few weeks ago there was a seminar with all the member states of the PAHO region participating where the first two MRNA production sites in Brazil and Argentina were launched.
This was done through a lot of regional consultations in a way that in the future will be sustainable, where there would be sharing of vaccine supplies across the region, where there would be also some countries that manufacture the raw materials while other countries are manufacturing the finished product so that at no time is there an interdependence between countries and at no time is there a situation in the future where the sort of vaccine nationalism that we've seen this time can impact vaccine supplies to all countries.
00:45:17
So this requires technology to be shared, know-how to be shared and, as Dr Simao just said, we have the mechanisms, we're working with the Medicines Patent Pool in order for transfer of technology to be done in a transparent manner but at the same time ensuring that there will be quality in that process, that the quality will be assured.
WHO will be launching a couple of other calls in the coming weeks. One will be for countries to express interest in receiving this MRNA technology so now that the global hub has been set up in South Africa we would like countries to apply to receive the technology. There'll be a process of screening and some criteria for selection.
We will also launch a call for countries to become training centres for manufacturing as a whole because we know globally that there is a big shortage of workers that will be needed for these new factories to be set up.
So while training on specific technologies might occur at these hubs there is a need also for training on all aspects of vaccine manufacturing.
00:46:27
So we will keep you informed as those calls are developed and set out but at the moment what we need really is for the experts, the know-how to make these MRNA vaccines to work with us, to work with our hub to make this a success as quickly as possible.
MH Thank you so much for all those answers. The next question goes to Margaret Bashir from Voice of America. Margaret, can you unmute yourself and ask your question.
MA Thank you so much. If you could just expand on the strategy a bit, I'm hearing a call to vaccinate 40% of the world by the end of this year but I'm not really hearing exactly how you're going to do it. There're 12 weeks left in 2021. It seems a bit ambitious when you're saying 10% are vaccinated and 56 countries fell short of the 10% target. So can you just expand on that?
And, Dr Tedros, would you make a call on rich countries to suspend booster shots until the end of the year perhaps in order to reach this 40% target? Thank you.
MH Thank you for those questions. Dr Kate O'Brien will start the answer.
00:47:47
KOB Thank you so much for this question about the 40% target. I think we have to be really clear about what has already happened and what the target would actually mean.
The first is on supply. I think it's clear from the analysis that we and others have been doing that there are enough doses that are being procured - first of all being manufactured on a monthly basis. We believe that there're approximately 1.5 billion doses of vaccines, largely WHO EULed vaccines, that are being manufactured on a weekly basis.
When we look at what it will take first of all for those 56 countries to get to 10% that's 200 million doses just to get the lagging countries that have not had adequate access to that supply. That's a week's worth of the global supply of the WHO EULed vaccines. If that can't be achieved I think there really needs to be a fine point put on that.
The next is looking at getting to the 40% and there are already a substantial number of countries that are well over the 40% target. This is not about whether the world is making enough vaccine that is adequate to achieve that 40% target. It's about whether those doses are going to the places that most need those doses in order to achieve the target.
00:49:12
So this is really a problem of distribution of the doses and that's what we're calling for and the DG has been very clear on this in the strategy. We're calling for actions now. We've heard the commitments, we've heard the talk.
The DG has called for actions and those are very clear in the strategy. Countries that have a substantial number of doses already and have achieved high vaccine coverage can swap their place in line for additional doses for the coming weeks and the coming months. The critical feature here is to get the doses to those places that are still lagging behind the target.
The second part of this is that funding is needed for those countries to actually deliver the doses. We believe from the analysis that most of those doses have been contracted already and that there is a pathway forward on the supply side.
00:50:07
But we also need to assure that the countries have the funding and the capacity within countries to deploy those doses. Understanding what that financial gap is is really an analysis that we've provided in the strategy. We think it's around $8 billion on the delivery part of deploying those doses.
So the actions that are needed right now in order to get to 40% are really about focusing the deployment of the supply to those countries that need those doses in order to match first the 10% target and then the 40% target.
MH Thank you, Dr O'Brien. Dr Aylward will add.
BA Yes, I want to take the second part of your question, Margaret, because that was the easy one, about the Director-General calling for a suspension on boosters. He did exactly that, I believe, over two weeks ago.
Director-General, you looked at the situation with the 10% coverage in countries and said, look, every single dose makes a difference. We need to make sure every dose right now is going into people who haven't received any doses, not additional doses going into those who already have.
We've had a lot of questions about that call for the suspension of boosters and we believe it's had a very big impact. The speed at which countries are putting these policies in place, how carefully they're putting them in place, the evidence they're looking at, who exactly they're targeting and really just the highest-risk people like immunocompromised; these are really important decisions that are helping to affect the global supply.
00:51:44
Just a comment on the first part about how ambitious this target is. It is, right, but if we look at the situation today, in North America more than 40% of the population has two doses of vaccines. In South America more than 40% of the population overall have two doses, in Asia over 40% of the population overall, in the Western Pacific they're getting very close to it.
So most continents now are getting closer. The problem is the gaps within and of course the problem in sub-Saharan Africa and we have an emergency here. The world locked down for 18 months. There's enough vaccine in the world. We have a distribution and delivery problem. If we can't solve that problem in 12 weeks that speaks poorly for the urgency we see in terms of ending the pandemic.
00:52:33
Mike and I were talking about this just before the press conference and Mike was highlighting, if we get to 40% we'll basically have ended the acute phase of the pandemic. That's how urgent this is and the IMF comes out regularly talking to the billions of dollars we're losing every single month that we fail to meet those kind of targets.
So it is ambitious but it's very doable. The doses are already paid for. The issue is just getting them prioritised for COVAX, for AVAT so they can get to the populations that are lagging behind and the countries that are lagging behind in this push.
MH Dr O'Brien.
KOB I just want to make one clarification also on this booster issue. The strategic advisory group of experts on immunisation has been meeting all this week and one of the topics that has been addressed is about additional doses.
I want to make a really big distinction between doses that are considered booster doses, which is what the DG has called for a moratorium on, and doses that are required for a small subset of populations that don't respond adequately to the primary doses that are in the schedules for the vaccine.
00:53:51
I think we need to make a very clear distinction as the DG has, that we're really talking about those doses that people would be receiving who have already received their primary doses, responded to those primary doses based on the evidence that we have.
We're not talking about immunocompromised people or for some vaccines in especially elderly populations where an additional dose for that primary response really to protect those high-risk people may be needed.
It's important that we not conflate those two issues and SAGE will be addressing the booster dose issue in the coming weeks, which is a very broad and complex issue and that moratorium is really clear, that giving boosters, for which there's very controversial evidence, is absolutely not the priority while so many people have not yet had even a primary series to protect them from the outset.
MH Thank you so much. We're really having excellent questions but we are coming up to the hour. In fact I think we're past the hour so just time for one more question. It will go to Donato Mancini from the Financial Times. Donato, please unmute yourself and ask your question.
00:55:13
DO Hi. Can you hear me? Can you hear me?
MH We can now but speak a little louder.
DO Thanks for taking my question. Is the US helping out in a significant way with IP waivers given this accord it signalled earlier this year?
I'm hoping to get a bit more detail here. Are there any governments or companies specifically that are not doing enough to achieve vaccine equity? Thank you.
MH Donato, I don't think we would call out specific companies but we could offer a general answer. I'm looking around.
BA I can take the second part of the question about, are any governments not doing enough to achieve vaccine equity. Every country that is over 40% coverage today, if they are not prioritising the lower-income, unvaccinated parts of the world, COVAX, AVAT, they're simply not doing enough to help achieve global equity.
00:56:27
So I think there's a huge number of countries, Donato, that could be doing more to try and help achieve vaccine equity. As Kate highlighted just now, we need the countries that have achieved high levels of coverage to allow the manufacturers to ensure that they prioritise the contracts that COVAX have.
We need the countries that have contracted huge numbers of doses beyond what they will use for their own populations to not only donate doses but, more importantly at this point - that's a stopgap measure - to swap their place in the queue so that COVAX, AVAT are serviced and to remove any excuses any manufacturers or others might have for not servicing the key instruments that are in place to achieve global equity in the roll-out of vaccines.
The only truly global mechanism in that regard is COVAX so that mechanism can assure any doses that come in are prioritised to the places that are lagging the most and so that's what we need prioritised. Every government that has contracted large numbers of doses beyond what they need and are still receiving those doses, any countries that have achieved high levels of coverage now, all of them need to be part of the solution, working with manufacturers to say, prioritise COVAX because we need the world vaccinated, we need it vaccinated fast.
00:57:51
MH Dr Mariangela Simao will add.
MS Just to add to what Bruce said, Donato, because you know that we are also doing the allocation rounds and we do urge the companies to come in and prioritise the delivery to the COVAX contracts.
But let me say that through the mechanisms we have we're trying to push the agenda of equity and we did an allocation round now in October exclusively for countries who were less than 10% and we're now working on allocations eight and nine, also prioritising the countries that are being left behind in this vaccine delivery and the vaccine equity.
So there are mechanisms that we're using to address the inequality and inequity in access but we also need the companies to prioritise the COVAX contracts. Thank you.
MH Dr O'Brien and then...
KOB I think one of the other things - to build on what Mariangela just said and what Bruce has identified - that we've been calling for for quite some time is that COVAX is completely transparent, as is AVAT, about where doses are going.
00:59:14
We are really asking for that kind of transparency from all other parties. It's nearly impossible to know and hold accountable the commitments that manufacturers have made and countries that already have a large number of doses are making unless we altogether understand where these 1.5 billion doses a month are actually going.
It's fantastic if and when manufacturers are prioritising COVAX and AVAT but it's a little bit difficult to square the commitments that are being made with what's actually happening and where the doses are flowing or not flowing.
So we're really also calling for this transparency around the doses, where they're being deployed to, how many are being manufactured on a monthly basis and that's how collectively we can all make adjustments that are needed to actually achieve the targets.
01:00:15
The targets are... This issue of equity is not for equity's sake although that is frankly a sufficient reason to pursue equity but it's really about what it's going to take to shut down this virus and vaccines cannot do this alone.
It's not about vaccines being the magic wand that's going to stop this but we're not going to get her unless we actually have vaccines being deployed as a significant part of the solution to getting population immunity. If we don't do that on a worldwide basis in a relatively equal step we're going to continue to have a prolongation of this pandemic.
That's the reason this should be done fundamentally, first and foremost, is we all want this pandemic to be over.
MH Thank you very much, Dr O'Brien. I think we all agree with what you just said. We want it over. I will now close this press conference. I know there are many, many more of you online. I thank you very much for your excellent questions and please send them to media enquiries.
We will help provide the answers. Now I'll hand it over to Dr Tedros for his final remarks and to close.
TAG Thank you. Thank you so much to all who have joined today, to our media and also thank you to Secretary-General for joining us and look forward to seeing you in our upcoming press conference next week. Thank you. All the best.
01:01:50