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How a WHO push for global vaccines needled Europe

Reuters

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A nurse prepares to administer the AstraZeneca/Oxford vaccine under the COVAX scheme against the coronavirus disease (COVID-19) at the Eka Kotebe General Hospital in Addis Ababa, Ethiopia March 13, 2021. REUTERS/Tiksa Negeri
A man displays a vial AstraZeneca's COVISHIELD vaccine as the country receives its first batch of coronavirus disease (COVID-19) vaccines under COVAX scheme, in Accra, Ghana February 24, 2021. REUTERS/Francis Kokoroko
European Commission President Ursula von der Leyen delivers a statement on EU's coronavirus disease (COVID-19) vaccine strategy, following a college meeting at the EU Commission headquarters in Brussels, Belgium April 14, 2021. John Thys/Pool via REUTERS

Last April, at the start of the COVID-19 pandemic, European Commission President Ursula von der Leyen added Europe to a global effort to ensure equitable access to a vaccine, which she said would be deployed "to every single corner of the world", write Francesco Guarascio and John Chalmers.

But despite pledging billions of dollars for the scheme set up by the World Health Organization (WHO) and publicly endorsing it, European Union officials and member states repeatedly made choices that undermined the campaign, internal documents seen by Reuters and interviews with EU officials and diplomats show.

A year after its launch, Europe and the rest of the world have yet to donate a single dose through the vaccine scheme, which is part of an unprecedented effort to distribute vaccines, tests and drugs to fight the pandemic. Diplomats say Europe's ambivalence stemmed partly from short supplies and a slack start to the global campaign, but also from concerns that the EU's efforts would go unnoticed in a vaccine diplomacy war where highly publicised promises from China and Russia were winning ground, even in its own backyard.

The programme, co-led by international agencies and the Global Alliance for Vaccines and Immunization (GAVI), is a bulk-buying platform to share doses worldwide. But with the administration of former U.S. President Donald Trump having turned its back on the WHO, the plan, called COVAX, was slow to win support and focused on using funds from rich countries to buy doses for less-developed ones.

Von der Leyen presented Europe's support for the COVAX campaign as a gesture of international unity. EU officials privately cast the bloc's vaccine aims in a less altruistic light.

"It's also about visibility," that is, public relations, Ilze Juhansone, Secretary-General of the EU Commission and the Commission's top civil servant, told ambassadors at a meeting in Brussels in February, according to a diplomatic note seen by Reuters. Juhansone declined to comment.

A senior diplomat said many of those at that meeting felt Europe, which is by far the largest exporter of vaccines in the West, had goals that would be better served by plastering "more blue flags with yellow stars" on vaccine parcels and sending them out itself, rather than through COVAX.

Brussels, which is coordinating vaccine deals with its members, has reserved a huge surplus - 2.6 billion doses for a population of 450 million so far. It has promised nearly €2.5 billion ($3bn) in support to COVAX. That made the EU the biggest funder until the administration of US President Joe Biden pledged $4n this year to the plan, which aims to distribute 2 billion doses by the end of the year.

But supplies for Europe's own population are behind schedule, and despite giving funds, the EU and its 27 governments have also hampered COVAX in several ways. Like other rich countries, EU nations decided not to buy their own vaccines through COVAX, and competed with it to buy shots when supplies were tight. All except Germany offered the overall programme less cash than requested.

More than this, Europe promoted a parallel vaccine donation system that it would run itself, to raise the EU's profile.

"There is huge frustration because there is a feeling that right now the race is on but we're not really out of the starting blocks," a senior diplomat told Reuters.

"We're spending money on COVAX and the return in terms of political visibility is nil."

Russia says it wants to supply vaccines to countries directly. China has pledged support to COVAX. But both Moscow and Beijing have separate deals to deliver more than 1 billion doses to Africa, Latin America, and to EU partners such as Turkey, Egypt, Morocco and Balkan states that are candidates to join the bloc.

Most doses will take time to be delivered, but Russia and China have already exported about twice COVAX's deliveries of around 40 million doses.

COVAX was also hit in March by export restrictions on vaccines from India, which slowed supplies from its main provider of shots.

WHO chief Tedros Adhanom Ghebreyesus has repeatedly urged rich countries to set aside nationalistic impulses and share vaccines, calling the current situation "a shocking imbalance." Non-EU member Britain, for instance, has already injected about as many shots as COVAX has delivered to more than 100 countries.

COVAX officials told Reuters they received sufficient funds by the end of last year, but these came later than expected.

A spokeswoman for GAVI, the vaccine alliance that runs the scheme and speaks for COVAX on such issues, said EU support had been "unequivocal" and it expects doses to be donated soon. The WHO added that von der Leyen's personal support had been "invaluable."

An EU Commission spokesman told Reuters COVAX had been very successful in structuring global collaboration and securing millions of doses. He called the programme "our best vehicle to deliver on international vaccines solidarity" and the EU's "key channel for sharing vaccines."

Part of COVAX's difficulty is structural. Soon after it was set up, the wealthiest countries were sealing advance orders with drug companies to secure doses as they became available. The vaccination scheme has always relied on rich states for cash, which they have been slow to give.

COVAX aimed to be a platform for countries to buy vaccines, which would give it bargaining power and allow it to dispense doses among those most in need worldwide. Recognising supplies would be tight, its initial aim was to distribute doses for at least 20% of each country's populations to cover the people most at risk.

At an internal meeting last July, an EU Commission official told ambassadors that member states should not buy their shots through COVAX as they would come too slowly, diplomatic notes show. The Commission later set the target to vaccinate 70% of adults in the EU by the end of September.

COVAX changed some of its terms the next month to try to convince wealthy nations to join in, but no EU nations signed up to use the platform for their vaccination drives. The EU gave COVAX financial guarantees to pay for vaccines, but also made it harder for COVAX to do this, by arranging to buy far more doses than the bloc needed.

In November, the EU pledged more money to COVAX, but only after it had signed contracts with vaccine makers for nearly 1.5 billion doses - more than half Brussels' estimate then of global production capacity for this year, internal documents show.

Even though Europe had reserved such a large share, the Commission told diplomats in a meeting that month that COVAX was too slow in procuring doses.

That was when the Commission raised the possibility of setting up a mechanism of its own to send shots to poor countries outside the EU.

Within a month, France started to flesh out that plan. Shots would be sent directly from manufacturers - possibly before deliveries started through COVAX - and labelled as "Team Europe" donations, a draft plan said.

The move, revealed at the time by Reuters, caused an outcry among officials at COVAX. Read more

One told Reuters in April the plan was driven by France's desire to get shots to Africa, where France formerly had colonies, and smacked of colonialism. French diplomats said they never showed a preference for any country, and Africa was most in need.

EU Health Commissioner Stella Kyriakides said in mid-January the EU's own plan would go ahead - because COVAX was not yet fully operational. Countries to focus on would include the Western Balkans, the EU's southern and eastern neighbours and Africa.

The next month, having reserved more than 2 billion doses but with actual deliveries hit by production problems, the EU doubled COVAX funding to €1bn. Russia and China had already delivered millions of doses across the world. COVAX had yet to deliver any. And France's President Emmanuel Macron was publicly losing patience.

Europe and the United States should quickly send enough vaccines to Africa to inoculate the continent's healthcare workers or risk losing influence to Russia and China, Macron said in a speech at a security conference, without specifying how these donations should be made.

Unless rich countries speeded up deliveries, "our friends in Africa will, under justified pressure from their people, buy doses from the Chinese and the Russians," Macron told the conference. "And the strength of the West will be a concept, and not a reality." Read more

Despite Macron's urgency, France's cash support for the overall WHO programme - to cover tests and treatments as well as vaccines - was limited.

The WHO asked countries for contributions in proportion to their economic power. France has committed $190 million - about 13% of the $1.2 billion requested, a WHO document dated March 26 shows.

Other EU countries are also far below expected contributions; some have given zero. But Germany has helped offset this by publicly pledging $2.6bn, well above the $2bn requested.

French diplomats said the country's contributions are expected to increase soon.

On 24 February, COVAX shipped its first vaccines. The EU softened its criticisms.

At a meeting on 9 March, at the height of the European Union's own problems in procuring shots for its own citizens, a Commission official told diplomats COVAX was the main tool for donating vaccines to other countries.

But the official said Europe still needed its own mechanism, because COVAX had money, but only a tiny portion of the shots it needed. And the EU scheme would have "the advantage of giving us visibility," the official said.

At that same meeting, EU ambassadors were shown data compiled by the EU's foreign affairs service which those present said revealed how far the bloc's vaccine diplomacy was lagging behind its competitors.

They learned that Russia had orders for 645 million doses of its Sputnik V COVID-19 vaccine with dozens of countries, and that China was shipping millions of doses to EU neighbours, the data showed.

"We are completely out of this game," one of the diplomats who was there told Reuters.

Reuters could not confirm the data exactly. But figures assembled by the United Nations agency UNICEF, which works with COVAX on vaccine deliveries, show Russia has deals to deliver nearly 600 million doses, including to EU states. China has deals to sell about 800 million doses, including agreements with European countries such as Serbia, Ukraine and Albania.

Later that month the EU's top diplomat, Josep Borrell, made the point candidly: "The EU is the major driver behind COVAX," he wrote in a blog on 26 March. "But we do not get the recognition that the countries using bilateral vaccine diplomacy do."

On Tuesday, the EU Commission said the EU would share over half a million doses with Balkan countries from May through the EU scheme. That was two weeks after COVAX had delivered its first shots to the region. Read more

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EU has not yet ordered more AstraZeneca vaccines, says internal market commissioner

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Syringes are prepared to administer the AstraZeneca coronavirus disease (COVID-19) vaccine at a new mass vaccination centre in WiZink sports arena in Madrid, Spain, April 9, 2021. REUTERS/Sergio Perez

The European Union has not yet made any new orders for AstraZeneca (AZN.L) vaccines beyond June when their contract ends, European Internal Market Commissioner Thierry Breton (pictured) said on Sunday (9 May).

Breton also said he expected that the costs of the EU’s recent order for more doses of Pfizer-BioNTech (PFE.N) vaccines would be higher than the earlier versions.

The Commission last month launched legal action against AstraZeneca for not respecting its contract for the supply of COVID-19 vaccines and for not having a “reliable” plan to ensure timely deliveries.

"We did not renew the order after June. We’ll see what happens," said Breton, adding that it was "a very good vaccine".

Concerns has risen on potential side-effects of the Anglo-Swedish COVID-19 vaccine.

Europe's medicines regulator said on Friday it is reviewing reports of a rare nerve-degenerating disorder in people who received the shots, a move that comes after it found the vaccine may have caused very rare blood clotting cases. Read more.

Breton said an increase in prices for second generation vaccines could be justified by the extra research required and potential changes to industrial equipment.

The European Union signed a new contract with Pfizer-Biontech to receive 1.8 billion doses of COVID-19 vaccines for 2021-2023, to cover booster shots, donations and reselling of doses, the European Commission said on Friday (7 May). Read more.

“There may be a little extra cost but I will let the competent authorities unveil it in due course,” he told France Inter radio.

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Hoping to lure back tourists, Greece reopens beaches after lockdown

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With widely spaced sun loungers and regular disinfections, Greece reopened its organised beaches on Saturday as the popular Mediterranean holiday destination eases COVID-19 curbs in preparation for the return of foreign visitors this week.

Tourism accounts for about a fifth of Greece's economy and jobs, and - after the worst year on record for the industry last year - the country can ill afford another lost summer. Read more

"We're pinning our hopes on tourism," said Nikos Venieris, who manages a sandy beach in the seafront suburb of Alimos, just outside the capital, Athens, where social distancing measures will remain in place.

"We're one of the places along the Athens riviera ... that receives many tourists so the number of visitors from abroad will play a big role in our finances," he added.

Under current measures, beach managers like Venieris will have to place umbrellas at least four metres (13 feet), carry out regular disinfections and test beach bar employees and other staff for COVID-19.

People enjoy the sun during the official reopening of beaches to the public, following the easing of measures against the spread of the coronavirus disease (COVID-19), in Athens, Greece, May 8, 2021. REUTERS/Costas Baltas
People enjoy the sea during the official reopening of beaches to the public, following the easing of measures against the spread of the coronavirus disease (COVID-19), in Athens, Greece, May 8, 2021. REUTERS/Costas Baltas

Greece fared well in keeping the first wave of the pandemic under control last year but a resurgence in cases pushed health services to the limit and prompted authorities to impose a second lockdown in November.

As infections have fallen and vaccinations gathered pace, authorities have steadily eased restrictions, opening bars and restaurants earlier this week.

On Friday, they announced that museums would reopen next week before the lifting of travel restrictions on vaccinated foreign visitors on May 15.

Greek Prime Minister Kyriakos Mitsotakis has said a combination of widespread testing, immunisation, and the fact that many activities would take place outdoors gave authorities confidence that tourists would be able to visit safely.

For Greek beach lovers, Saturday's reopening of the country's largest beaches was a chance to let off steam after months of lockdown.

"We've been longing for this for six months now, because we're winter swimmers and we've really missed it," said Spiros Linardos, a pensioner, reclining on a sun lounger at Alimos.

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EU calls on US and others to export their vaccines

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European Commission President Ursula von der Leyen speaks during the opening ceremony of an EU summit at the Alfandega do Porto Congress Center in Porto, Portugal May 7, 2021. Luis Vieira/Pool via REUTERS

The European Commission called on Friday (7 May) on the United States and other major COVID-19 vaccine producers to export what they make as the European Union does, rather than talk about waiving intellectual property rights to the shots.

Commission head Ursula von der Leyen told a news conference on the sidelines of a summit of EU leaders that discussions on the waiver would not produce a single dose of COVID-19 vaccine in the short- to medium-term.

"We should be open to lead this discussion. But when we lead this discussion, there needs to be a 360 degree view on it because we need vaccines now for the whole world," she said.

"The European Union is the only continental or democratic region of this world that is exporting at large scale," von der Leyen said.

She said about 50% of European-produced coronavirus vaccine is exported to almost 90 countries, including those in the World Health Organization-backed COVAX program.

"And we invite all those who engage in the debate of a waiver for IP rights also to join us to commit to be willing to export a large share of what is being produced in that region," she said.

Only higher production, removing exports barriers and the sharing of already-ordered vaccines could immediately help fight the pandemic quickly, she said.

"So what is necessary in the short term and the medium term: First of all vaccine sharing. Secondly export of vaccines that are being produced. And the third is investment in the increasing of the capacity to manufacture vaccines."

Von der Leyen said the European Union had started its vaccine sharing mechanism, citing delivery of 615,000 doses to the Western Balkans as an example.

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