Achieving global equity for COVID-19 vaccines: Stronger international partnerships and greater advocacy and solidarity are needed

Abstract

Many may not be aware of the full extent of global inequity in the rollout of Coronavirus Disease 2019 (CAU : PleasenotethatCOVID À 19hasbeendefinedasCoronavirusDisease2019inthesentenceM OVID-19) vaccines in response to the Severe Acute Respiratory Syndrome Coronavirus 2 (SAU : PleasenotethatSARS À CoV À 2hasbeendefinedasSevereAcuteRespiratorySyndromeCo ARS-CoV-2) pandemic.As of June 20, 2021, only 0.9% of those living in lowincome countries and less than 10% of those in lAU : Pleasenotethatlow À andlowermiddle À incomeco ow-and middle-income countries (LMICs) had received at least 1 dose of a COVID-19 vaccine compared with 43% of the population living in high-income countries (HICs) [1] (Fig 1).Only 2.4% of the population of Africa had been vaccinated compared with 41% of North America and 38% of Europe [1,2] (S1 Fig).Primarily due to the inability to access COVID-19 vaccines, less than 10% of the population in as many as 85 LMICs had been vaccinated compared with over 60% of the population in 26 HICs [1].Only 10 countries account for more than 75% of all COVID-19 vaccines administered [3].This striking and ongoing inequity has occurred despite the explicit ethical principles affirming equity of access to COVID-19 vaccines articulated in WHO SAGE values framework [4,5] prepared in mid-2020, well prior to the availability of COVID-19 vaccines.The COVID-19 pandemic highlights the grave inequity and inadequacy of the global preparedness and response to serious emerging infections.The establishment of the Coalition for Epidemic Preparedness Innovations (CEPI) in 2018, the Access to COVID-19 Tools Accelerator (ACT-A), and the COVID-19 Vaccines Global Access (COVAX) Facility in April 2020 and

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