Saturday, February 06, 2021

Palestinians have been excluded from Israel's impressive vaccine rollout so far

Erin Snodgrass
INSIDER Sat., February 6, 2021,

A Palestinian health worker gets vaccinated against Covid-19 at Dura hospital, west the West Bank city of Hebron, on February 4, 2021. - The Palestinian Authority began vaccinating health workers in the occupied West Bank against Covid-19, after a pressure campaign on Israel to provide the jabs. Photo by HAZEM BADER/AFP via Getty Images

Israel is leading the rest of the world with its swift and effective vaccine rollout.

But the country has sparked debate over whether they have an obligation to include Palestinians.

Some say it's Israel's obligation as an occupying force, while Israel says it's not their job.

Since the first COVID-19 vaccine was administered less than two months ago, Israel has had the quickest and most effective vaccine rollout of any country by far. Leading the world in inoculations so far, it is the first country where vaccines are truly beginning to curb the virus.

Since the operation began in early January, more than a third of Israel's 9.3 million people have already received at least one shot, according to The Associated Press. More than 1.9 million have gotten both doses.

The nation's vaccine operation is even fittingly named "Getting Back to Life," and Prime Minister Benjamin Netanyahu said last month that the country's agreement with Pfizer will allow all Israeli citizens over the age of 16 to be vaccinated by the end of March.

In January he said "...we will vaccinate the entire relevant population and everyone who wants to will be able to be vaccinated," during an update on vaccines.

But despite its success, the country has drawn growing international criticism over its exclusion of Palestinians from its impressive vaccination drive.

In mid-January, the World Health Organization raised concerns about the unequal distribution according to the Associated Press. Weeks later, almost all Palestinians living in the occupied West Bank still haven't received a first dose, The New York Times reported.

The inequity has prompted a global debate over whether Israel has an obligation as an occupying power to vaccinate Palestinian people.

International rights groups argue that Israel has a legal responsibility to extend its vaccination efforts to the Palestinian people who live in the Israeli-occupied, Palestinian territories of the West Bank and Gaza.

But Israel disagrees. They claim the Palestinians assumed control of their own population's health services when they signed the Oslo Accords - a pair of landmark agreements between the government of Israel and the Palestine Liberation Organization - in the 1990s.

According to the accords, the Palestinian Authority is in charge of administering health care for the West Bank and Gaza, while both sides are tasked to work together when it comes to epidemics.

Nearly three million Palestinians reside in the West Bank which is also home to about 450,000 Israeli residents, according to The Times.

Critics of the occupying power highlight the inequity of the hundreds of thousands of West Bank Israelis who are eligible for the vaccine because of their nationality, living among the millions of Palestinians who are not.

"Nothing can justify today's reality in parts of the West Bank, where people on one side of the street are receiving vaccines, while those on the other do not, based on whether they're Jewish or Palestinian," Omar Shakir, Human Rights Watch director for Israel and Palestine, said in a statement to the AP. "Everyone in the same territory should have equitable access to the vaccine, regardless of their ethnicity."

Israel has insisted its priority must be in vaccinating its own population, though officials have said they may consider sharing more supplies with Palestinians at some point, the AP reported.

"We want everyone in the area to be vaccinated, but the Palestinian Authority is the party responsible for providing for the health of Palestinians," Yoav Kish, Israel's deputy health minister told The Times. "Our responsibility is to vaccinate our own population,"

Human rights groups say Israel has a moral obligation to include the Palestinians in vaccinations since the country clearly has the resources to help. Others have pointed to the public health risk of not vaccinating Palestinians, many of whom regularly cross into Israel for work.

"It will be very difficult to ensure full protection of the Israeli population while not ensuring also that adequate vaccinations are done on the Palestinian side," Dr. Gerald Rockenschaub, head of the WHO office for the Palestinian territories, told the AP.

While the Palestinian vaccine rollout has at least now begun - The Times reported that the Palestinian Authority launched its campaign this week, starting with frontline medical workers and using vaccines given to them by Israel - it significantly trails Israel's.

"After 50 years of occupation with no end in sight, Israel's duties go beyond offering spare doses," Shakir told The Times.

After public health experts recommended it, Israel reportedly gave the Palestinian Authority 2,000 Moderna doses and said they had future plans to give another 3,000, the newspaper reported.

The Palestinians also received 10,000 doses of Russia's Sputnik V vaccine and expect to get hundreds of thousands more in the coming months through the global-sharing Covax initiative, sources told The Times.

Many of Israel's defenders say the country simply moved quicker than the Palestinian Authority in securing deals with vaccine distributors.

According to The Times, the Palestinian Authority did not initially call on Israel to include Palestinians in their rollout because they thought they would be able to acquire enough vaccinations themselves through a combination of international donations, pharmaceutical company contacts, and private discussions with Israeli officials.

It later became clear that would not be enough, and the Palestinian Authority started making public demands that Israel fulfill its "international duty."

Read the original article on Insider

NFL Offers President Biden Team Stadiums

As Covid-19 Vaccination Sites; League Welcoming 7,500 Heath Care Workers As Super Bowl Guests

AFTER ALL THE STADIUMS ARE OWNED BY THE TAXPAYERS WHO FUNDED THEM

Dominic Patten and Erik Pedersen

Fri., February 5, 2021,

Just over 48 hours before Super Bowl LV literally kicks off, the NFL have made Joe Biden an offer he is very unlikely to refuse.

“The NFL and our 32 member clubs are committed to doing our part to ensure that vaccines are as widely accessible in our communities as possible,” league commissioner Roger Goodell said to the President in a February 4 letter made public today (read it here). “To that end, each NFL team will make its stadium available for mass vaccinations of the general public in coordination with local, state, and federal health officials.”

Countries impose export controls on vaccines

There is a real danger that other countries may now introduce export controls on vaccines produced within their borders to protect supplies for their own populations. The manufacturing of vaccines is geographically concentrated in very few countries, such as India. Any decision by one of these manufacturing countries to introduce export controls themselves would severely disrupt the global supply of vaccines.

Some countries have already demonstrated their tendency to hoard their supplies during the pandemic - not least the US, which last year said it would seize exports of medical equipment including masks and gloves to determine whether it should be kept in the country to fight the pandemic.

Countries impose export controls on manufacturing supplies

Some of the ingredients commonly used in vaccine production are geographically concentrated in only a few countries. One example is an extract from Chilean soap bark tree, a product commonly used in vaccines that boosts the body's immune response to the jab. It is expected to be used in at least one COVID-19 vaccine produced by Novavax, the Atlantic reported.

The world embarks on a retaliatory trade war

Protectionism has already reared its head during this pandemic. For example, Turkey was accused by Spanish officials of seizing medical ventilators using parts from China that were destined for Spain, and Tunisia last year accused Italy of seizing a shipment of medical alcohol bound for the country.

The fundamental problem is that there is not enough manufacturing capacity to vaccinate the entire global population this year or even next year. A report published by UBS found that - at current rates - only 10% of the world will be immunized against COVID-19 by the end of this year, rising to just 21% at the end of 2022.

That limited supply will almost exclusively be used to immunize wealthy countries' populations, which have bought almost the entire forward supply of vaccines. But a nationalistic approach will carry an enormous public health cost by prolonging the pandemic and increasing the chance of a new, vaccine-resistant strain emerging.

It would also carry a high economic cost. Last week, a report commissioned by the ICC found that unequal distribution of the COVID-19 vaccine would cost the global economy $9 trillion by extending the pandemic. Half of that cost would be borne by rich countries.

The fear is that in a global vaccine war, all sides would ultimately lose out.

Read the original article on Business Insider

Unwilling to wait, poorer countries seek their own vaccines

MARIA CHENG and ANIRUDDHA GHOSAL

Sat., February 6, 2021

NEW DELHI (AP) — With coronavirus cases still climbing, Honduras got tired of waiting to get vaccines through a United Nations program, so the small Central American country struck out on its own, securing the shots through a private deal.

Honduras “cannot wait on bureaucratic processes or misguided decisions" to give citizens “the peace of mind” offered by the COVID-19 vaccine, said Juan Carlos Sikaffy, president of the Honduran Private Business Council, which helped complete the purchase by providing a bank guarantee.

Other nations are getting impatient too. Unlike past disease outbreaks, where less wealthy countries have generally waited for vaccines to be delivered by the U.N. and other organizations, many are now taking matters into their own hands. Experts are increasingly concerned that these go-it-alone efforts could undermine a U.N.-backed program to get COVID-19 shots to the neediest people worldwide.

Countries including Serbia, Bangladesh and Mexico recently began vaccinating citizens through donations or commercial deals — an approach that could leave even fewer vaccines for the program known as COVAX, since rich countries have already snapped up the majority of this year's supply.

FILE - In this Jan. 29, 2021, file photo, Sri Lankan nursing staff administer COVID-19 vaccines to front-line health workers in Colombo, Sri Lanka. India has gifted neighbors, including Sri Lanka, Bangladesh and Nepal, with more than 5 million doses. (AP Photo/Eranga Jayawardena, File)

Led by the World Health Organization, a coalition for epidemic preparedness known as CEPI and a vaccine alliance called GAVI, COVAX was created to distribute COVID-19 vaccines fairly. Countries can join either to buy vaccines or to get donated shots.

Mustaqeem De Gama, a diplomat at the South African mission in Geneva, cited “a level of desperation” fueled by spreading virus variants and “the uncertainty of when any COVAX vaccines might arrive.” He doubted that countries that signed up for COVAX ”will even get 10% of what they require.”

Even if the effort succeeds, COVAX’s stated goal is to vaccinate less than 30% of people in poor countries, meaning that governments must seek other sources to obtain enough shots to achieve herd immunity.

Serbian President Aleksandar Vucic said his country was forced to cut its own deals after watching rich countries scramble for the scarce shots. He criticized nations that, he said, bought more doses than they needed.

“It’s as if they intend to vaccinate all their cats and dogs,” he said.

Although Serbia paid 4 million euros to COVAX last year, it has not yet received any shots and last month began its immunization campaign with vaccines from Pfizer, China's Sinopharm and Russia.

Recent manufacturing delays in Europe raise concerns about whether drugmakers will be able to fulfill the multiplying orders.

“There are so many deals being signed that I think it’s hard to see how the numbers could possibly add up for all the doses ordered to actually be produced in the foreseeable future,” said Amanda Glassman, a public health expert and executive vice-president of the Center for Global Development.

Last week, the African Union completed a deal for 400 million doses of the AstraZeneca vaccine, to be produced by the Serum Institute of India. That’s on top of a previously negotiated African Union deal for 270 million doses from several pharmaceutical companies and in addition to the 600 million doses Africa expects to receive from COVAX.

Some experts warn that these new deals could move COVAX further to the back of the line, especially if some countries are willing to pay a premium for speed.

To ensure South Africans got doses of the AstraZeneca vaccine quickly, government officials reluctantly agreed to pay a higher price per shot than Europe or North America. The first shipments arrived this week.

COVAX hopes to start sending its first vaccine batches to Africa later this month, but those plans are subject to change depending on manufacturers' production capacities and countries' immunization plans.

Mexico began vaccinating health workers in December because of a direct purchase agreement with Pfizer, but progress has been slow. In recent weeks, the country gave emergency approval to Russia’s Sputnik V vaccine but said the first batches weren't due until sometime later this month.

Kate Elder, senior vaccines policy adviser at Doctors Without Borders, said developing countries should not be criticized for securing private vaccine deals since that is precisely what rich countries did last year.

“Every country is just doing what it feels it needs to do to protect their people,” she said, but the ability of poor countries and regions to get vaccine faster than COVAX could hurt future U.N. efforts.

“If countries are getting vaccines on their own, then how are WHO and GAVI delivering for them?” she asked.

Although India is contracted to provide COVAX with several hundred million doses of vaccine, the shots have not yet been authorized by the WHO, meaning India cannot release them for the U.N. program. In the meantime, India has already gifted neighbors, including Sri Lanka, Bangladesh and Nepal, with more than 5 million doses.

Dr. Haritha Aluthge of Sri Lanka’s Government Medical Officers’ Association, called for the WHO to intervene amid the intense competition for vaccines and the failure of COVAX to deliver.

“Not a single dose (from COVAX) has been received,” Aluthge said.

WHO chief Tedros Adhanom Ghebreyesus warned recently that the world is on the brink of a “catastrophic moral failure” if COVID-19 vaccines are not distributed fairly, but the agency has no authority to force rich countries to share.

Its entreaties for countries to act in solidarity have mostly been ignored.

Norway is the only country that said it would send vaccines to developing countries as its own citizens are immunized, but it has not specified how many would be donated. Britain said it would not divert any vaccines until it finishes its own immunization program. Australia, which has mostly stamped out COVID-19, has no timeline for when it might share vaccines with its poorer neighbors in southeast Asia and the Pacific islands.

The unrelenting pressure on the world’s vaccine supplies might only lift when more shots prove successful, said Krishna Udayakumar, director of the Duke Global Health Institute.

“COVAX is the only global, multilateral platform to enable something close to global access and equity, and yet, it has access to a relatively small amount of vaccines,” he said. “The only way out is to have more vaccines.”

___

Cheng reported from Toronto. Associated Press writers Dusan Stojanovic in Belgrade, Christopher Sherman in Mexico City, Marlon González in Tegucigalpa, Honduras, and Krishan Francis in Colombo, Sri Lanka, contributed to this report.

A Covid-19 vaccine apartheid would endanger us all

Until the whole world is vaccinated, no one is safe.

REUTERS/SIPHIWE SIBEKO/FILE PHOTO

LONG READ

This story was first published by the Bureau of Investigative Journalism, a nonprofit newsroom based in the UK.

By Madlen Davies & Rosa Furneaux
February 6, 2021

Senam Agbesi has been trying to make the best of lockdown in London. “I’ve done lots of Zooms, lots of walks,” he said. The 34-year-old National Health Service (NHS) manager believes he could get the vaccine this month, as he is starting a new job that would mean visiting hospitals regularly.

Despite the good news about his own vaccine, he worries about his father, Yao, who lives in Accra, Ghana. Yao is 65 and has sickle cell trait, a condition that puts him at higher risk of suffering severe illness if he catches Covid-19.

A close family friend recently died of the virus and Senam wishes his father would be more careful. “He thinks he’s invincible. He drinks his little tea of lime juice and ginger in the mornings and thinks he has an invisible fortress around him,” he said.

Yao has not been given any information about being vaccinated nor seen any concrete information in the media about when any vaccines will arrive. Predictions suggest that the majority of the Ghanaian population will not be vaccinated until 2023, and some other sub-Saharan countries will be waiting until 2024.

Not only will poorer countries be forced to wait, but many are already being charged much higher prices for every dose. Uganda, for example, has announced a deal for millions of vaccines from AstraZeneca, at a price of $7 a dose—more than three times what the European Union (EU) paid for the same jab. Including transport fees, it will cost $17 to fully vaccinate one Ugandan.

Campaigners and scientists warn that we are on course for a “vaccine apartheid” in which people living in the global south are inoculated years after those in the West.

The effects of this inequity would be stark. Modeling by Northeastern University indicates that if the first 2 billion doses of Covid-19 vaccines were distributed proportionally by national population, worldwide deaths would fall by 61%. But if the doses are monopolized by 47 of the world’s richest countries, only 33% fewer people will die.

As the EU bickered with AstraZeneca last week over securing more vaccines, leaders in the bloc parroted the mantra “no one is safe until everyone is safe.” But globally unequal distribution will harm all of us—leaving reservoirs for the virus across the world in which new, potentially more dangerous variants will emerge and spread.

Distracted by in-fighting and protectionism in the West, we are sleepwalking into a world that will suffer more cases, more economic chaos and more deaths.
Survival of the quickest

In the rush to secure vaccines for their citizens, and before it was known which ones would be most effective, countries quickly arranged deals for billions of doses. About 12.7 billion doses of various coronavirus vaccines have been bought so far, enough to vaccinate roughly 6.6 billion people. (All of the vaccines approved so far require two doses, but some nations have already ordered a single-dose vaccine that has yet to be approved.)

More than half of those doses—4.2 billion secured, with the option of buying another 2.5 billion—have been bought by wealthy countries home to only 1.2 billion people.

Canada has bought enough doses to inoculate every Canadian five times, while the US, UK, EU, Australia, New Zealand, and Chile have purchased enough to vaccinate their citizens at least twice, although some of the vaccines are yet to be approved.

These vast existing orders leave fewer doses for poorer regions and raise questions over whether Covax, an organization created to ensure low-income countries can access vaccines, will be able to meet its target to vaccinate those most at risk across the world this year. (Covax told the Bureau that it was confident it would meet the target and hoped to exceed it.) Low- and-middle-income countries have made deals directly with pharmaceutical companies, but have so far secured only 32% of the world’s supply to cover 84% of the world’s population.

In Israel, which has the fastest vaccination program in the world, more than a third of people have had one dose, and over a fifth have had both. The Palestinian Territories is still waiting for vaccines from Covax to arrive, although Israel recently announced it would transfer 5,000 doses to immunize Palestinian frontline health workers.

“We’re in such a massive crisis,” said Fatima Hassan, the founder of South Africa’s Health Justice Initiative. “If even in South Africa we can’t get even half of our population vaccinated soon, I can’t even imagine how Zimbabwe, Lesotho, Namibia and the rest of Africa will cope. If this is going to continue for another three years, we’re not going to get any kind of continental or global immunity.”
Demand exceeding supply

This frenzied grab for vaccines is happening because supply is finite. After developing their vaccine, pharmaceutical companies must modify their product so it can be manufactured on an industrial scale, before transferring the technology to licensed factories around the world.

AstraZeneca, the company behind the Adenovirus-based vaccine developed with Oxford University, has licensed 10 other companies in the UK, India, Brazil, Japan, South Korea, China, Australia, Spain, Mexico and Argentina to make its product, on top of its own factories in the UK and Europe. While most of these companies have permission to make the vaccine only for a specific geographic area, it is at least an attempt to manufacture at scale globally. Campaigners have criticized other pharmaceutical giants for failing to license more manufacturing companies around the world.

Instead, some of these companies appear to have focused on supplying the West. Public Citizen, a US think tank, has found that just 2% of Pfizer/BioNTech’s global supply has been granted to Covax, while last year people familiar with Moderna’s plans believed the US company intended to prioritize high-income nations. In January, the South African government said Moderna has no intention of registering its vaccine in the country.

Pfizer and Moderna’s vaccines are also much more expensive. Although many of the vaccine deals have been kept secret, information leaked by a Belgian official showed the EU paid between $2 and $18 per dose, with Pfizer and Moderna’s mRNA vaccines the priciest at over $14—much more than low-income countries can afford.

Pfizer told the Bureau: “We have allocated doses for supply to low- and lower-middle-income countries at a not-for-profit price.”

AstraZeneca has promised to make its vaccine available at cost in the Global South in perpetuity (there is an as-yet-unspecified time limit for that price in the West). But some poorer nations have already ended up paying more for the AstraZeneca vaccine too, under another name.

In India, where much of the world’s pharmaceutical manufacturing takes place, the Serum Institute is producing the largest shipments of both AstraZeneca and Novavax’s vaccines. However, because it has a non-commercial license for the AstraZeneca jab, the Serum Institute can export its own version—Covishield—to 92 of the world’s poorest countries. Unlike AstraZeneca, the Serum Institute has not promised to keep to cost price, and is charging India $3 per dose, South Africa and Brazil $5, and Uganda $7, where the EU only paid AstraZeneca $2. Neither AstraZeneca nor the Serum Institute responded to a request for comment.

Many nations, particularly in Latin America, Asia, and the Middle East, have turned to Russian and Chinese vaccines, which are yet to be approved by what the WHO defines as a stringent regulator. According to the manufacturer’s website, more than 50 countries have also applied for Russia’s Sputnik V vaccine.

China has given at least 30 million doses of its homegrown vaccines to its citizens, and Indonesia and Turkey have begun administering doses. Last June, Chinese president Xi Jinping promised African countries they would “be among the first to benefit” from China’s vaccines, but it is not clear if any have yet arrived. In Uganda, at least one Chinese company has been allowed to import vaccines to inoculate its Chinese workers and their families before Ugandan nationals.

With inadequate supply at the root of both delays and inequity, many public health experts and campaigners are calling on pharmaceutical companies to waive patents to allow more factories to make vaccines. Within two months of declaring the pandemic, WHO had set up a mechanism for sharing intellectual property and data. Membership was voluntary. Not a single pharmaceutical company has participated.

In October 2020 a group of countries, led by India and South Africa, asked the World Trade Organization to temporarily suspend intellectual property rights for Covid-19 vaccines and medicines, meaning any generic producer could start making them. While the WHO supports this, countries including the US, Canada, Australia, EU, and UK are siding with pharmaceutical companies to oppose it. However, the recent row over AstraZeneca’s supply delays in Europe means even the EU Council is discussing waiving intellectual property rights.

Dr Mogha Kamal-Yanni, global health policy consultant at the People’s Vaccine Alliance, told the Bureau: “We’re all fighting for pieces of a small pie. Why not increase the size of the pie so everyone can get a fair slice?”

Critics from the pharmaceutical industry have argued there is no spare manufacturing capacity, either in approved factories or in trained technicians, so suspending vaccine patents would not increase supply.

Pfizer told the Bureau that those calling for IP waivers “disregard the specific circumstances of each situation, each product and each country.” It added: “IP will also continue to play a crucial role long after this pandemic is over, to ensure that the world is prepared with innovative solutions for future global health crises, in addition to other pressing healthcare needs.”
Counting on Covax

The difficulty in securing supply of the vaccine will leave many poorer countries dependent on Covax, an organization created in April 2020 to provide “innovative and equitable access to Covid-19 diagnostics, treatments, and vaccines.” It is coordinated by WHO, the Coalition for Epidemic Preparedness Innovations and GAVI, the international vaccine alliance.

Covax has a target of delivering 2 billion doses globally, including at least 1.3 billion for 92 low- and middle-income countries, by the end of 2021. This would be enough to inoculate 20% of each countries’ population—prioritizing health workers, the elderly and those with underlying medical conditions—although that target has been criticized as inadequate to deal with the pandemic.

It has negotiated advance deals for these 2 billion doses. However, Duke University analysts believe that the doses can only be delivered this year as planned if the Serum Institute can make all 900 million doses ordered as “options,” which they judge unlikely given the company’s publicly stated capacity and extant orders. The analysts estimate instead Covax will provide between 650-950 million doses, split between 145 nations—including some of those with enough confirmed deals for vaccines to inoculate their citizens several times over.

“The problem is GAVI has never worked in a situation where they’re competing with rich countries for vaccines,” said Prabhala. “They’ve never been in a situation where they are trying to supply highly, highly sought after vaccines to countries in developing countries and in the West.”

The Bureau understands that Covax is relying on a legally binding agreement with the Serum Institute to deliver all of its optioned doses, and that its figures do not include doses donated by other nations.

Although many countries entitled to Covax vaccines have already arranged other deals for more than enough doses, uncertainty over delays mean wealthy nations including Canada and New Zealand have opted to receive Covax vaccines in the first wave, rather than wait for poorer countries to receive theirs first.

Covax told the Bureau: “Nothing like COVAX has been attempted before, however we do know what would happen without it. As we saw in the 2009 H1N1 pandemic, those countries without the ability to pay would be left with no vaccines, the best route out of this pandemic, potentially for a year or more after the first wealthier countries. We are now well on track to bring down this lag to a couple of months.”

In January, Cyril Ramaphosa, president of the African Union, announced a deal for 270 million vaccines from multiple suppliers, and suggested the continent could not rely on Covax alone.
A fairer way forward?

Experts differ on the solutions to the vaccine supply crisis. The WHO has asked manufacturers to prioritize supplying Covax and urged countries ordering doses beyond their needs to donate—but that looks increasingly politically unpalatable as countries experience delays in supply.

Covax has only recently set up a mechanism for donation and, so far, only Norway, which has recorded fewer than 600 Covid-19 deaths, has agreed to donate supplies at the same time as rolling out their national vaccination plan. Canada will give up to CA$5 million in funding to this donating mechanism, but cannot commit to a timeframe of when it will begin handing over vials.

There are fragmented attempts at donation outside this mechanism. The EU, rowing back from earlier proposals for regular donations to Covax, has agreed to send vaccines to inoculate health professionals across Africa and the western Balkans. Australia and New Zealand have similar plans to sell or donate to neighboring countries in the Pacific, Southeast Asia and Polynesian islands.

According to the Times, the UK’s health secretary Matt Hancock acknowledged that the 400 million doses his department had ordered were “more than the UK population needs” and said the government would be generous while also completing its vaccination program.

Some campaigners believe the WHO is foolish to think asking countries to donate is a good solution. “I think it’s honestly the most ridiculous, most unworkable…most problematic solution I’ve ever seen,” said Prabhala. “I just don’t understand how anyone in this moment could justify donating vaccines that they have, and getting away with it.”
A deadly and destructive delay

Without equal access to vaccines, there are fears many lower-income countries will not have enough stock to inoculate key populations, including healthcare workers, in 2021. On the ground, health workers are struggling. “The situation is very tense,” said Ireen Mutombwa, national disaster management co-ordinator at the South African Red Cross. “Everyone’s life is at risk, especially when you are someone who is involved in working with the community.”

Scientists are also concerned that allowing the virus to thrive unabated in some countries could lead to greater risk for all. “The more circulation there is, the more opportunity there is for the virus to mutate,” said Marie-Paule Kieny, a virologist and director of research at Inserm. Mutated variants could result in more direct deaths in under-vaccinated countries, and may potentially make vaccines less effective over time.

The global economic cost could be vast. A study by RAND Corporation estimated that failure to ensure equitable Covid-19 vaccine allocation could cost the global economy up to $1.2 trillion a year. (Another study has put the figure even higher, at more than seven times that amount.) Even if wealthy countries vaccinated their populations, they could still lose around $119 billion a year if the poorest countries are denied a supply, RAND’s modeling showed.

“If you ask a random person on the street, they would never think we were in any way dependent economically on low-income countries,” Marco Hafner, lead author of the study, said. But because wealthy countries rely on global trade links, economic slowdown in poorer nations caused by pandemic restrictions will have a knock-on effect across the world.

“[There are] true economic incentives to provide equitable access to everyone, rather than just seeing this as some sort of act of charity,” Hafner said. “If you compare the costs of [funding Covax] to the benefits, just for wealthy nations, it’s kind of peanuts.”

“Governments are realizing that this mantra, ‘nobody’s safe until everyone is safe,’ that they have been saying but then doing the opposite is true, they are in danger,” Kamal-Yanni said. “The mutations mean now rich countries realize they can’t just vaccinate their own people.”

Back in the UK, Senam and his two brothers are hoping to go to Ghana for Christmas, once they’ve been vaccinated. It seems unfair to them that they will likely receive the jab before their more vulnerable father.

“It’s very frustrating,” Senam said. “You see in the news at the moment these fickle bickerings between the EU and AstraZeneca: ‘me, me, me’. It just demonstrates the selfishness of the Western world.”

BACKGROUNDER/LONG READ

Myanmar coup: Why the generals really took back power from Aung San Suu Kyi

A strangely familiar sight dominated the front pages of Myanmar's state-owned newspaper this week: photos of men in green military uniforms sitting in seats of power.

Soldiers stand guard along a blockaded road near Myanmar's

Parliament in Naypyidaw on February 2, 2021.

left, Myanmar's then foreign minister, walks with Senior Gen.

Min Aung Hlaing, right, Myanmar military's commander in chief, in Naypyidaw.

It was as if time had rewound a decade. "The Global New Light of Myanmar" has long been considered the mouthpiece for whoever is running the country, its pages dedicated to government propaganda and stiff images of officials on mundane visits to agricultural or development projects.

From 1962 until 2011, successive military regimes ruled Myanmar, formerly known as Burma, with an iron fist -- asserting their absolute power over the people through fear and brutality.

But six years ago, there was hope of change when Aung San Suu Kyi -- a Nobel Peace Prize winner and former political prisoner -- formed the first civilian government with her National League for Democracy Party (NLD) after winning a landslide in elections.

That all changed Monday, when the military seized power in a coup, arrested 75-year-old Suu Kyi, cut internet services and took news channels off the air. A presenter on the military-owned news channel announced that the 64-year-old commander in chief Min Aung Hlaing was now running the country.

"Senior General makes speech at government meeting" was Wednesday's "New Light" headline, a sign that Myanmar is now back under military rule, at least for the next 12 months.

Devastated residents in the country's biggest city, Yangon, said history was repeating itself. With many still bearing the mental and physical scars of the past, they expressed fears that the intervening years were all for nothing.

on the streets of Mandalay on February 3, 2021.

Myanmar has changed markedly in the years since the military last ruled, with more social freedoms, foreign investment and a growing middle class. For example, SIM cards that used to cost $1,000 a decade ago are now cheap and ubiquitous, and the population has quickly moved online with social media sites like Facebook synonymous with the internet.

While deep economic and inequality issues, conflict, and ethnic strife remain, Myanmar is a different place today than it was 10 or 20 years ago, especially in the major cities.

But the imperfect transition was not working for everyone.

The military justified their takeover by alleging widespread voter fraud during the November 2020 general election, which gave Suu Kyi's party another overwhelming victory and dashed hopes for some military figures that an opposition party they had backed might take power democratically.

But according to analysts a simpler explanation is that the coup, as most usually are, was driven by power and the personal ambition of an army chief who felt he was losing control and respect.

"This was a standoff between two people who were not allowed the presidency and both wanted it: Aung San Suu Kyi and the commander in chief. And he put his personal ambition ahead of the good of the military and the good of the country," said Yangon-based analyst Richard Horsey

This screengrab provided via AFPTV and taken from a broadcast by Myanmar Radio and Television (MRTV) in Myanmar on February 3, 2021 shows military chief General Min Aung Hlaing in Naypyidaw following the military coup.

CNN was unable to reach Myanmar's military for comment.

What is the Tatmadaw and who is Min Aung Hlaing?

The first thing to know about Myanmar's military -- officially known as the Tatmadaw -- is that it never really gave up political power.

Just over a decade ago, the military chiefs put in place a plan that would permit the country to hold elections, liberalize the economy, and transition into a semi-democracy while still maintaining their authority.

The 2008 constitution allocated the military a quarter of seats in parliament, giving it effective veto power over constitutional amendments, and the generals kept control of three key ministries -- defense, border and home affairs.

For 50 years, the military was the most powerful institution in the country. The army had control of the government, economy and every facet of life. Its sustained conflict with ethnic minorities has displaced hundreds of thousands of people, and rights groups have long linked soldiers to atrocities and human rights abuses, such as rape, torture and other war crimes.

Riot police block a road in Yangon, Myanmar, 06 February 2021.

A string of ruthless military dictators turned Myanmar into a pariah state. Gen. Ne Win, who seized power in a 1962 coup, plunged the country into poverty with his disastrous economic and socialist policies.

The general was alleged to have made policy decisions based on the advice of astrologers and demonetized several large denominations of Myanmar's currency, replacing them with bank notes that added up to nine. Citizens' savings were wiped out overnight.

His successor was labeled the "Butcher of Rangoon" (the former name of Yangon) for his brutal suppression of mass pro-democracy demonstrations in the then-capital during the late 1980s

© STR/AFP/Getty Images Protesters hold up the three finger salute during a demonstration against the military coup in Yangon on February 6, 2021.

Political persecution, harassment and violence against opponents, journalists, and minority groups has continued into recent years under the guidance of military chiefs and the government.

Min Aung Hlaing, who was picked as commander in chief as Myanmar's transition began in 2011, oversaw the campaign of violence waged against the Rohingya ethnic minority population in the country's west. Some 720,000 people fled into neighboring Bangladesh following the crackdowns in 2016 and 2017.

United Nations investigators said the offensive was carried out with "genocidal intent," accusing the military of horrific crimes such as gang rape, torture, arson and extrajudicial killings. The military and government deny the claims, saying they were targeting terrorists

Min Aung Hlaing, commander in chief of the Myanmar armed forces,

pictured in Yangon on July 19, 2018.

In 2019, the United States sanctioned Min Aung Hlaing for serious human rights abuses related to the atrocities committed against the Rohingya. A genocide case at the International Court of Justice (ICJ) is ongoing.

The military is also reported to be extremely wealthy, controlling a vast web of companies with links to industries such as jade and ruby mining, tobacco, beer, manufacturing, tourism, banking and transport to name a few. Last year, an Amnesty International investigation found that almost every military unit had shares in the military-founded conglomerate, Myanmar Economic Holdings Limited (MEHL), which runs a huge business empire that includes global partners.

A 2019 UN report found that the military used its businesses and arms deals to support brutal operations against ethnic groups that include forced labor and sexual violence.

"This is a completely unreformed and unreconstructed, authoritarian, brutish institution that has violence and cruelty in its DNA," said David Mathieson, an independent analyst based in Yangon.

The commander sees his chance as relationship breaks down

The continuing power and influence of the military placed civilian leader Suu Kyi in a delicate position, as the NLD tried to move forward with its reform agenda while avoiding pushing too hard and potentially kindling a coup.

Analysts say Suu Kyi and Min Aung Hlaing's relationship was bad from the moment she took office in 2015, but had recently deteriorated, leading to what is believed to be a breakdown in communication between the two power-sharing bodies.

Myanmar's recently deposed State Counsellor Aung San Suu Kyi pictured at the Presidential House in Naypyidaw on September 1, 2020.

When she entered office, Suu Kyi was wildly popular because of her decades-long struggle against military rule. However, unlike her standing in the West, her popularity sustained at home over her first term.

Suu Kyi's failure to condemn the Rohingya crisis led to her fall from grace internationally, but her appearance defending the country -- and the military -- from accusations of genocide at the ICJ may have actually increased support domestically ahead of the elections.

Analysts say the generals may have underestimated her continued popularity and were wary of what they saw as her outsized role in the country's governance.

The military drafted constitution was originally designed to constrain her power. A clause bans anyone with foreign family members from becoming President, and because Suu Kyi was married to a British man, she was barred from the top job.

To get around this clause, the NLD created the position of State Counsellor, making Suu Kyi de facto leader of the country and more powerful than the generals had ever intended for her to become.

Referring to the NLD's apparent circumvention of the rules, analyst Horsey said: "There was a feeling that the government and Aung San Suu Kyi violated the constitution and weaponized the military's own constitution against them." A feeling likely made worse by recent attempts by the government for constitutional reform seeking to curb the military's power.

Though Suu Kyi was criticized for not doing more to stand up to the military in parliament, analysts say she was not keen to work with them either.

"Negotiations, talks, discussion and deals are not in Aung San Suu Kyi's DNA," said Khin Zaw Win, director of Yangon think tank the Tampadipa Institute. "She stonewalled everything that came from the military."

With Min Aung Hlaing set to retire when he turns 65 in June, experts say he had his sights set on the presidency. To do that, the military's proxy Union Solidarity and Development Party (USDP) would need do well in the November elections. But Suu Kyi's NLD won 83% of the vote, giving her a mandate and signaling a strong rejection of the military -- putting those presidential ambitions out of reach

Soldiers keep watch inside the City Hall compound in Yangon on February 1, 2021.

The USDP claimed widespread voter fraud and the military demanded the election commission investigate, but the body said any voting irregularities were not enough to impact the result of the ballot. Min Aung Hlaing asked the NLD to hold a special session of parliament to discuss the claims, which was denied.

"I think a feeling in the officer corps is that the NLD and Suu Kyi had disrespected them, and they were not paying any attention to their views and concerns," Horsey, the Yangon-based analyst said. "The military commander justified his coup via a manufactured crisis. But it tapped into genuine grievances among the top brass."

Intense meetings between Min Aung Hlaing and Suu Kyi's envoys didn't go well in the days before the coup, according to Horsey. The opening of the new parliament on Monday in the capital was the opportune moment for the army chief to reassert his power.

"It's very convenient that all members of parliament just happened to be in Naypyidaw right now, because you can put all of them under house arrest at the one time," said Melissa Crouch, law professor at University of New South Wales, Australia and author of "The Constitution of Myanmar." "This is more than simply election fraud, this is about the military perhaps feeling as though it's lost a bit of control or perhaps needs to reassert its power and its dominance in the political system."

Other analysts have called the move a "preemptive strike" as the generals didn't like how powerful Suu Kyi had become.

"This is a coup to protect their interests," Mathieson said. "(They thought) she has a mandate now to dilute our economic power and our constitutional power, and our immunity from prosecution. There is no way that we're going to allow ourselves to be that vulnerable."

What happens next

The military's coup, coming as it did during a period of crisis owing to the coronavirus pandemic and disregarding the overwhelming will of millions, is a leaf out of the playbook of the Burmese militaries of old, and suggests the new generation of generals are not so different from their forebears. The threat of further international sanctions, experts have said, would likely not have bothered them.

"Min Aung Hlaing is a dictator. He was a dictator all along," Mathieson said. "This is a coup against democracy in Myanmar because it's not as if this was a close election -- it was overwhelming, with a high turnout during a pandemic."

What happens next, and what kind of regime Min Aung Hlaing will run, is uncertain.

Fears of a wider clampdown targeting critics, activists, and journalists are rampant. Myanmar human rights organization, Assistance Association for Political Prisoners (AAPP) has documented at least 133 government officials and legislators, and 14 activists detained since Monday. Suu Kyi is under house arrest, charged with breaching the Import Export Law, while ousted President Win Myint is accused of violating the Natural Disaster Management law -- charges that have been described as "trumped up."

On Saturday, large-scale protests broke out, with thousands of people taking to the streets of Yangon in the first major organized demonstration since the military seized power.

The crowd, many of whom could be seen waving flags and holding banners, called for the military to release Suu Kyi, and other democratically-elected lawmakers.

But Khin Zaw Win, the director of the Yangon think tank, said this coup differs from those of 1962 and 1988, which were brutally enforced and imposed a new order over the country.

"This time it's been, lets say, very restrained and the language they use and the statements ... appears they are trying to placate the population," he said. "In the past, the existing constitutions were ditched, this time they are being meticulous about it."

At this stage, there is little to suggest the military wants to unwind the progress of the past 10 years or drastically change citizens' way of life. Investigating election fraud and fighting the pandemic are priorities, according to the new regime.

Myanmar will be under the whims of the military -- and a state of emergency -- for at least a year and Min Aung Hlaing has said elections will be held once the fraud probe has been completed, though analysts say they will want to ensure Suu Kyi cannot contest.

But dictators have a nasty tendency of promising one thing and doing another. And if street protests do gain momentum in the weeks to come, the full force of the military's might could be unleashed.

LA REVUE GAUCHE - Left Comment