Disparities caused by Covid-19 remain stark, and those who were hit the hardest will be the slowest to recover, says the latest Goalkeepers Report from the Bill and Melinda Gates Foundation.

The pandemic has pushed an additional 31 million people into extreme poverty in 2020, compared to 2019. And while 90 per cent of advanced economies will regain pre-pandemic per capita income levels by next year, only a third of low- and middle-income economies are expected to do so, said the report co-authored by Bill and Melinda French Gates, co-chairs of the Foundation.

To ensure equitable recovery from the pandemic, the report calls for long-term investments in health and economies, similar to the efforts that led to the rapid development of the Covid-19 vaccine. While the world had stepped up to avert some of the worst-case scenarios it was not enough, the report said.

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In fact, addressing the vaccine inequities that exist, the report called for global investments in research, manufacturing and innovation “in places closer to the people who stand to benefit.”

Last year’s report saw the Institute for Health Metrics and Evaluation (IHME) predict a drop of 14 percentage points in global vaccine coverage —“effectively erasing 25 years of progress in 25 weeks”. But new IHME analysis shows that the decline, “while still unacceptable, was only half of what was anticipated,” the report said.

“If we can expand upon the best of what we’ve seen these past 18 months, we can finally put the pandemic behind us and once again accelerate progress in addressing fundamental issues like health, hunger, and climate change,” the co-authors said.

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Pointing out that “Women face structural barriers in every corner of the world, leaving them more vulnerable to the impacts of the pandemic,” Melinda French Gates urged Governments to invest in women and spur a more equitable recovery.

‘Did not benefit equally’

The report pointed out that the unprecedented development and deployment of the Covid-19 vaccine existed primarily in wealthy countries, and “the world did not benefit equally”. In fact, Bill Gates called the lack of equitable access to the vaccines, “a public health tragedy.”

“We face the very real risk that in the future, wealthy countries and communities will begin treating Covid-19 as yet another disease of poverty. We can’t put the pandemic behind us until everyone, regardless of where they live, has access to vaccines,” he observed.

In the recent past, Gates has received flak for being opposed to a temporary waiver of intellectual property protection on vaccines. Later though, the Foundation’s Chief Executive Mark Suzman clarified and reversed the position saying, they supported a “narrow waiver” to improve access to the vaccines.

Access and location

More than 80 per cent of all Covid-19 vaccines have been administered in high- and upper-middle-income countries to date, with some securing two to three times the number needed so they can cover boosters; less than 1 per cent of doses have been administered in low-income countries, the BMGF report said.

“Covid-19 vaccine access has been strongly correlated with the locations where there is vaccine R&D and manufacturing capability. Though Africa is home to 17 per cent of the world’s population, for example, it has less than 1 per cent of the world’s vaccine manufacturing capabilities,” the report said, calling the world to invest in research, infrastructure and innovation closer to the people who needed it.

“We must invest in local partners to strengthen the capacity of researchers and manufacturers in lower-income countries to create the vaccines and medicines they need,” said BMGF chief Suzman.

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