Monday 5 July 2021
Last month the richest nations on the planet squared up to its greatest public health challenge, how to vaccinate every adult everywhere against Covid. They failed. The story of how and why they came up catastrophically short is a litany of political parochialism, low ambition and poor organisation – with potentially dreadful consequences
James Harding: This is the story of seven days in June. Of the seven leaders of the world’s wealthiest nations.
[Clip: ‘Gee Seven’ by Sir Tim Rice and Peter Hobbs plays]
And it’s the story of 7 billion people – the historic promise to take care of each of us by protecting all of us.
On 3 June, seven days before the G7 leaders began to gather in Cornwall…
“Our headlines this morning: A shot in the arm for the prime minister, as he urges other people to take up the vaccine…”News report on Boris Johnson getting vaccinated
…Boris Johnson, the UK’s prime minister, had his second shot of the Oxford-AstraZeneca vaccine.
The UK’s vaccine programme had by then jabbed nearly 80 per cent of its population, nearly 60 per cent of them double-jabbed. In the world’s 100 or so poorest countries, that number was lower than 1 per cent.
And so, on Sunday 6 June, just a few days before the start of the G7 summit in Cornwall, Boris Johnson pledged to vaccinate everyone against Covid-19.
“What we want the G7 to try to agree, is that instead of vaccinating the whole world by 2024, or 2025 which is the current… what we’d achieve on the current timetable, we need to get this done by the end of next year, by 2022.”Boris Johnson on vaccinating the world
He told journalists: “Vaccinating the world by the end of the year would be the single greatest feat in medical history.” He said he was “calling on my fellow G7 leaders to join us to end this terrible pandemic.”
The World Health Organisation estimates that 11 billion doses are needed. That’s two doses each for 70 per cent of the world’s adult population. So Boris Johnson was making no small ask.
But then, the UK had helped to establish Covax, the multi-agency effort to vaccinate the world – as close as it comes to the Avengers Assemble in the fight against the coronavirus. And the UK was one of its biggest donors; in fact, more than 9 out of 10 of its jabs so far have been the UK’s Oxford Astra-Zeneca vaccine. And the British government has form – it’s got form in bringing the world together when it matters.
“So if you wanted a country that was sort of middle ranking in terms of financial heft, but influential in the right ways, you’d want to pick the United Kingdom to host this moment. We have the right networks, good scientists. We have also had a very good vaccine rollout, so we’re in a good position to be a great host, and a great leader at this moment.”
Even the weather – not the UK’s most reliable partner on these occasions – played its part. The sun shone over Carbis Bay, the turquoise sea sparkled. And after the years of Trump discord and the long pandemic year of virtual diplomacy, it seemed that a real internationalism was back. Global leadership to meet a global crisis.
“…the England football team are not able to watch this press conference live in the way…”Boris Johnson’s press conference on the G7
Boris Johnson only wished that the England football team, preoccupied as they were by the Euros, could tune into his press conference to witness what he called “the triumphs of the G7”.
[Clip: ‘Gee Seven’ plays again.]
But seven days after Boris Johnson had made his call to bring the G7 together to vaccinate the world, what he actually announced was this:
“A week ago I asked my fellow leaders to help in preparing and providing the doses we need to vaccinate the whole world by the end of 2022. I’m very pleased to announce that this weekend, leaders have pledged over one billion doses either directly or through funding to Covax, that includes a hundred million from the UK to the world’s poorest countries, which is another big step towards vaccinating the world.”Boris Johnson on the one billion vaccine doses
It was a fraction of what the world needed. One billion doses out of 11 billion. In the days that followed, it became clear that even the one billion didn’t quite add up. But, worse, the summit had failed – it had failed to come up with the funding for the global vaccine, testing and treatment programme that was needed. It had failed to address the urgency of the global vaccine crisis now, failing to meet the growing shortfall in vaccine supply for this summer. And it had delayed the delivery of even the one billion pledged vaccines into next summer, delaying the vaccine rollout for frontline workers worldwide beyond the end of this year.
I’m James Harding, and you’re listening to the Slow Newscast. This is the story of the vaccine failure of Carbis Bay – the G7’s deadly sin.
Most journalism is an attempt to find out what just happened and why. This is a story about what didn’t. It’s a who-didn’t-dunnit. Imagine if the Beatles had got together at Abbey Road, but somehow didn’t record the album; or Pele had missed that bicycle kick against Belgium in 1968. A great thing that nearly happened, but then didn’t.
Because, if the seven leaders of the world’s richest countries had surely one job, even among all their other pressing business, well, when they met at Carbis Bay in June 2021, it was to tackle the pandemic. Covid has killed millions of people, locked down hundreds of millions more, and paralysed the world economy. As they gathered, a third wave was beginning to wash over Africa…
Gabriele Fontana: Thank you for having me on the podcast. This is Gabriele Fontana. I’m the regional health advisor for UNICEF for Eastern South Africa.
James, narrating: Gabriele is seeing the impact of these rising cases on countries like Zambia, Zimbabwe and Malawi.
Gabriele: Sometimes, I think we miss the bigger picture. if you don’t have vaccines, you cannot reopen. European countries know that well, they started reopening now when they got to certain level of vaccination and immunity in the population. We can’t reopen in African countries because we don’t have the vaccines. If you don’t reopen what happens here?
In Africa, you close the schools and now you have children that are in households that are impoverished by the pandemic. They’re more exposed to violence. We have seen adolescent pregnancy skyrocketing. We’ve seen malnutrition going up among children because many of them get their main meal at school at lunch and schools are closed.
Some of the children will never come back to school. We know that – we have seen it when we had the Ebola outbreak in 2014, 15 in west Africa. Many of those children, after schools were closed for a few months, they never went back to school.
So this is what we have in front of us. Vaccines are not just for immunizing, vaccines are for living here.
James, narrating: Meanwhile the delta variant is also starting to lap back against the shores of developed, vaccinated countries such as the UK itself. So why, given that they’d made the promise to fund and deliver vaccines for the world by the end of next year, why didn’t it happen?
To what is an unlikely coalition of people – people in well-worn Birkenstock sandals and those in buffed Church’s brogues, charity activists and Tory backbenchers, Boris Johnson’s G7 started with another 7: 0.7.
“Sticking rigidly to spending 0.7 per cent of our national income on overseas aid is difficult to justify to the British people, especially when we’re seeing the highest peacetime levels of borrowing on record.”
Rishi Sunak justifying the government’s decision to cut overseas aid spending
In November of the previous year, he and his chancellor Rishi Sunak had announced that the UK was cutting its promise to spend 0.7 per cent of the budget on international aid.
Kirsty McNeill: So I think this story really starts in November 2020. So as soon as the UK government decided to cut its aid budget, the die was cast really for the G7.
James, narrating: Kirsty McNeill is the executive director for policy advocacy and campaigns at Save the Children.
Kirsty: The reason I say that is the G7 as a forum is a place where the chair has a huge influence. So it’s not like the WTO or the COP or somewhere else where other parties are kind of equally powerful.
At G7 the host really does set the tone and the level of ambition and the tempo. And as soon as the UK government as host said we are going to step back from all these commitments – and in fact it was the only G7 country to do so in the middle of a pandemic, every other country has maintained or increased their aid budget.
When the UK government decided to cut back, it made it very hard to almost impossible for them to rally others behind any of their priorities because other countries quite rightly said, why would we step up to pay for that when you’re scaling back?
James, narrating: But in the early months of 2021, Boris Johnson’s team in Downing Street had good reason to hope that the G7 was going to show that global leadership – and, in fact, global Britain – were working.
The prime minister’s two key lieutenants in this were John Bew, the historian, now serving as a foreign policy advisor in Number 10, and Jonathan Black, the civil servant in the Cabinet Office who had been appointed the UK’s sherpa to the G7 Summit, i.e. the man holding the pen on that final communique, the statement that’s worked up over a matter of months and ultimately agreed by all seven world leaders.
To Bew and to Black, one of the main ambitions of the Carbis Bay Summit was to demonstrate that the G7 itself was back in business. After all, the G7 Summit had had a sorry run of it. The one that was due to be held in June 2020 at Camp David in the United States had been cancelled. In 2019 in France, the G7 met but they couldn’t even agree a joint statement. The previous year, in Canada, there had been a proper dust-up: President Donald Trump left early after a public dispute with the host, Prime Minister Justin Trudeau. Bew, Black and their boss, Boris Johnson, wanted to show that this time it would be different, that this time, in Cornwall, the world’s leaders could come together and lead.
And the omens were good. In February, Covax, that international vaccine alliance, set out its first, confident forecast of vaccine distribution worldwide, thanks largely to commitments of the Oxford-AstraZeneca vaccine, that were going to be produced at the Serum Institute in India. And then in April, President Biden gave another boost to the Carbis Bay summit: he announced that his first foreign trip would be to join world leaders at the G7 in June.
Lily Caprani: The story for Covax starts out really positively, and most of the supplies that Covax was receiving were coming from the Serum Institute in India, which you probably know is the biggest vaccine manufacturer in the world.
James, narrating: I’m talking here to Lily Caprani, who works at the Unicef headquarters in New York.
Lily: We had done a deal with AstraZeneca to produce AstraZeneca vaccines: very affordable at high volumes. And we were starting to ship high volumes of vaccines to countries that otherwise wouldn’t have had them, especially in Africa. But we started to get really concerned as we moved into this spring that there was a spike that we started to see in Covid cases in south Asia, and as we all know, turned into a really awful surge of the virus in India, that then rapidly affected all of the neighboring countries.
At one point I think in May, there was an area of Nepal where 40 per cent of their healthcare workers were infected with Covid-19, meaning, you know, not only was that awful for them, but their kind of healthcare systems were collapsing – it became such a deadly wave.
And as a result, India just wasn’t able to export those vaccines anymore. So we very suddenly found ourselves in a situation where not only was the world, you know, trying to massively scale up its capacity to manufacture vaccines at a rate never seen before, but suddenly the country that was able to give us the volumes couldn’t anymore.
So Covax was suddenly completely under supplied and all of these countries that otherwise were going to get new vaccines were left with nothing.
So Unicef started talking to high income countries – to the G7. They needed money to secure the future supply of vaccines, to be able to go out and buy them for themselves.
Lily: More urgently than that, we were facing a complete lack of supply. So we were asking the G7 to recognise that they already had so much supply available to them – more than they need for their own populations, that they also needed to give us the doses available to them, not just the money to buy them in future.
James: And what was their response on that?
Lily: So individual countries made a lot of, signals of intention that they would donate doses at some point. But there was a real lack of kind of timeliness around it.
I think we started to hear, throughout the spring, you know, warm words and commitments being made with no timeline from the UK, from the US. President Macron calling on other members of the European union.
The challenge was none of that was time bound, and we were in an emergency situation where we literally had no supplies, and as we’ve seen in those countries that have got very low coverage – vaccination coverage – new variants were emerging and sure enough they have ended up challenging the rest of the world. It’s never just one country affected by a new variant, and we were warning, time and time again, if you leave these countries without vaccines, this is going to be harmful for all of us. It’s not just those countries that will suffer.
James, narrating: When the G7 foreign ministers met at Lancaster House in London in May, there was the first hint that the topline rhetoric was drifting away from the small print.
Lily: When the foreign and development ministers’ meeting took place in advance in June, we didn’t see any firm commitments to sharing doses and we were really concerned at that point that we weren‘t going to see any progress.
James, narrating: In fact, the pandemic came well down a long laundry list of other international issues and, on vaccinations itself, the foreign ministers largely recognised the work of others and patted the G7 on their collective backs for funding commitments so far. But there was no talk of pledges for the future.
By the beginning of June, the row over the 0.7 per cent was not only damaging the UK’s international reputation, it was beginning to eat into domestic politics. In fact on the weekend before the G7 itself, Boris Johnson and Rishi Sunak found themselves facing a symbolic rebellion in the House of Commons from MPs, including Conservative ones, who were urging the Government to recommit on its aid spending.
“I mean morally this is a devastating thing for us to have done.”
David Davis MP on the cut to aid spending
And so, while the prime minister might have wanted to be arm-twisting fellow world leaders, well, he was on the phone to Tory backbenchers.
Kirsty McNeil: And instead, what we saw with the UK host was, on the Sunday before the summit, the chancellor ringing round his backbench colleagues, trying to get them not to rebel on UK aid.
There was, if you remember, this very overblown claim in the Sunday Times that we had before the summit, that said the UK wants a plan to vaccinate the world.
And on the Monday of the week of the summit, the prime minister himself ringing round parliamentary colleagues, trying to get them not to rebel on UK aid. And that really was a mess of their own making, that exactly when they should have been intensively ringing round other capitals, they were intensively ringing round constituencies, trying to keep their own parliamentary majority.
James, narrating: There was a growing fear, too, just a week out from the G7 Summit that the seven leaders at Carbis Bay were going to miss the boat. That they somehow just didn’t get it. That, given the agenda around climate change, gender, pandemic preparedness and building the economy back better, well, the urgent business of vaccinating the world would be forgotten.
Richard Curtis, the Make Poverty History campaigner, put a video out that went viral.
And it had a simple hashtag: #WhyNotShare.
And so it seemed more than promising – it felt on that Sunday, 6 June, well it felt almost redeeming, when Boris Johnson chose that moment to make his promise to vaccinate the world.
“What we want the G7 to try to agree, is that instead of vaccinating the whole world by 2024, or 2025 which is the current… what we’d achieve on the current timetable, we need to get this done by the end of next year, by 2022.”
Boris Johnson on vaccinating the world
Vaccine campaigners like Kirsty McNeill immediately – i.e. on that Monday morning – tried to find out what the prime minister’s pledge actually meant.
Kirsty McNeill: When we dug into that, it became very clear that that was not going to be a deal about patent sharing. That wasn’t going to be a deal about burden sharing on the financing – that was looking ever more like just a deal on dose sharing, which is important, but let’s remember dose sharing is a correction for a previous policy failure.
The only reason you’re in a position to share your excess doses is because you’ve accumulated an excess in the first place. So if the system was working equitably and everyone had access to the vaccines that they needed, dose sharing wouldn’t really be a tool in our toolkit.
So the credibility of dose sharing, as the answer, rather than burden sharing of the financing was really hanging by a thread, even going into the summit.
James, narrating: Meanwhile, as so often happens in politics, the big row turns out to be not quite that. The argument over the 0.7 per cent was defused by a technicality. The vote was denied on a Monday, bumped into a debate on the Tuesday, and there was hot talk in the Commons but there was no government defeat.
Meanwhile, by Wednesday, the United States was doing what it generally does – taking the lead.
“The United States will purchase half a billion doses of Pfizer Covid-19 vaccine to donate to nearly 100 nations that are in dire need in the fight against this pandemic.”
President Biden announces 500 million doses
Eloise Todd: I’m Eloise Todd, and I work for the Pandemic Action Network
Well I think on the Wednesday night before the G7 weekend, I got very excited when Biden made his announcement on the 500 million Pfizer at cost, because it felt like “Oh, wow, this is maybe like the start of a tsunami of pledges and he’s kind of going out big and they’re all going to go in the slipstream.”
James, narrating: And there was reason to think that momentum really was building. The week before, Kristalina Georgieva, a development economist and now in charge of the International Monetary Fund, the IMF – not, I should say, the organisation that you’d think would naturally lead a global effort to roll up the world’s sleeves and get jabbing – well Kristalina Georgieva and the IMF had orchestrated a call with the head of the World Trade Organisation, the head of the World Health Organisation and the World Bank to accelerate the vaccine programme.
What the IMF plan said was this: it wanted 40 per cent vaccination by the end of 2021; it wanted 60 per cent of the world vaccinated by the summer of 2022. And its argument, as you’d expect, was numerical: the cost of the vaccine programme would be about, say, $50bn – of which $35bn should be paid by donor countries – and the benefit to the world – to the world economy – would be $9 trillion.
And so on Thursday, as the sherpas, the media and the whole G7 caravan headed to Cornwall, it seemed there were more calls, more momentum, for funding the global vaccine and treatments programme, the programme that’s known as the ACT-Accelerator. And it wasn’t just coming from activists outside the room, it was coming from heads of government inside it: Angela Merkel, the German chancellor; Justin Trudeau, the Canadian prime minister; and Erna Solberg, the Norwegian PM who has been the driving force behind the ACT-Accelerator. Together they wrote an open letter in the Financial Times calling for the G7 to pick up its fair share of the vaccine tab.
Eloise Todd: And then on Friday night Joe Biden put out what could be described as a bit of a G1 communiqué, it kind of lists from the US of all the things that the US was doing.
And again, that gave me pause for thought. I was like, hang on a minute. Is there going to be some, again, some competitive race to the top where every country says, look what I’m doing or is this basically it? And unfortunately it was like there wasn’t really a team performance. They kind of lost the match. Biden was a bit of a star player, but the team didn’t really get anywhere.
James, narrating: As the leaders gathered and their sherpas traded terms on the communiqué, back in the real world, this felt like much more than a high stakes game of Cluedo.
Here’s Kirsty McNeill again:
Kirsty: And then on the Friday the summit begins. From a Save the Children point of view, the summit begins with devastating news, which is our colleagues in Afghanistan tell us that the entire country has run out of doses.
The entire country of Afghanistan has run out of doses.
So when we say the sense of urgency was lacking in Carbis Bay that’s what we mean that UK negotiators seem to be treating this like just another summit, just another policy process, not something taking place while pandemic was raging all around us, as it still is.
James, narrating: By now, the world’s leaders have gathered in Cornwall. And we’re getting the usual kind of summitry stories – the ones about Justin Trudeau’s flip-flops, or about the Bidens’ trip out for tea, there was one about Cornish pasties that had been created specially for the occasion of the G7 summit, that look suspiciously like the kind of Cornish pasties that you’d see on any other occasion.
But the bulk of the detail on any deals coming out of the summit, well those had already been agreed.
There’s a lot of external pressure – Kristalina Georgieva, Erna Solberg, Angela Merkel herself pressing for a financing deal on global vaccines. So why didn’t it just happen?
Kirsty: So it’s been, it’s been estimated that the cost of vaccinating the world, which is of course what the prime minister told the Sunday Times he wanted to do, but the cost of doing that is anywhere between $50 billion and $66 billion. And we’d calculated that the G7’s fair share of that is two thirds. But new money was not on the table in Carbis Bay and our understanding is that’s because the host didn’t ask for it to be, the host had decided that it was the dose sharing announcement that would be the most eye-catching, and that’s what should be focused on.
Even the dose sharing agreement, however, is not at the right level of ambition. So what was agreed was that a billion doses would be shared by the end of next summer. When actually what’s needed to get ahead of the epidemic is a billion doses to be shared by the end of this summer.
So we would argue that the UK focused on the wrong issue to the wrong timetable, when actually the big player that was here to be made was financial burden-sharing. And that wasn’t secured as an outcome because it wasn’t sought as an outcome.
And, here, it’s worth taking a step out of time, because the thing is, when you are in the driving seat, when you are running a G7 summit, you really can make a difference. Summits, believe it or not, these moments of international diplomacy, can actually change the world.
The G8 summit in Gleneagles in 2005, set against a backdrop of Make Poverty History and Live 8 campaigning – it did just that.
James: So Justin, can I start by asking, who are you and what do you do?
Justin Forsyth: I’m Justin Forsyth, I work for an amazing campaign called Count Us In, which is a movement of people and organisations to get a billion people to take action in their own lives on climate change.
James, narrating: Back in 2005 Justin Forsyth was working with Tony Blair. He was an adviser on Africa and international development and he was tasked with making the G8 a success. I wanted to know how that happened.
Justin: What Tony Blair said from the very beginning is he wanted a big ambitious outcome and he instructed his negotiator that their sherpas, as we know them, who was Sir Michael Jay in those days – he’s now Lord Jay – to negotiate a very ambitious outcome at Gleneagles and not to blink first, and I think that’s the most important ingredient.
James, narrating: Listening to him it struck me that there is one of big differences between now and then – and it’s us: we, the people. In 2005, there was a global, public campaign behind debt reduction and aid. It was called Make Poverty History. Today, in 2021, there’s no such campaign for vaccines. So I wanted to know from Justin whether all that effort – the global concerts, the marches on the street, whether they’d made any difference at all to what actually happened at Gleneagles.
Justin: It affected it enormously, Make Poverty History and Live 8 were the backdrop to these negotiations. I remember at the penultimate meeting of the sherpas – which was just down the road in Whitehall from Live 8, which was happening in Hyde Park – of hearing, as the sherpas were literally meeting and doing the negotiations, the music in the background with the bands warming up.
We then went up to Scotland, in Gleneagles, and Michael Jay hadn’t done a deal on several parts of the communiqué on Africa, on the big bits – on aid, on debt, on access to AIDS treatment. Even as president Bush was landing in Air Force One, we were on the phone to his chief negotiator in the plane, as they were flying in, negotiating one of the key clauses of the communiqué. And he then agreed it – President Bush, on the plane. And we went round that night. As all the leaders’ teams were meeting in Gleneagles in the hotel, and told them all that they were the only delegation – one by one we went around and told them that the only delegation that now held out on this key clause on universal access to AIDS treatment, it was a massive thing that the very poorest people in the world have AIDS drugs, when actually in effect only the US had agreed it.
So there was all this brinkmanship, all this negotiation and the Make Poverty History campaign was really creating the noise that allowed Tony Blair to hold out and to push right to the wire of getting the maximum possible.
James: And tell me more about the dynamics between the leaders – so how much did Tony Blair have to – and I know these things get fabled in the telling of it – but how much is true, Justin, in Tony Blair’s role in eyeballing or arm-twisting the leaders themselves?
Justin: One leader, Chancellor Schroder from Germany, was very reluctant to support Tony Blair on anything he was proposing, and, you know, at one point, not to get too carried away, but he and Schroder were in the toilets at Gleneagles with, I think Tony Blair didn’t quite have him up against the wall, but almost pressing him to sign on the dotted line, which he finally did.
James, narrating: 2005 then is a story about the power of leadership, abou planning and, of course, about public support. Public pressure. Not from activists, but from middle Britain, from middle America.
And there’s something here worth reflecting on because, for all the guilt and the second-guessing around well-meaning, white, wealthy saviour complexes, this is a story about the West and the rest; it is about the responsibility of rich countries to poor countries, not because there’s a moral, human thread that connects us all, but because this time generosity is self-interest. No one is safe until everyone is.
Peter Sands: If you wanted to design a strategy to give the virus maximum opportunity to evolve in ways that evade the vaccines, then allowing it to run rampant in places where there are very low levels of vaccination and a lot of first dose vaccination but without the second dose…
James: It’s sort of like sending the virus to the gym.
Peter: It is absolutely sending the virus to the gym. And we’re sending lots of the virus to the gym, cause we’re not suppressing it effectively with other means. So that’s the really alarming thing about what we’re doing right now.
James, narrating: I’m talking to Peter Sands
Peter: I am the executive director of the global fund to fight AIDS, tuberculosis and malaria, based in Geneva.
James, narrating: In the conversations I’ve had with him, he’s pointed me to the pace at which the Delta variant has been spreading across Africa: infections and deaths up 40 per cent in a week; exponential growth each week for the past five weeks. So I wanted to get a sense from Peter of the bigger picture – not just of this pandemic, but previous ones, because, of course, Covid isn’t the first.
Peter: When pandemics are threatening the lives of people in the wealthy countries, the world mobilizes pretty effectively as we have seen with Covid. But that once, to put it bluntly, people stop dying in wealthy countries, that the level of political visibility, focus and resources tails off pretty sharply, and so we have a a long tail of unfinished pandemics: HIV/ AIDS; tuberculosis was a pandemic, it still kills something like 1.5 million people a year; and of course, perhaps the oldest – malaria, a pandemic that was all over the world hundreds of years ago, but is still killing hundreds of thousands of children.
James, narrating: Peter used to run one of the biggest banks in the world, Standard Chartered, so perhaps it’s no surprise that he points out that, in the scheme of things, global vaccines, testing and treatments are very affordable.
Peter: Look, the rich countries in the world, the OECD countries have mobilized over $12 trillion in their responses to Covid-19. What we’re talking about in terms of accelerating global rollout of vaccines, PPE, diagnostics, treatments, and so on is of the order of $30 to $50 billion. It’s a tiny fraction of, in a sense… it’s a tiny fraction to solve the problem of what we’ve spent dealing with the consequences of the problem.
James, narrating: But, as I keep being told, this is a classic problem of collective action. Everyone knows it’s a good thing to do. Everybody wants someone else to do it.
Back at the Summit, back at Carbis Bay in Cornwall, it’s now Saturday.
Lily Caprani: Yeah we saw the draft communique quite late. I think it was on the Saturday that we saw the version that we thought would be probably the final agreement, but it was still being debated.
Those numbers were still being debated as well. I think it, you know, honestly, I’m sure that it was very hard for them to reach agreement. And there was clearly an ambition to at least reach this billion figure, which you probably know, the billion doses that they’re committed to donating, when you break it down is a kind of combination of true donations and not really donations and top-ups of contracts and previously committed doses.
When, though, is a billion not a billion?
Jamie Drummond: It was clear that the billion vaccines was the big idea. And the problem with a billion vaccines was that it’s the right number at the wrong time. So this summer a billion vaccines is the right number, by say the end of August, early September. But by next summer, it’s exactly the wrong number. It’s just missing the moment quite remarkably.
James, narrating: This is Jamie Drummond. I’ve known him for years and he’s always been working on campaigns, either with Bono or the Gates Foundation, with One and with Data, and he now coordinates a group of the most influential NGOs around the world – campaigners looking to try to coordinate their efforts around the health agenda, around climate change and social justice.
The point he’s making here cuts to the chase: the vaccine failure at Carbis Bay wasn’t just about the scale of the pledges, it was about the urgency. Covax may have started in February with a confident assessment of the vaccines it would deliver in 2021. But since then, things have got worse and worse and worse. And by some estimates, it’s 290 million doses short now of what it needs for this summer: its target for the end of the year has slipped into the spring of 2022.
Jamie: We need to understand that means that what didn’t happen at the G7 needs to happen now.
And that means we need that billion vaccines now, before August, September – certainly multiple hundreds of millions, so that the under-vaccinated regions of the world get vaccinated to help fight the third wave.
James, narrating: I asked my colleague at Tortoise, Lara Spirit, to look into the numbers themselves, how much of what was promised at Carbis Bay was double counting, and what about that billion doses, what about that pledge itself? Is it real?
Lara Spirit: So no. And this was by no means clear in the reporting. Past commitments were actually folded in to reach the one billion figure which went all the way back to February. Even to get to the 870 million doses, which is actually the more accurate figure, you have to include commitments made in the weeks leading up to the summit.
Genuinely new doses have amounted to just 613 million. There’s also this question of dollars versus doses – it’s not quite so simple as saying one equals the other. Canada, for instance, says it’s giving up to a hundred million doses, but it’s only pledged 13 million directly, and the rest rolls in cash contributions it’s made previously to Covax. It’s complicated because, of course, vaccine prices vary enormously.
James, narrating: Of course, this is an infectious virus, it’s a mutating pathogen that moves as fast as we do. Boris Johnson said that vaccinating the world would be the greatest feat in medical history. But is it even doable? Is it reasonable to ask the G7 to secure enough vaccines for the world by the end of 2022. Can we make them, can we store them and distribute enough of them?
Zoltan Kish: My name is Zoltan Kish. I am a research associate working at Imperial College London in the future vaccine manufacturing hub. And we have been looking into how to mass produce mRNA vaccines for a pandemic response for over three years now, even before the pandemic.
James, narrating: What I learnt was that manufacturing an mRNA vaccine is, at least to Zoltan, a relatively simple process but… well, it seems there are lots of buts.
Crucially some of the components needed are highly specialised and there aren’t currently enough factories to make these components. There aren’t enough factories to make the vaccines either.
Zoltan: Those are the main challenges.
But they aren’t the only obstacles that need to be overcome before we can ensure a global supply by 2022.
Helpfully Zoltan had made a list.
Zoltan: Let me see, cause I wrote the list. There’s also what I would call consumable and single-use equipment. The process has been established based on single-use equipment, right? Most of the process, meaning that, you know, you use one component once and then you throw it away basically, it’s single-use.
These are things like filter membranes for purification of the vaccine, chromatography resins, even bio-reactive bags, and different storage units are single-use right?
All of these components are used not only for making mRNA vaccines, but for making other vaccines as well. So you have to make sure that there’s enough of these components.
James: What else is on there? I’m worried about your list, Zoltan. What else is on there?
Zoltan: Making sure that there’s the right distribution networks around the world.
Then you have to make sure that there’s enough people who vaccinate, right? The people who administer the vaccines. So there’s a limited number of vaccinators in developing countries as well.
And there’s the issue of vaccine hesitancy and people not trusting the vaccine, right? So, for overcoming vaccine hesitancy, you should make sure that you produce the products at high quality, consistently at high quality so that you don’t have any incidents with side effects and so on, right? And you should also combat misinformation.
James, narrating: So a quick recap of Zoltan’s list, and it gives you just a sense of the challenge: raw materials, specialised components, single-use consumables, facilities, expert people, expert know-how, cold storage, delivery of vaccine into the actual arms of people and tackling hesitancy.
And, to be clear about some of the reporting that’s been left on the cutting room floor here in making this podcast, there are plenty of people who say that we focus too much on vaccines, that they are only a small part of the answer. There’s testing, there’s treatments, there’s therapeutics, there’s effective healthcare systems, social distancing rules that are communicated and observed. Vaccines are, to be sure, just a part of it.
It is, though, a big part. The biggest. And, both practically and totemically, the most significant statement the G7 could have made in ending the pandemic, protecting the world and bringing its own citizens back to safety and something like normal, concerned vaccines.
But at the end of the summit on Sunday 13th June, with the Cornish seaside behind him, Boris Johnson came out to make his announcement on vaccines. It was the one billion dose pledge.
“A week ago I asked my fellow leaders to help in preparing and providing the doses we need to vaccinate the whole world by the end of 2022. I’m very pleased to announce that this weekend, leaders have pledged over one billion doses either directly or through funding to Covax, that includes a hundred million from the UK to the world’s poorest countries, which is another big step towards vaccinating the world. That’s in addition to everything scientists and governments and the pharmaceutical industry have done so far to roll out one of the largest vaccination programmes in history.”
Boris Johnson on the one billion vaccine doses
Journalists, as we often do, had plenty of questions, and not all of them – in fact few of them – were about vaccines. There were plenty about climate, about Northern Ireland and Brexit and, as ever, with the paradoxically parochial news agenda in this global pandemic, the latest details, not on the state of the world, but the timeline of the UK’s own lockdown. To be fair, the media wasn’t taken in by the grand claims of triumph on vaccines. Robert Peston of ITV put to Boris Johnson:
“Gordon Brown has described the billion doses of vaccine as a ‘moral failure’, he simply says it’s just not enough.”
When the former British prime minister joined us a couple of days later at a Tortoise ThinkIn, here’s how he described it:
Gordon Brown: I do fear it’s because Britain was cutting overseas aid that they were worried about making further commitments… you need a leader at a summit like this, someone has got to, you know, on each issue, someone has got to lead, otherwise things don‘t happen.
The informality of the G7 can actually be an excuse for inaction, because you’re all sitting round the table speculating at the world, you can give sort of free thoughts about everything and people will listen, but unless you actually have someone pushing for a decision you don’t actually get the decisions you need.
James, narrating: So, what had happened?
In the eyes of the UK’s Foreign Office, the G7 Summit was a success. I’ve spoken to a fair few people in government in reporting this out, but, when it comes to speaking on the record, all we’ve got is a statement. It’s from a foreign office spokesman, and the person says: “‘The UK has led the global effort to protect humanity against this deadly disease. We helped establish Covax last year, pledging £548 million to the scheme, which has so far provided 81 million doses to 129 of the world’s poorest countries. We’ve also used our G7 presidency to get the world’s biggest nations to pledge one billion Covid vaccines globally.”
And, behind closed doors, the fact is the UK really is pleased with what it achieved in Cornwall. After the G7 fiascos of the last few years, there was meaningful, multilateral agreement. Officials and ministers say the billion doses was a big step forward. Not far enough, they admit, but it was real progress. And they point out it’s not the G7’s job to vaccinate the whole world, they need to vaccinate their own countries – the G7 countries – and the poorest ones. They don’t need to vaccinate middle-income countries, and when you look at the numbers, the billion doses pledged could vaccinate most of the people in those 92 low income countries now looking to Covax to supply vaccines.
But a world still waiting for vaccines will surely be left scratching its head at a G7 Summit that over-promised and under-delivered. So why?
Well, there wasn’t a financial commitment to the vaccines in 2022, because, frankly, it’s still a lot of money. The UK found that, in the absence of fancy debt facilities to fund the vaccines, there was not much appetite from any of the G7 countries to write those cheques now. On vaccine sharing, well, they admit, it may not be enough and it certainly may not be soon enough, but the UK’s sense is that they got the G7 countries to go as far as they could. Politicians are protective of their own people: over the coming summer months in the UK, for example, vaccine supply is tighter than you’d think. This is democracy at work: you ask a democratically elected leader to choose between vaccinating a young person in their own country or a healthcare worker in Africa and it’s really no question at all.
In part, the explanation is of a different category. Boris Johnson had an idea of a renewed internationalism, but it was not the same as the one that the vaccine campaigners hoped it would be: they wanted a forum for global solutions, but to the prime minister, a successful G7 was as much about world leaders getting together and working through some of their own issues, their bilateral issues, one-on-one. And of course, we’d be naive to think there aren’t personal, political currents to all this too. Presidents Merkel and Macron did not seem eager to go out of their way to hand Prime Minister Johnson a victory on the world stage; behind the scenes, the relationship between the White House and Number 10 started the year very, very frosty and it’s only just beginning to thaw now.
Some officials admit there was an excessive emphasis on preparing for the next pandemic, when Covid-19 is clearly far from done with us now. In fact, as one of the UK’s leading medical scientists put it to me, this pandemic, as far as the world is concerned, is nearer the beginning than the end.
And psychologically, the curious thing about Covid is that it’s been a catastrophe, but, not in the classic sense, a crisis: it’s been a year of chronic health problems, but there’s not been a moment, as in the financial crisis of 2008, when it’s seemed the global system is on the point of collapse. There’s not been, as one official described it to me, a moment of the world teetering on the brink.
In the few weeks since the G7 in Cornwall, it already seems clear that the world leaders’ response to the pandemic was inadequate.
“The Delta variant of the coronavirus is driving waves of new infections in countries around the world.”
“Indonesia stands on the brink of a coronavirus catastrophe.”
News clips on the spread of the Delta variant
The coronavirus is not stopping – and the G7’s part in tackling it needn’t end here, either.
Lily Caprani: What really mattered the most was the US commitment because they put a time limit around it.
James, narrating: This is Lily Caprani of Unicef, pointing to good news – and the possibility.
Lily: They said they’d start doses coming in June, which is what we desperately needed and sure enough, they are doing that. And we’ve just seen the first arrivals this weekend.
James: Where do the vaccines go? The ones that just arrived from the US, where did those go?
Lily: So we had the first donated Moderna vaccines and which were donated to Covax so that we could distribute them. They went to Honduras on Sunday and this coming week we’re anticipating quite a lot more. So we’ve got millions moving this week and next week from the US. Still not enough and still a huge gap to fill, but it’s the first evidence of those promises actually turning into reality. Whereas most of the other pledged doses, we still don’t have any timeframe around.
And if they don’t come till the end of the year, they just won’t be as valuable to us, you know? A dose delivered today, arguably could do more good than two delivered in six months time when we probably will have a healthier supply pipeline anyway.
James, narrating: And, so here’s the card that Boris Johnson still has up his sleeve. The UK is the host of the G7 until the end of the year. In 2022 it hands over to Germany. But between now and then, there’s still time to do more. If he wanted to, Boris Johnson could convene a G7 Vaccines Summit before the UN General Assembly in September.
There were seven days lost in June. Seven leaders who fell short of what 7 billion people need. But the UK’s G7 presidency is not over yet.
If he wants to, Boris Johnson can yet show that seven is a lucky number.
You’ve been listening to the Slow Newscast – Vaccine failure: the G7’s deadly sin. I’m James Harding, the producer is Katie Gunning, the sound designer is Tom Burchill, and a special thank you to Pete Hobbs, Sir Tim Rice, and the Truro Choir, for giving us the chance to listen to Gee Seven.