As of February 2021, the UN’s refugee agency, UNHCR, had tallied more than 49,000 COVID-19 cases among refugees and displaced people around the world, including 446 deaths.
Beyond the immediate humanitarian impacts, the cost of helping the world’s most vulnerable 10 percent facing COVID-19’s socio-economic repercussions could total $90 billion, according to UN estimates. The World Bank estimates the pandemic pushed between 119 million and 124 million “new poor” into extreme poverty last year – a shift unlikely to be reversed in 2021.
Vaccines: Queue-jumping, unequal rollouts, and humanitarian stockpiles
There’s a clear divide in who has early access to coronavirus vaccines.
Public health officials warn of “vaccine nationalism”, hoarding, and queue-jumping as wealthier countries buy up early supplies.
“The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries,” said the WHO’s director-general, Tedros Adhanom Ghebreyesus.
As of mid-February, three quarters of all global doses were in only 10 countries, and more than 94 percent of countries beginning vaccinations were high-income or upper-middle-income. Some 130 countries hadn’t yet administered a single dose.
The WHO has inked agreements to reserve some 1.3 billion doses for 92 low- and middle-income countries under the COVAX programme, which was created with the goal of ensuring equal vaccine access, including doses for at least 20 percent of countries’ populations.
But Tedros said wealthier countries are circumventing COVAX by signing dozens of bilateral deals with manufacturers – driving up prices and potentially delaying COVAX deliveries. He urged countries to vaccinate health workers and older people, then share excess doses with COVAX.
Countries will receive their first COVAX doses in late February or early March, the WHO and other agencies behind the scheme announced on 3 February. Bosnia and Herzegovina, Colombia, the Philippines, Rwanda, and South Africa will be among the first handful to receive vaccines through the programme. Current planning calls for some 330 million doses – enough to cover 3.3 percent of participating countries’ populations – in the first half of 2021.
Beyond vaccine access at the country level, there are fears that marginalised groups often left out of government health planning at the best of times – migrants, refugees, and other people in crises, for example – may be at the very back of the queue.
“Those living in humanitarian emergencies or in settings that are not under the control of national governments are at risk of being left behind and must be part of COVID-19 vaccination efforts,” warned the Inter-Agency Standing Committee, an umbrella group for humanitarian responders.
The UNHCR says 94 of 130 countries have “committed to include forcibly displaced people” in national vaccination plans.
The COVAX programme includes plans for a “humanitarian buffer”, which would see five percent of the total doses stockpiled for “acute outbreaks” or for use by humanitarian groups. Potential uses could include vaccinating “refugees who may not otherwise have access”, according to Gavi, the global vaccine alliance.
At the same time, vaccine hesitancy is growing around the globe, according to researchers at the Duke Global Health Innovation Center, and could become “the primary obstacle to global immunity”. Researchers pointed to multi-country surveys that suggest rising reluctance to vaccinate. “If this is the case, we will soon find that producing enough vaccines does not translate to enough vaccinations,” the researchers said.
Other vaccine news:
– The United Kingdom is calling for vaccine ceasefires across the globe so that people trapped in conflict zones can be protected against COVID-19. UN Secretary-General António Guterres made similar calls last year as the coronavirus pandemic surged. At the time, a handful of ceasefires were announced, though many were quickly broken. Aid group Oxfam called global peace efforts during the pandemic a “catastrophic failure”.
– The WHO gave a green light to two versions of the Oxford-AstraZeneca vaccine on 15 February, clearing the way for the vaccine’s global rollout through the COVAX programme. Most low-income countries are relying on COVAX supplies to drive their early immunisation rollouts, and the Oxford-AstraZeneca vaccine represents 99 percent of the programme’s pipeline through mid-2021. COVAX is distributing the first vaccine approved by the WHO for emergency use, the Pfizer-BioNTech vaccine, to only a handful of countries. This is partly due to limited supplies and the difficulties of shipping and storing the vaccine, which requires “ultra-low-temperature” freezers.
– Rohingya refugees are included in Bangladesh’s COVID-19 vaccination plans, a UNHCR spokesperson told TNH. The national vaccination plan began in January in the capital, Dhaka, and will be extended across the country. The Rohingya refugee camps have a young population – more than half of residents are under 18. There are an estimated 30,000 people older than 60.
– Refugees in Nepal will be included in the country’s vaccination drive, the UNHCR reported on 9 February. Vaccination campaigns started in January, and people older than 55 (and people with ”comorbidities” between 40 and 54) are a second priority after health staff and other frontline workers. “Refugees who meet these conditions will be included,” the UNHCR said. There are at least 19,500 refugees and asylum seekers in Nepal, including people from Bhutan, Tibet, Pakistan, and Myanmar.
– The Oxford-AstraZeneca vaccine can be used in countries where troubling new variants are taking hold, a WHO panel recommended on 10 February. Days earlier, South Africa suspended its rollout of the vaccine after one study suggested it was “minimally effective” at preventing mild or moderate cases caused by a COVID-19 variant. The WHO panel said the South Africa study was unable to determine the vaccine’s effect on severe cases. The “known and potential benefits” outweigh the risks, the panel said. The WHO said the emergence of multiple variants showed the importance of equitable vaccine access, and for donors to keep funding research for “next-generation” vaccines.
– Undocumented people in Malaysia will “in principle” receive free COVID-19 vaccines, the country’s minister in charge of immunisation, Khairy Jamaluddin, said on 11 February. Refugees and asylum seekers said they faced arrests and growing xenophobia as coronavirus lockdowns escalated in 2020.
– Colombia will provide 10-year temporary protection status to some 1.7 million Venezuelans sheltering in the country, opening access to COVID-19 vaccination plans and the national health system, UN agencies announced on 8 February. The move comes after Colombian leader Iván Duque previously said that undocumented Venezuelans would not receive free doses. Duque later called for international help to vaccinate Venezuelans.
– Burundi is among at least four African countries left out of initial COVAX distribution plans for the first half of 2021. The country’s health minister told reporters vaccines were “not yet necessary”, the Associated Press reported on 5 February. Earlier, officials in Tanzania announced the country would not accept vaccines. Tanzania hasn’t reported COVID-19 cases to the WHO since last May, and doctors have sounded the alarm over their country’s coronavirus response. Eritrea and Madagascar are also forgoing COVAX-supplied vaccines, The Wall Street Journal reported. All four countries are eligible for free vaccines through COVAX.