Spend billions, save trillions: it’s in rich nations’ self-interest to vaccinate the world

Late last year, it was tempting to view Omicron as a blessing of sorts, a light dusting of COVID-19 that would give us more antibodies and greater protection. But death, illness and disruption rates are back to near their global worst and are through the roof in Australia.

As for Omicron meaningfully adding to a “wall of immunity”, this is, at best, a hopeful hypothesis. Widespread infections with previous COVID variants have not prevented major outbreaks of the next. Britain, for example, has had enormous outbreaks with the Alpha variant (where it originated), then with Delta and now Omicron. Nor is a variant simply a facsimile that automatically weakens and blurs with each copy. The next variant could well be more powerful than the last.

In Papua New Guinea, just 3 per cent of the population is vaccinated.Credit:

And economically, it’s an ongoing disaster. The International Monetary Fund estimates the cost may rise beyond $US12.5 trillion by the end of 2024. That’s a very large slice of a circa $100 trillion global economy. In its reassessment, IMF managing director Kristalina Georgieva singles out huge gaps between rich and poor, especially in COVID-19 vaccine rates.

We speak too often about COVID as an exercise in individual risk management, when really it’s a macro challenge. Imagine the global caseload of COVID as a giant reservoir of virus. The more that reservoir grows, the greater the opportunity for a variant with a “fitness advantage” that can better transmit or avoid immunity. Conversely, if we drain the reservoir the risk grows smaller. This can only happen by vaccinating every person, regardless of where they live and what they can afford.

Notably, the three major variants of concern arose in poorly vaccinated populations.

To Australia’s near north, Papua New Guinea represents the exact conditions for mutation. Only 3 per cent of its 8 million people are vaccinated. That’s far lower than in Southern Africa – the likely source of the Omicron variant – where the vaccination rate is 25 per cent.

This logic applies beyond PNG. Wherever there are poor controls on growth and low vaccination rates, the conditions for new variants are ripe. As it stands, low-income countries have less than 10 per cent vaccine coverage while high-income countries are delivering their third doses.

Further vaccine-resistant mutations will also cost Australia financially as governments reimpose lockdowns or citizens enact defacto ones. This is evident now, with half-full restaurants, hesitant travellers, and a stunted return to offices. Retails sales were down 4.4 per cent in December.

Two looming international public health efforts give Australia an opportunity to invest in medical forward defences.

The COVAX initiative to vaccinate the world has already delivered more than a billion shots in just under a year – an unprecedented achievement. COVAX delivers vaccines where the disease burden is heaviest, to ensure need is not overwhelmed by greed. This is the most rational and effective way to prevent both spread and mutation and accelerate the end of the pandemic.

Nations are stepping up their COVAX investment. The US has already pledged $5.5 billion, Germany $1.6 billion and Canada $656 million. These funds will do more than purchase vaccines. They will also be spent delivering them, overcoming disrupted supply chains and constrained health systems.

Australia’s contribution so far has been $130 million. We should, at the very least, provide another $250 million to COVAX.

We also need to invest $100 million to the Coalition of Epidemic Preparedness Innovations, which has been critical to the COVID-19 response. It announced its first vaccine partnership in January 2020 when only 581 cases were confirmed globally. It has since helped fund 14 vaccine candidates to increase chances of success.

CEPI needs additional funding to continue its important work on COVID-19 and its future vision, which included compressing vaccine development timelines to a “100-day moonshot” and supporting the national health security of low and middle-income countries, for future pandemic risks.

These investments are modest compared with the benefit they confer: fewer mutations, a lighter disease burden and a safer more prosperous world. At a global scale, it’s investing billions to save trillions.

Professor Jane Halton is chair of the Coalition for Epidemic Preparedness Innovations. Professor Brendan Crabb is chief executive of the Burnet Institute and chair of Pacific Friends of Global Health.

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