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00:00This vaccine nationalism now we have Germany saying that Europe should keep its own supply of Pfizer. This is just going to get worse for the poorer nations. It is I think we run the risk really that what we've started to see around vaccine nationalism continues especially if we start to see more hiccups in the supply of vaccines in the short term. So it's unfortunate to see what's coming out of Europe. It's similar to what we saw coming out of India a few weeks ago. But the government in India walked back any talk about export control and hopefully we won't see any being put in place in Europe either. And the thing is Kovacs was meant to perhaps level the playing field make it more equitable but it's not really working out the way it was planned. Yeah. Kovacs is a very complex mechanism and we live in a world that is a bit disjointed. So I would say if you compare Kovacs to the aspiration of the ideal state it has certainly been disappointing. But if you look at Kovacs relative to what the world would look like without it it's serving a critical purpose with one hundred and ninety different participants at the table at least talking about mechanisms for global equity. So I really see Kovacs as necessary for global equity and an appropriate response but in no way sufficient. So we're going to have to see Kovacs really be successful. And in addition we're going to have to see many more things happen for the global response to be successful. Give us a sense of the disparity in terms of access between the haves and the have nots. Because you know some reports suggest that countries are paying a premium and that can only happen if you're rich. Yeah. It's moved to a point now where we're really even beyond what the price may be as countries that are getting more desperate. We know that more than 7 billion doses of vaccine have already been purchased and more than half of those have been purchased by high income countries that have less than a fifth of the world's population. In addition what we're starting to see is that as poorer countries become more desperate they are starting to look for options beyond what we have good data for in terms of efficacy and safety in terms of different vaccine candidates. Krishna David here. That was good. I wanted to follow up on that is is it. Are the non Western vaccine options and necessarily also the poor quality ones. It's what I'm trying to get at. That's well because eventually that's so far what developed nations realistically can can can can reach at the moment. That's the critical question and the answer is we don't know. I think what we really need is a level playing field in terms of access to the data on efficacy and safety as well as regulatory review. So in that sense the World Health Organization through their regulatory review process and emergency use listing are going to play a really important role. So far the Pfizer biotech vaccine has received emergency use listing and more than a dozen other candidates are under review. And especially with some of the Indian Chinese and Russian developed or manufactured vaccine being important for global access we really need to see better data and more transparent data on what they actually represent. Our hope is that they will be high quality vaccines that become available to many low and middle income countries. But we just haven't seen the data yet to have that level of confidence. You know this conversation a part of me isn't surprised this is happening although that doesn't make this any less heartbreaking frankly to put it that way. How do we fix this. And frankly I'll be straight. Can poor countries expect rich countries to step up and help them. I think we should expect those that have more to step up and in addition to the really strong humanitarian or ethical argument. We know that there's a really strong health argument to be made if we really want to save the most lives possible. It has to be global equitable distribution. And in addition even if we want to make the selfish argument there's a really strong argument that high income countries are going to have stronger economic recoveries. Their economies will grow faster more quickly if they allow for better and more equitable access to vaccines around the world. So no matter how you look at it whether it's humanitarian health or just in terms of pure economic lens the answer is still the same which is to do more to get vaccines out to the rest of the world. How much of this and there might be a risk. The reason I bring this up there might be a risk that of course we're going to likely see. A faster vaccine rollout in higher income countries simply because things like logistics execution things just run more smoothly in those places. Is there anything that governments in poorer countries can do looking at what's been done so far. I'd mentioned Israel for example has done very very well that they can emulate to hopefully mitigate this imbalance. Yeah I think there's a lot to be learned both in terms of what to do right and also things to avoid from my own country. Here in the US or others. And we should recognize that many low and middle income countries have handled this global pandemic much better than several high income countries. So this should really be about global lessons learned not just learning from rich countries to to implement in poorer countries. And in that sense no matter when the vaccinations happen. We know that a really strong public health response is going to be critically important for an indefinite period of time. We also know that there has to be really strong health system components in place to be able to distribute especially out to the last mile. We know that having equity as a driving factor of vaccinations is really important. And what we've learned already from implementation in the US and others is that the prioritization wild driven by equity equity as well as access will burnable populations also has to be simple enough to be implemented at scale. So we can't make this more complicated for the sake of trying to get it exactly right. I think we have to figure out what's good enough and go quickly. Chris now very quickly the target now is to get hard in unity and you can only get that if everyone is vaccinated including the poorer nations. Realistically when will we see. Herd immunity. I think realistically we're probably two to three years away which is depressing but unfortunately the reality even if Kovacs hits its targets for 20 21. We're talking about a goal of 20 percent of population's immunized in low and middle income countries. And we know that's not near enough to reach herd immunity. So we're really looking at two or three years of dealing with this pandemic.

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How Would 'Vaccine Nationalism' Affect Poor Nations?

On this episode of "Bloomberg Equality," Krishna Udayakumar, director of the Duke Global Health Innovation Center, looks at how the efforts around the world to obtain effective Covid-19 vaccines are affecting poor nations. European Union regulators have proposed requiring drugmakers to flag exports of coronavirus vaccines, a move that could disrupt deliveries of the shot made by Pfizer Inc. and BioNTech SE, which is manufactured in Belgium. Udayakumar speaks on "Bloomberg Markets: Asia." (Source: Bloomberg)

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