“Some pandemics don’t end, they become invisible to the wealthy” | Coronavirus

Do you believe that the burden of the COVID-19 pandemic will shift to poor countries?

Madhukar Pai. First, I believe there is a persistent myth to be debunked that COVID-19 has not affected the poorest countries, especially in Africa. We know that these countries have vastly underreported cases and deaths. The World Health Organization (WHO) has also recently shown that it is in low- and middle-income countries that excess mortality is highest. This means that poorer nations are more affected.

We must also take into account the inequity that exists between countries in terms of access to tests, vaccines and antiviral treatments.

we are lucky [au Canada] to get our third or even our fourth dose. We have access to antivirals. This is not the case for the poorest countries. Most countries in Africa have vaccinated less than 15% of their population with two doses.

The rich countries have been miserly. It’s selfish, it’s short-sighted. But no one seems to be listening.

Could COVID-19 only become endemic in rich countries?

PM Yes, the disease will become endemic for these countries, but not for those with few resources and who are among the most vulnerable. COVID-19 will thus be added to the list of diseases that are killers in low-income countries, such as malaria, tuberculosis and HIV.

With COVID-19, we see that things are happening exactly as in the past. When a disease stops affecting white people, the rich, the privileged groups, we move on and the disease becomes invisible.

For example, for tuberculosis, the same vaccine has been used for 100 years. How many vaccines have we already developed against COVID-19? The amount invested in the fight against COVID-19 is 1000 times higher than what is invested against tuberculosis.

50 to 100 years ago, there was still a lot of tuberculosis in Montreal, there was even a sanatorium. But rich countries have been able to move on because they have the resources. And yet, even today, we have high rates of tuberculosis among the Inuit and we do nothing.

For several thousand years, malaria was a global threat. In 2020, almost all of the 627,000 deaths from this disease occurred in sub-Saharan Africa. The first malaria vaccine was only developed in 2021! And it is still difficult to access in the places that need it most.

If malaria had continued to affect the more affluent countries – if malaria were present in Canada – I guarantee you that this vaccine would have been developed more quickly.

As for HIV, not so long ago, [attraper la maladie] it was a death sentence. When effective antiretroviral drugs first became available in the early 1990s, they were expensive and mostly accessible to people in high-income countries. It took a decade for them to arrive in Africa and it took India to start manufacturing generic antiretrovirals to make them accessible and affordable for less wealthy countries. How many people died before that?

” Shows how little we care about these other diseases [endémiques]. And there’s no reason to believe that won’t happen again with COVID-19. »

Can we wait 10 years for the vaccine against COVID-19 to be accessible to all? How many deaths are we willing to accept? How can we justify losing so many lives when we have the tools and the science at our disposal?

So COVID-19 will add to the burden of poor countries, already struggling with various diseases?

PM Yes, and we are already seeing the impact. The incidence of other diseases (malaria, tuberculosis, HIV) has worsened due to the pandemic. The fight against tuberculosis has suffered a devastating setback over the past two years. We lost a decade of progress because many people couldn’t get treatment because of the pandemic. Tuberculosis mortality is increasing. HIV testing has declined in Africa. Basic immunization in children has declined. Measles is making a comeback.

All care has been delayed and with each wave, health systems have been disrupted. If COVID-19 continues to spread in low-income countries, healthcare workers will continue to be too busy fighting COVID-19; they won’t be able to focus on other diseases and basic immunization.

In addition, inflation is out of control, as are gas and food prices. An estimated 100 million people will be pushed into extreme poverty, forced to live on less than $2 a day. And we know that poverty goes hand in hand with tuberculosis, HIV, malaria… and now COVID-19.

What is the risk of letting COVID-19 become endemic in some places?

PM If by any chance the next variant is more deadly, we’ll all be in a very bad spot. A pandemic is a transnational catastrophe: you cannot contain it in one part of the world.

Instead of investing now to prevent this situation [et vacciner plus de personnes]we will end up paying billions of dollars [pour vaincre un nouveau variant].

And if there is a new variant and a new vaccine or treatment, it is the rich countries that will buy everything and the others will have to wait once again.

This myopia is the reason why we are in the third year of the pandemic and I can guarantee you that I will repeat the same things to you next year…

What is the solution?

PM I have no hope [qu’on réussisse à rattraper les retards] if we don’t get COVID-19 under control. And I’m convinced we can’t do that without fairly vaccinating against COVID-19.

We have all the tools, give them to people. It’s not rocket science. Science during the pandemic has made extraordinary advances, but these advances only benefit the wealthy.

The real obstacle to ending this COVID-19 crisis around the world is not science or resources, it is us.

But I am discouraged because I see the momentum to vaccinate the world has waned over the past few months.

” Wealthy nations, including Canada, want and will move on, because they can afford it. We’re going to leave the rest of humanity behind… Supporting her should have been our priority. »

I am not satisfied with what Canada has done [en matière d’approvisionnement de vaccins aux pays pauvres]. We could have done more. Canada promised 200 million doses to poor countries; we only gave 15 million. We continue to grab millions of doses for ourselves which will expire soon and we have no plans to offer them to other countries.

The most important thing we have learned from this pandemic is that low-income countries no longer rely on the generosity of wealthy countries because they no longer believe in it. These countries want to be self-reliant and take care of their own people.

Our lack of solidarity scares me. Politicians are geographically blind, they cannot think beyond their borders. They cannot think beyond the next election. But topics like climate change and the fight and prevention of pandemics require serious long-term thinking.