More than a year since the COVID-19 pandemic halted life as we knew it, the world is now in a very different place. There are now eight vaccine candidates approved for full use and more than 1 billion doses administered worldwide — the international community is on its way to ending the pandemic.

But the availability of a COVID-19 vaccine is not the final answer to the problem. In order to cease transmission of the virus, enough of the global population needs to be vaccinated to reach a level of herd immunity. 

One of the main barriers to achieving this level of immunity is the inequitable access to vaccine doses, especially when there is still a limited supply. A stark gap has already formed between the haves and the have-nots: North America currently boasts a vaccination rate 35 times higher than that of Africa.

Emanuele Capobianco, director of health and care at the International Federation of Red Cross and Red Crescent Societies (IFRC), spoke with Global Citizen about the importance of achieving a global target for herd immunity and how his organization has been helping to work toward that goal.

Global Citizen: What would it look like to reach herd immunity globally and why is it so crucial to ending the pandemic?

Capobianco: The coverage of a vaccine is a need in order to protect the global population from the further spread of the virus. If we get to the level of so-called herd immunity, we will be able to really slow down the transmission of the virus globally. But the 60% [to] 70% immunization rate needs to be achieved across the globe. If you have 90% immunized in one country and 20% in another country, that doesn't work.

There is also a need to bring the coverage within countries and make sure that they don't have pockets of high coverage, and then marginalized parts of the society with low coverage, because that will continue to fuel the transmission of the virus. And so there is a public health argument that reaching this level of immunization across countries and within countries will benefit everyone, the poor and the rich.

How does inequity get in the way of achieving herd immunity globally?

It’s very clear to us as the Red Cross Red Crescent that the value of each life is really equal, but what we have seen reflected in political choices made over the past several months is that certain lives are more valued and more protected than others. 

Unsurprisingly, the lives that are the least protected are the ones that are most vulnerable already — those that have the least access to health services, that have no ability to distance from others because they live in crowded places, no ability to stay at home because they need to go out and work and face the risk of infection.

Let me bring in some statistics. The poorest 50 countries in the world account for 2% of the doses administered globally. And the richest 50 countries are being vaccinated at a rate that is 27 times higher than the rate of the 50 poorest countries. Another way to look at this: Africa accounts for 1% of the doses that have been administered globally, and yet the population of Africa is 14% of the global population. The inequities are stark in front of our eyes.

What are the consequences of a vaccination process that doesn’t make sure access is equitable?

If we don't ensure equitable access, then what happens within the countries with low coverage will eventually impact those living in the rich countries, particularly when it comes to the emergence of new variants. We may end up in a situation in which the disregard for the poorest leads to a new pandemic with a virus that is more transmissible, more lethal, that may be attacking and killing people of younger age.

The role of politicians is to defend their people, so it is understandable that there may be a prioritization. But at the same time, there should be an effort to work toward reducing transmission elsewhere. What we need is the ability for politicians to bring these two arguments together — the protection of their own people and the solidarity with others — in a way that will work best for all of us and bring the best out of humanity.

What has the IFRC been doing to help ensure equitable access to COVID-19 vaccines among the most vulnerable communities?

We are a humanitarian organization of 14 million volunteers who bring services to meet the socioeconomic needs of the most vulnerable groups all across the world in 192 countries. When it comes to vaccines, as of December 2020, we started an ambitious program that aims to support the vaccination of 500 million people by the end of this year.

In the Maldives, where a lot of [undocumented] migrants live, our Red Crescent Society has been able to register these [undocumented] migrants in order for them to obtain a vaccine. In Bangladesh, we have a Red Crescent Society that has been very active within the Cox’s Bazar refugee camp, providing hospitals, health centers, and volunteers to support these refugees from the health and socioeconomic sides.

In the Amazon in Brazil, a country that has been dramatically hit by COVID-19 over the past several months, our volunteers are operating and supporting provision of services. We have homeless people that are taken care of and injecting drug users in many countries that are really prioritized. That is what the Red Cross Red Crescent is trying to do in many countries — identify where the inequities are higher and then to come in to provide the support.