Vaccine equity: Equal access to vaccines for all, really?

 

Vaccine equity - that's the new buzzword I'm hearing during the current Covid-19 crisis. What exactly are we talking about here? In early January 2021, the World Health Organization (WHO) issued a call to all countries to work together in solidarity and bring an end to the Covid crisis. Equal access to the vaccine for all.

In a perfect world, this would be the perfect call to action. It is at the heart of WHO's campaign for #VaccinEquity and nearly 1500 organisations around the world signed the #VaccinEquity Declaration. This sounds good, or does it?

Personally, the alarm bells started sounding off because of two specific incidents. Firstly, our Science, Technology, and Innovation Minister Khairy Jamaluddin described the hoarding of vaccines by industrialised nations as immoral and lashed out at global vaccine inequity.

The other was when I read that more than 50,000 companies have registered over two million of their employees for vaccination under the Selangor state government's vaccine programme (Selvax).

The first statement highlights the immorality of vaccine inequity while the second statement seems acceptable with the proviso that it does not impinge on the rights of those who are not lucky enough to work with companies in Selangor or are so deeply entrenched within the Orang Asli settlements of our rainforests that they have no idea what is happening.

How does all this impact people like me, volunteering at ground zero in a vaccination centre (PPV) in Kota Bharu, Kelantan? How does it affect the senior citizens waiting for the magic call from MySejahtera? What effect does it have on the unregistered disadvantaged communities in and around Kota Bharu, the disabled, the wheelchair-bound autistic, the hypertensive makcik paralysed with a stroke?

On the ground at the PPV, we do not often see the B40 groups (bottom 40 percent income earners), disabled or otherwise. That worries me. On the ground, we are happy at the rate of vaccination, thinking that we are having such a great effect on the pandemic. That worries me a lot too.

Then last night, I heard that a certain hospital is allowing their staff to get their own extended families vaccinated. That worries me even more. The fact that no one thinks this is wrong, really really scares me. A great deal.

According to the WHO, “increasingly, a two-track pandemic is developing, with richer countries having access and poorer ones being left behind.” Vaccine equity seems to be something understood only by politicians and academicians, beyond the grasp of the ordinary person. Let them deal with it, we may say.

But I beg to differ.

Vaccine inequity is real. It is not just a buzzword. It is here alongside the Covid virus. It is within the community. You can see it at the PPV where I volunteer. Slowly but surely, the rift between the haves and have-nots is becoming an ever-deepening chasm. It is a social, economic, moral and health issue, the divisiveness of which will haunt us for generations to come.

Providing vaccines at massive PPVs is the quickest way of getting vaccines into arms and it is mesmerising to watch those YouTube videos showing how our massive PPVs can work quickly and efficiently, without a hitch.

Yet, look closely, and you will see that in many instances, they have failed in terms of equity. Where are the unregistered and disabled, the paralysed, the disadvantaged? They have always been and will continue to be marginalised. Nothing has changed.

This time it is dangerously different. Something has to change. The virus is insidious in its ability to upend our social fabric. It is no longer an issue of the rich getting richer and the poor getting poorer. The danger here is that if we do not vaccinate this marginalised group fast, it will be at our own peril.

Which group of people do you think will be unable to withstand the prolonged economic, social and mental strains of a prolonged lockdown? Which group of people do you think will have a greater chance to end up in the ICU, who will drain our oxygen supplies and push our health system to the limit?

The answer is self-evident and embodied within. It is the unheard, but certainly not an unthought-of idea, that “it won’t happen to me. I can ride out this lockdown. Just stay home and learn something new. Use this time to bond with my children”. A luxury that is not accessible to marginalised communities.

The task of solving local vaccine inequity on the ground is my responsibility as much as it is yours. The alternative is too scary even to contemplate. The scenario is stark. If current practices prevail, the chances are that the greatest number of Covid-positive people will be from the B40 group.

Among the B40 group, the most vulnerable, the disabled, unregistered and undocumented migrants will be the most sufferers. This will be a breeding ground for Covid variants to spread and since it is a highly democratic virus, it is just a matter of time before it spreads out of the B40 group to the rest of the community.

Remember this every time you try to jump queues at a PPV. Think about it when you get your cousins, nieces, and nephews vaccinated ahead of the vulnerable population just because you can.

If we want to get out of this pandemic, if we want our elusive herd immunity, if we want to stay safe, then let us get the vaccine into the arms of marginalised communities as soon as possible.

I hear you when you say that, on the ground, there are mobile units ready to vaccinate the disadvantaged communities in their homes. I hear you when you say you have drive-ins where the paralysed can perhaps drive themselves to get vaccinated. I hear you when you say you have the funds and the means.

Yes, I hear you, but I just do not see it happening yet. On the ground, this is just not happening. And if it is happening, one cannot help but feel that it is just lip service.

The task of solving local vaccine inequity on the ground presents us an opportunity to build a better world, of restoring vaccine equity. We need to share ownership of vaccines, reallocate, and redistribute to solve vaccine inequity.

Here at our PPV, in cooperation with two local government agencies, we are doing our little bit to help correct vaccine inequity. You can read about our small project here.

Support your local PPV and volunteer to do your bit to help the marginalised communities who remain the most vulnerable to Covid-19 infection. Every time you respond to a white flag situation, ask if they have been registered under MySejahtera or register them here. Check if they need and know how to get to and from a PPV.

We cannot lose sight of the unequal balance of power within our communities. We cannot lose sight of the fact that beyond the reallocation of vaccines, restoration of vaccine equity means the difference between life and death. The next life you save could very well be your own. - Mkini

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DR ZALINA ISMAIL is a retired professor with an MBBCH, PhD in neurophysiology, as well as an LLB and LLM in medical law - skillsets she hopes to use while in retirement.

The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.