Omicron puts travel bans and vaccines inequity front and centre in pandemic politics

When South African officials held a briefing introducing a new and worrying coronavirus variant late last month, the reaction was swift: countries around the world threw up travel bans, decimating flight schedules and isolating nations across southern Africa.

As African leaders decried the moves and warned of dire economic impacts, the global fallout began.

A top South African scientist said the bans were disrupting imports of lab materials critical for generating data needed by the world. And a highly anticipated World Trade Organization meeting set to discuss Covid-19 vaccine access was postponed, because some ministers were blocked from flying in.

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WHO officials were quick to push back, praising South Africa and Botswana for detecting and reporting the new variant, known as Omicron, and denouncing blanket travel bans.

“Our current system disincentivises countries from alerting others to threats that will inevitably land on their shores,” WHO chief Tedros Adhanom Ghebreyesus said, calling for reforms.

Rather than blanket travel restrictions, the WHO leaned towards screening and quarantining new arrivals.

It also invoked an agreement made more than 15 years ago, when WHO member nations pledged not to “significantly interfere with international traffic” during public health emergencies without providing proper scientific justification.

Much has been learned in the pandemic, but experts largely argue that travel bans – while possibly buying countries more time to prepare for a variant’s onset – will not keep the virus out for long in most cases.

With the Omicron variant, the coronavirus has already been identified in several dozen countries, and genetic evidence has shown that it was already in at least one other nation before the South Africa report. But countries have largely yet to revise their early restrictions against African nations.

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“It is clear that a travel ban cannot stop the circulation of virus and, more importantly, can jeopardise the effort to fight against the outbreak,” Jaouad Mahjour, the WHO assistant director general of emergency preparedness, said last week.

Other scientists at WHO’s Africa news briefing on Thursday described difficulties both in shipping samples of the virus to labs around the world and in obtaining materials like reagents needed to detect and characterise the virus.

“There are fewer flights to choose from to bring in reagents, to bring in equipment, in addition to send out specimens and isolates for people to be able to work with Omicron,” said microbiologist Anne von Gottberg of the National Institute for Communicable Diseases, South Africa.

A laboratory in Johannesburg, South Africa, where PCR Covid-19 tests are administered. Photo: AFP

WHO virologist Nicksy Gumede-Moeletsi said that if bans expanded to more countries, they would be affected too.

“That is going to be a serious setback as far as the characterisation, the sequencing and the monitoring of the Omicron variant are concerned,” she said.

Omicron has turned the global spotlight on these issues just as WHO member countries agreed last week to write new rules on how to work together to prevent and respond to pandemics. Negotiations could ultimately shape a future pandemic treaty.

Countries have said they hope a new agreement could improve outbreak alerts and the sharing of data and pathogens.

They also aim to repair a system that has led to gaping inequities in access to Covid-19 vaccines. Low-income countries, most of them in Africa, have received just 0.6 per cent of all vaccines administered globally, according to the WHO.

Doing so may also require navigating another long-standing issue: how to balance expectations about sharing data or pathogens while ensuring access to medical goods built off such information.

Such concerns have played out in real time on Twitter following Omicron’s emergence.

On Monday, Tulio de Oliveira, the director of the South African consortium Centre for Epidemic Response & Innovation, accused countries of “saying thanks” for data from Africa, while punishing the region with travel bans and continuing to “hoard” vaccines and diagnostics.

De Oliveira, who led the early sequencing of the variant in South Africa, came forward on Twitter to say his lab was having trouble importing critical materials due to flight bans.

He pointedly asked who would profit from any new vaccines or diagnostics developed by pharmaceutical companies as a result of data collected and shared by South Africa about the Omicron variant.

These are not new questions. In 2007, Indonesian officials stopped sending H5N1 virus samples to the WHO’s reference labs for a similar reason. They wanted to challenge a system where samples provided freely by developing countries were used by companies in wealthy ones to produce medical goods that developing countries could not afford.

“If the world continues to operate in this way, the discrepancies will become wider and wider,” Indonesia’s health minister and other scientists wrote at the time. “The poor will become poorer and the richer become richer. It is the responsibility of all nations to change this situation.”

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The 2014 Nagoya Protocol – on sharing benefits arising from genetic resources – sought to resolve this, but some public health leaders have called for a more streamlined system for health emergencies, such as including the sharing of pathogens and data more generally in a potential pandemic treaty.

But it may be challenging to do so without taking steps to ensure fair vaccine access, experts say.

“Without connecting data sharing and pharmaceutical or vaccine access, there’s little incentive for countries – particularly those in the global south – to go along with a pandemic treaty or any sort of more robust regime,” said global health politics expert Jeremy Youde, a dean at the University of Minnesota in Duluth.

It is unclear how the Omicron variant emerged, but scientists and world leaders have cited the sharp inequities in vaccine access for allowing the virus to continue to spread, and as an engine for the emergence of variants. Omicron has renewed urgent calls for dose donations, tech sharing and global reforms.

At last week’s meeting at the WHO, Ghanaian Health Minister Kwaku Agyemang-Manu was among those attributing the ongoing crisis to “vaccine hoarding” by rich nations.

He pledged to ensure that any pandemic pact included building capacity for local production of vaccines in Africa and other developing countries “to end the world’s reliance on a few vaccine producers”.

But whether Omicron can be the spur to a revamp of the global system remains to be seen.

Antoine Flauhalt, director of the University of Geneva’s Institute of Global Health, called equity in production, distribution and access to vaccines and medical products a “prerequisite of any treaty”.

Achieving this, however, would require a host of actions, he said, including waivers in patents, technology transfer, capacity building and public-private partnerships.

For more than a year, South Africa has been promoting a proposal to waive intellectual property protections around Covid-19 vaccines and other medical products in a bid to ramp up production. The proposal – supported by more than 100 countries – has been blocked by a handful of wealthy nations.

It was on the agenda for last week’s meeting of the WTO, which was cancelled because of the Omicron travel bans.

In the absence of that meeting, the proposal’s future – like that of global vaccine access amid Omicron’s spread – remains unclear.

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