A year ago, when the Covid-19 pandemic was still in its relative infancy, the head of the World Health Organization stressed thata global approach would be the only way out of the crisis.
"The way forward is solidarity: solidarity at the national level, and solidarity at the global level," WHO Director General Tedros Adhanom Ghebreyesus told a media briefing in April 2020.
Fast-forward 12 months and the devastating scenes in India, where hospitals have been overwhelmed by a surge of Covid-19 cases and thousands are dying for lack of oxygen, suggest the warnings went unheeded.
India is not the only global Covid-19 hotspot. Turkey entered its first national lockdown Thursday, an unwelcome step prompted by infection rates which are now the highest in Europe.
India's Covid-19 crisis is a problem for the world
Iran reported its highest daily Covid-19 death toll so far on Monday, with many towns and cities forced into partial lockdown to curb the spread of the virus. Iranian President Hassan Rouhani has said the country is suffering a fourth wave of infections.
The picture across much of South America is also gloomy. Brazil, with more than 14.5 million confirmed coronavirus cases and nearly 400,000 deaths, according to Johns Hopkins University data, continues to have the highest daily rate of Covid-19 deaths per million in the world.
Some countries have offered help as hotspots emerge, for example flying in oxygen concentrators, ventilators and other medical supplies to India in recent days. But the coordinated global response urged by Tedros a year ago -- and repeatedly since, by WHO and other global heath bodies -- remains elusive.
COVAX roll out in Africa offers hope of vaccine equality 02:13
And while some Western countries are eying a return to more normal life in the coming weeks, the worldwide picture remains dire. The number of global Covid-19 cases has risen for the ninth consecutive week and the number of deaths is up for the sixth week straight, WHO said last Monday.
"To put it in perspective, there were almost as many cases globally last week as in the first five months of the pandemic," Tedros said.
COVAX, the global vaccine-sharing initiative that provides discounted or free doses for lower-income countries, is still the best chance most have of procuring the vaccine doses that might bring the pandemic under control.
But it is heavily reliant on India's capacity, through its Serum Institute of India (SII), to produce doses of the AstraZeneca vaccine which are the cornerstone of the COVAX initiative.
While India promised to supply 200 million COVAXdoses, with options for up to 900 million more, to be distributed to 92 low- and middle-income countries, its own rapidly worsening situation has prompted New Delhi to shift focus from the initiative to prioritizing its own citizens.
At the same time, Western countries have been criticized for vaccine stockpiling. Some, including the United States, Canada and United Kingdom, have ordered far more vaccine doses than they need.
UK Health Secretary Matt Hancock said Wednesday that the UK -- which is now vaccinating healthy people in their 40s, having already offered at least one dose to all its older and more vulnerable residents -- had no spare vaccines to send to India. The UK government has said it will share surplus doses at a later stage.
India is one of the world's top 10 buyers of Covid vaccines. It still has nowhere near enough
The SII "are making and producing more doses of vaccine than any other single organization. And obviously that means that they can provide vaccine to people in India at cost," Hancock said. "India can produce its own vaccine, based on British technology, that is... the biggest contribution that we can make which effectively comes from British science."
In the United States, everyone age 16 and older is now eligible for a Covid-19 vaccine and 30% of the population is fully vaccinated, according to data Friday from the US Centers for Disease Control and Prevention. Earlier in the week, the White House said it would donate up to 60 million doses of the AstraZeneca vaccine -- of which it has a stockpile but has not yet authorized -- in the coming months following a federal safety review.
Well over half of Israel's total population has received at least one dose of the coronavirus vaccine, and the country is easing restrictions.
As of early April, just 0.2% of the over 700 million vaccine doses administered globally were given in low-income countries, while high-income and upper middle-income nations accounted for more than 87% of the doses, according to Tedros.
In low-income countries, only one in more than 500 people has received a Covid-19 vaccine, compared with almost one in four people in high-income countries -- a contrast Tedros described as a "shocking imbalance."
Patients sit in a monitoring area after they were inoculated with the Pfizer/BioNTech vaccine against Covid-19 at a mass vaccination center on April 15, 2021 in Berlin, Germany.
"Some [of the 92 lower-income countries] haven't received any vaccines, none have received enough and now some countries are not receiving their second-round allocations on time," Tedros told a global donor event on April 15.
"We've shown that COVAX works. But to realize its full potential, we need all countries to step up with the political and financial commitments needed to fully fund COVAX and end the pandemic."
While many wealthier nations have pledged funds, they have been less ready to give up their Covid-19 shots. France last week became the first country to donate AstraZeneca doses from its domestic supply to COVAX.
"The problem is the people with the power are predominantly national governments," said Michael Head, senior research fellow in global health at the University of Southampton, in England. "The WHO offers guidance, but it doesn't have much power. And it's the WHO that works on things like equity to ensure that the world is as protected as it can be.
"Obviously national governments are there to act in their own citizens' interests, and when it comes to a pandemic the world is quite selfish, all countries are quite selfish -- they to a certain extent quite reasonably look after their own people first."
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