“A question central to the teaching of Jesus was ‘And who is my neighbour?’ During the pandemic we have seen the best of people, communities and countries when hands have been held out to help others deal with the consequences of COVID-19. An infection that respects no boundaries has also taught us afresh that everyone is our neighbour and that we will only be able to respond effectively to the pandemic when we remember that truth. At the start of 2021, this presents us with two main challenges.
“Firstly, many of us are tired, dis-spirited and anxious. Digging deep into our faith and trust in God is essential to us keeping on looking outwards and serving our neighbours. Secondly, in some contexts, with the advent of vaccine programmes, there is an increasing sense that the end may be in sight. While this may be true for countries able to access large numbers of vaccine doses, for many this will not be the case. If we want a world free of Covid, then looking towards all our neighbours will remain essential.
“My prayer is that all of us will remember and act on that knowledge. Jesus’s response to the question ‘Who is a neighbour?’ is ‘The one who shows mercy’. In 2021, this must be the action call for us all.” Bishop Michael Beasley, Bishop of Hertford and convenor of the emerging Anglican Health and Community Network.
As we enter 2021, the Covid-19 pandemic is still raging, a full 11 months on from its declaration. Across the world, there have been over 88 million confirmed cases and nearly 2 million deaths. New variants have been identified in recent weeks, which are able to spread faster than the initial strain. We are also now more aware of Long Covid, which can have a catastrophic impact on people’s lives, including those of many young people. The social and economic impacts continue to be enormous and will be with us for a long time to come, even when the acute phase of the pandemic has passed.
However, there is some very real light in the midst of all this, with the development, trial, approval and now roll out of several vaccines, which have been shown to protect people from getting severe illness with Covid-19 infection.
The Anglican Alliance wants to acknowledge, praise and give thanks to the many scientists who have been tirelessly developing these vaccines over the last several months and to the World Health Organization, the Global Alliance for vaccines and Immunization (GAVI) and the Coalition for Epidemic Preparedness Innovations (CEPI) who have worked to create the global COVAX facility to help establish global equity of access to them. We also give thanks to God that we are indeed “fearfully and wonderfully made” (Psalm 139:14), with complex immune systems which can be activated to provide protection against pathogens.
In this piece, we provide some pointers to information about the state of vaccine development and roll out and outline three areas of concern, which have been identified by the Covid-19 global task force convened by the Anglican Alliance. These are: i) the importance of keeping going with measures to limit transmission of the virus; ii) the dangers of misinformation; iii) issues of global equity of access to the vaccines.
Vaccine development and roll out
In December, the World Health Organisation briefed the Anglican Health & Community Network and the Anglican Alliance on the current state of the Covid-19 pandemic and progress towards the roll out of effective vaccines. A recording of the half hour briefing is here. It provides a clear and concise overview of the vaccines in development and some of the logistical considerations. A write-up of some of the key points to emerge from the webinar is here.
This is a fast-moving area and, since the briefing a month ago, a few of the vaccines have achieved regulatory authorization or approval in several countries. Vaccination programmes are now underway in these places. These include the UK, which was the first country to vaccinate people (outside of a trial) and which has so far vaccinated 1.5 million people (as of 11th January). High profile people to receive the vaccine include Queen Elizabeth II and President-Elect Joe Biden.
Most of the Anglican clergy in Israel are also amongst recipients of the vaccine. Bishop Hosam Naoum, Coadjutor (Assistant) Bishop for the Diocese of Jerusalem, said this week, “The Minister of Health encouraged us to do that so we can encourage others to do so as well, because there has been a lot of fear and concerns about the vaccination – what they can do and all the conspiracy theories that come with it… The clergy, including myself and Archbishop Suheil have taken it because we work in public. Unfortunately, this is not the case in other places such as the West Bank, Gaza, Jordan, Lebanon and Syria because the vaccine has not reached them yet. But we took the decision to go ahead with the vaccination because we wanted to make our personal contribution to ending the pandemic and one way we can overcome this pandemic is by vaccinations.”
Vaccines offer the hope of ending the acute phase of the pandemic. Vaccines are arguably the most effective health interventions known to humankind and have saved the lives of millions of people from diseases such as smallpox, tetanus, polio, measles, diphtheria, TB and many more. Vaccination is also highly cost effective, utilising the body’s natural defence mechanisms and exemplifying the proverbial saying “prevention is better than cure”.
Given the potential benefits of the Covid-19 vaccine(s), it is tempting to think that the end of the pandemic is imminent. However, this is, sadly, not yet the case. As mentioned above, there are three particular areas for consideration, concern and caution.
We must keep going with measures to reduce the transmission of the virus
Having effective vaccines and vaccinating sufficient people to bring the acute phase of the pandemic to an end are two different things. The sheer scale of the pandemic and the enormous logistical challenges of producing and distributing sufficient quantities of the vaccine(s) mean that Covid-19 will be with us for quite some time. In addition, it is not yet known whether vaccination prevents people transmitting the virus, even though they themselves are protected from developing severe disease.
It is therefore essential that there is no let-up in behaviours and measures to reduce transmission of the virus. Physical distancing, wearing masks, hand hygiene, good ventilation, reducing to a minimum the number of interactions with other people as well as effective testing, contact tracing and isolation of contacts etc will need to be the cornerstone of prevention measures for the coming months. After nearly a year of restrictions, this is a difficult and unwelcome message. Church leaders will need to be helping their congregations cope with the ongoing loss and tiredness, constantly encouraging perseverance with these prevention measures (see here for resources for churches). Finding ways to maintain good mental health will continue to be essential.
Focusing solely on the vaccine and presenting it as the way out of the pandemic can also be a means by which governments can deflect attention from their own responsibilities and their failures to control the virus. If governments promote the vaccine beyond its capacity, any perceived failure of the vaccine to deliver the promised results plays into the hands of conspiracy theorists, allowing them to say, “We told you it wouldn’t work”.
Misinformation and the need for clear, accurate information
In December, the Anglican Alliance carried out a small survey amongst colleagues across the Communion about what people are hearing and saying about the vaccine and attitudes towards it. From this questionnaire, and from other conversations, it is apparent that many people are being exposed to misinformation and conspiracy theories, facilitated by social media. There is also a desire for accurate, clear and simple information from trusted sources to counter misinformation.
The Anglican Alliance and the emerging Anglican Health and Community Network are both represented on the WHO’s newly formed community of practice for faith-based organisations on Covid-19 vaccine communication. This group is working on resources to help faith leaders communicate clearly and accurately with the communities they serve and will be convening a webinar on this in early February. Please contact email@example.com if you would like to join the webinar.
Equity of access to Covid-19 vaccines
The number of people needing to be vaccinated globally far exceeds the current supply levels of vaccines. Numerous factors are in play affecting who will receive the vaccines first. Some of these are to do with countries’ regulatory bodies authorising the vaccines for use and the logistics for distribution being in place, but others are to do with countries’ purchasing power and, therefore, raise issues of fairness. There is urgent need for the Church to be awake to the ethical issues of equitable access to Covid-19 vaccines, both globally and within countries. This calls the Church to reflect on and engage with equity issues, nationally and globally. For national considerations, please see this paper from the World Council of Churches and World Jewish Congress which discusses ethical issues to do with Covid-19 vaccine access both globally and nationally.
There are around 200 Covid-19 vaccine candidates, at different stages of development and clinical trial. Usually in vaccine development only a minority of vaccines under development are successful. This, and the pressure on governments to vaccinate their populations, has led those countries which can afford to do so to make ‘Advance Market Commitments’ (AMCs) – that is, they have pre-purchased or reserved large stocks of several candidates (not knowing which ones – if any – would be authorised by regulators for use). As a result, Duke Global Health Innovation Center report that, as of January 8th 2021, “High-income countries currently hold a confirmed 4.2 billion doses, upper middle-income countries hold 1.2 billion doses, and lower middle-income countries hold 495 million doses.”
They continue, “While this makes sense from the perspective of an individual country, it leads to deep inequities in terms of global allocation… Canada has purchased enough to vaccinate its population five times over.” They emphasise that not all of the pre-purchased vaccines will necessarily be approved for use, so the real amount of excess usable vaccine stock is unknown. However, they were not “able to find evidence of any direct deals made by low-income countries”, clearly putting them at a disadvantage.
Thankfully, a global mechanism is already in place to help address the issue of equitable access to Covid-19 vaccines: COVAX. COVAX is a platform coordinated by the WHO, GAVI and CEPI, to “support the research, development and manufacturing of a wide range of COVID-19 vaccine candidates, and negotiate their pricing.” It is a way for participating countries (there are 190 participating economies) to pool resources to enable accelerated vaccine development (and share the inherent risks).
COVAX is designed to give all participating countries, regardless of income levels, equal access to these vaccines once they are developed and sufficient doses to immunise at least 20% of countries’ populations. This means that low-income countries will have access to vaccine for 20% of their population. However, their own lack of purchasing power for bilateral deals with manufacturers suggests they will be entirely reliant on what they can access through COVAX, raising serious questions about how the rest of the population will have access to the vaccine. A recent update on the current state of funding and advance purchasing under COVAX is here. As of December 18th, COVAX had arrangements in place to access nearly two billion doses of COVID-19 vaccine candidates, with “guaranteed access to a portion of the first wave of production, followed by volume scales as further supply becomes available”. COVAX had by then received US$2.4bn towards its Advance Market Commitments and “is seeking at least US$4.6bn in additional funding in early 2021 to ensure the purchase of COVID-19 vaccines for at least 20% of the population of all AMC-eligible economies in 2021”. So, funding is still needed to purchase sufficient vaccine doses to fulfil the 20% aspiration of COVAX and further funding needed for ongoing research and development and delivery support.
As the different vaccines receive regulatory approval for use, it is possible – or even probable – that high-income countries that have pre-purchased multiple vaccine candidates will have excess usable stock. With such a precious commodity, it is vital these vaccine stocks do not go to waste. COVAX has drawn up a set of Protocols for Sharing Vaccine Doses with COVAX, which will ensure spare doses can be shared in a fair and timely manner. COVAX is seeking commitments from potential dose-sharing countries and manufacturers to adopt the principles and “partner with COVAX to provide additional doses for equitable distribution”.
Thus, the mechanisms for equitable vaccine distribution and sharing of countries’ excess doses both exist. The role of the Church and others will be both to argue and advocate for their use.
Reasons for supporting equity in global distribution of vaccines:
As the World Council of Churches and World Jewish Congress have argued in their joint paper on the ethical issues related to Covid-19 vaccine distribution, scriptural principles underpinning our responses include:
- The God-given dignity and worth of every human being. (Genesis 1:27)
- The commandment to love our neighbours as ourselves. (Leviticus 19:18; Mark 12:31)
- The faith calling to care especially for the weakest and most vulnerable among us. (Isaiah 1:17; James 1:27)
As well as the clear ethical case, there is a self-interest argument for equitable distribution. The rapid global spread of Covid-19 in the first three months of 2020 demonstrated how interconnected we are. Conversely, as WHO Director Tedros Ghebreyesus has said, “”No one is safe until everyone is safe”. GAVI explain, “Every government has a responsibility to put its citizens first – and during a pandemic, this means thinking and acting globally. If manufacturing agreements or export restrictions obstruct the deployment of vaccines and the virus survives anywhere, no one can be safe from the impact of the pandemic.” People’s lives and countries’ economies will continue to be adversely impacted until people everywhere are immunized and the pandemic brought under control.
The Church can call on the governments of wealthier nations to:
- Fund COVAX.
- Adopt the COVAX principles for sharing Covid-19 vaccine doses, advocating for them to be donated.
The Anglican Alliance will continue to develop its thinking and resources in all the above areas in the coming weeks, adding to our Covid-19 resource hub.
Please note that it is also possible for individuals and organisations to donate to WHO’s Solidarity Response Fund.