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Who will get the Vaccines?
Ask pharmaceutical corporations about how they will ensure access to Covid-19 vaccines, and they say “Gavi”. Ask the wealthiest governments in the world what they are doing to ensure global equity, and they too say “Gavi”.
Gavi, the Vaccines Alliance, is a 20-year old public-private partnership that believes the marriage of markets and philanthropy will bring vaccines to everyone in the world. At the Global Vaccine Summit held earlier this month, Gavi raised a record-breaking $8.8bn. Gavi launched its newest initiative, a fund for future Covid-19 vaccines – the Covax Facility – which invites countries to invest in a wide portfolio of potential vaccines, pool their risk, and gain dedicated access to eventual products.
Pharmaceutical companies say they will make no money off the pandemic, that they will supply vaccines at a cost. Yet, they have already seen multibillion dollar increases in their market capitalisation, and are unwilling to relinquish the monopolies that drive their outsize profits. Leaders of rich countries (apart from the US) have said all the right things about equitable access to vaccines. Yet they are entering into multiple advance deals to stock up on possibly far more vaccines than they will ever need
The first deal – a US$750m agreement with AstraZeneca for 300 million doses of the potential Oxford University vaccine – was heralded as a commitment by industry to meet the needs of the world’s poorest countries. But it came at a high price, representing only a minor discount over the full price paid by the US government. The problem is, we know very little about this deal because the agreement isn’t public, despite all the public money involved. We don’t know if, for example, AstraZeneca gets to keep the money if its vaccine fails. We don’t even know for a fact that all the vaccines bought are intended for use in poor countries.
The World Health Organization’s forthcoming Global Allocation Framework will specify that the most vulnerable people in the world be given the vaccines first and in a fair and equitable way. Yet, a report prepared for the Gavi board meeting that starts this week, and circulated ahead by Gavi to stakeholders, including civil society organisations, proposes that rich countries can ignore the WHO framework, with only poor countries having to abide by it. According to the document, it seems Gavi will allocate rich countries enough vaccines for a fixed percentage of their population, which their “national advisory bodies” will decide. Poor countries, meanwhile, will only get vaccines for their highest priority people, after demonstrating proof.
Rich countries are “encouraged (but not required)” to donate vaccines if they have more than they need, but we do not know when poor countries will get these donated vaccines: will it be at the same time as the rich countries, or only after they have used up all the vaccines they need?
The prospect of a two-tiered system puts into question the fundamental issue that Gavi was founded to address: equitable access to vaccines.
Three decades of getting medicines and vaccines to poor people have revealed the problem and the solution: monopolies over vaccines in the pharmaceutical industry, enforced through patents which, when suspended, result in prices going down and supply going up. The rich countries and organisations who fund Gavi are equally culpable: the US, UK and EU have committed billions towards vaccine research, almost all of which has gone to private pharmaceutical companies – without any conditions to prevent them from monopolising their vaccines. All these countries have further stockpiled future vaccines by making direct deals with manufacturers, again without any access conditions whatsoever. At best, Gavi has failed at negotiating control over the vaccines it funds. At worst, it believes that pharmaceutical monopolies, which have thwarted equitable access, are somehow essential to achieving it.
Seth Berkley, the Gavi CEO, cannot claim to want “the world to come together” with “no barriers” while failing to tackle both rich country nationalism and pharmaceutical industry greed.
https://www.theguardian.com/commentisfree/2020/jun/24/worlds-poorest-people-coronavirus-vaccine-gavi
Poverty – UK
Even after taking account of emergency additions to the welfare safety net launched as the virus spread to Britain earlier this year, the Institute for Fiscal Studies (IFS) said benefits for out-of-work households were worth 10% less than in 2011.
For an average out-of-work household with children, the shortfall jumps to £2,900 a year or 12%, less than was available in 2011 before the cuts kicked in.
Highlighting the scale of the Tories’ austerity drive and the stuttering recovery from the 2008 financial crisis, the IFS said cuts to working-age benefits and tax credits meant low-income households in particular had experienced stalling improvements in living standards.
Finding that the impact was entirely down to benefit cuts, which offset growth in wages over the period, it said incomes for the poorest 10th of households were essentially the same in 2018–19 as they had been five years earlier in 2013–14.
Without the temporary changes announced by Rishi Sunak in March to raise the value of universal credit and other benefits to soften the blow delivered by Covid-19, households would have been 15% worse off, and families with children 16% worse off, the IFS said. The changes are due to last for 12 months. Unemployment is expected to more than double this summer.
UK Inequality
White households in the UK have incomes 63% higher than black households, and even after taxes and benefits are nearly a fifth better off.
ONS also found that income inequality in the UK has widened over the past two years – partly due to the benefits freeze – and indicated that it is likely to widen further as a result of the Covid-19 pandemic.
The average white household income in the financial year to 2019 was £42,371, compared with £35,526 in Asian households and £25,982 in African-Caribbean households. After tax and benefits, the average white household had a “final” income of £38,222, 9% more than Asians on £35,023, and 18% more than black households on £32,353.
ONS said it did not have separate data for different groups under the “Asian” category, which included Indian, Bangladeshi, Pakistani and Chinese. But it pointed to earlier data from the Family Resources Survey, which found that 42% of Indian households had an income above £1,000 a week, compared with just 20% of Bangladeshi and Pakistani households.
Income inequality had been rising for two years before Covid-19 struck, said the ONS, which it said “most likely reflects a moderation in the value of cash benefits”. The UK Gini coefficient, a measure of income inequality, rose by 1.5 percentage points between the financial years 2016-17 and 2018-2019. A higher Gini number indicates higher inequality. Overall, inequality in the UK rose sharply in the late 1970s and through the 1980s, and has remained at elevated levels since.
It is also likely to worsen as a result of the pandemic, said the ONS. It found that employees in occupations that had a higher propensity for home working were on average more likely to have a higher household disposable income. It also found that 40% of workers in the poorest fifth of households work in occupations that have great exposure to coronavirus, such as care work and catering.
https://www.theguardian.com/inequality/2020/jun/23/white-household-income-in-uk-is-63-higher-than-black-households-ons-finds
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Jordan has surpassed Indonesia to have the highest smoking rates in the world. Including e-cigarettes and other “smokeless” products, more than eight in 10 Jordanian men are nicotine users. Surveys show tobacco use is still growing, on the back of a rise in women taking up the habit and the popularity of water pipes, which doctors say can be equivalent to consuming approximately three packs of cigarettes over a 45-minute session. Analysts suspect smoking rates may be just as high in countries such as Iraq, Lebanon and Syria – Jordan is just advanced and stable enough to be able to measure its problem.
“In Jordan we consider someone who smokes a pack a day to be a light smoker,” Firas al-Hawari, a physician who directs an anti-smoking clinic says. “We have people who smoke three, five, seven packs a day.” Often their offspring have been exposed to so much secondhand smoke that they have become addicted, too. “For every four cigarettes their parent has smoked, the child has smoked one.”
The impacts of so much smoking are already stark: tobacco use is linked to one in eight deaths in the country, compared with one in 10 deaths worldwide, and costs Jordan’s GDP an estimated three times the global average. The true scale of the problem will be known in about 2030, when a bulk of the country’s disproportionately young population reaches 40 – the age at which tobacco-related illnesses, such as heart disease and cancer, start to manifest.
“It’s going to cause an enormous surge in non-communicable diseases that we won’t be able to handle,” Hawari says.
Smoking used to be endemic in wealthier countries such as the US, Australia and many in Europe. But decades of aggressive public health campaigns and restrictions on the ability of tobacco companies to advertise and lobby have succeeded in dramatically cutting their smoking rates. Many of those corporate tactics have now migrated to countries in the Middle East and Africa, where regulations are more lax and poorly enforced. The majority of the world’s smokers now live in middle- and lower-income countries.
Raouf Alebshehy, a monitoring coordinator in the tobacco control research group at the University of Bath, explains, “One of the important factors we have found in this region is that the multinational companies started to invest and expand here. They started to shift work from developed markets to emerging markets here and in Africa where tobacco demand is still growing, and they bought up local manufacturers.”
Jordan has the most tobacco company interference in policymaking in the world after Japan, according to a 2019 analysis by a civil society group.
“Big tobacco is preying on our countries, wanting to really own the lungs of our youth,” says Dina Mired, the president of the Union for International Cancer Control. “And they are doing so successfully.”
Those who push to implement the same anti-smoking laws that have been effective overseas say they are warned of the financial impact in a country where tobacco taxes make up 18% of annual revenues (pre-Covid figures)
“Members of parliament tell me: ‘This is an economic matter, you are affecting the Jordanian economy and threatening the jobs of people working in the industry’,” says Mervat Mheerat, the deputy manager for health in Greater Amman Municipality. “They correlate tobacco with the economy. And that’s the message they get from the tobacco industry.”