In the last week of November 2021, well known South African general practitioner and chair of the South African Medical Association, Dr Angelique Coetzee, announced that a young man she had seen in her practice had tested positive for COVID and has a new variant of what the world now knows as the Omicron variant. From all indications, this variant had been in circulation in Southern Africa for a while and possibly in other parts of the world having been previously identified in Botswana.

Botswana’s leader says foreign diplomats who travelled from Europe were among the first known Omicron cases, suggesting that the Omicron variant likely originated from Europe, but the first genomic sequencing and identification came from South Africa. Surprisingly, the announcement of the discovery by a prominent South African physician and national medical leader thrust the Omicron virus on to the world stage and led to unprecedented panic and hysteria leading national governments to irrational and widespread travel bans and severe restrictions. Rather than South African scientists being saluted and applauded for their remarkable science and transparency, the world reacted with xenophobic hysteria targeting Africa, notwithstanding the fact that at the time of the announcement, no one in South Africa was known to have been hospitalised with the virus.

The richer nations focused on vaccinating their entire population but paid only scant attention to vaccine poverty in the less developed nations despite the science that informs that no one was safe unless everyone was safe. This was compounded by the reckless race-tinged decision some months ago by the European Union that the AstraZeneca vaccine administered to millions in Africa would not be acceptable in the vaccine passport regime of EU, suggesting that this vaccine was inferior to the AstraZeneca vaccine administered in Europe. These discriminatory conducts mirror the long-standing history of global imbalance fuelled by racial prejudice and so encouraged suspicion and vaccine hesitancy in these communities. It was not surprising, therefore, that new variants of the virus would continue to pop up in a world with uneven access to vaccinations and health-care resources. One wonders if the mass hysteria and the reactionary travel bans and restrictions on Africa would have been the response if the new variant was first announced in Europe or North America. We think not, especially at a time when no data suggested that such partial bans and restrictions have any meaningful impact on stemming the global spread of the virus. To the contrary, we have evidence that while the SARS-CoV-2 virus was first identified in Wuhan, China, its entry into the USA was not from China but from Europe. In the same vein, while travel bans focus on Africa, the Omicron variant has been found in many countries in the West including the USA, UK, Netherlands, Canada, Germany, Sweden, Spain, Japan, Canada, Finland, Ireland, Italy, Luxembourg, etc. Should we then lock down travel from these other countries as well?

The current crisis was avoidable, but the world paid no heed

Using publicly available figures, the Washington Post reported earlier in the year, that about 50 per cent of all vaccine doses administered so far had gone to just 16 per cent of the world’s population in what the World Bank considers high-income countries. Through the summer and fall of last year, wealthy nations cut deals directly with vaccine-makers, buying up a disproportionate share of early doses — and undermining a World Health Organization-backed effort, called COVAX, to equitably distribute shots. So now, in a small number of wealthy nations, vaccine doses are plentiful and mass immunisation campaigns and booster doses are progressing at a rapid pace while much of the world is experiencing severe shortages of vaccine supplies. While herd immunity seems achievable in wealthy nations, it remains elusive in the poorer nations. While many wealthier nations in the West currently have oversupply of vaccines, many poorer nations of the world will unfortunately wait for years to vaccinate a significant portion of their population. The problems with access, supply, and distribution of vaccines in the least economically advanced countries of the world will prolong the pandemic and impede recovery in the more developed countries, despite oversupply of vaccines in these countries. Vaccine inequity between countries and regions will continue to pose a significant and unnecessary risk to an already uneven and fragile global recovery.

What does the future hold?

Much of the Western world has responded with hysteria and a strategy focused on protecting their citizens without much attention to global health security. Such a strategy is flawed and likely to achieve only limited relief. While increased surveillance and vaccinations including boosters would help stem the spread of the virus within national borders, it will have no lasting impact on ending the pandemic. A world in which some countries achieve 80 per cent vaccination rates while many more achieve less than five per cent is not a world that will stop new variants from arising. As long as the global inequity in vaccine access, distribution and administration continues, we will continue to experience periodic and frequent disruptions from new COVID-19 variants. A global response that is underpinned on health equity will result in an expanded access to testing and vaccination to contain the pandemic on a global scale. Interrupting transmission remains our best defence against this virus and path to returning to normalcy. We can only achieve this through mass global vaccination and adherence to the proven safety measures such as wearing face masks, physical distancing, and regular hand washing.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Correspondence to info@caribbeanheart.com or call 876-906-2107