Worldwide, health restrictions are dropping because many wealthy countries, endowed with vaccines, now want to live with COVID-19. Dr Madhukar Pai, professor of epidemiology and global health at McGill University in Montreal, however, sees the danger that again, poor countries will be left for themselves in the fight against the virus, as this is the case of malaria, tuberculosis and AIDS. Maintenance.
Do you believe that the burden of the COVID-19 pandemic will shift to poor countries?
Madhukar Pai. First, I believe there is a repeated myth to deny that COVID-19 does not affect the poorest countries, especially Africa. We know that these countries have massive unreported cases and deaths. The World Health Organization (WHO) also recently showed that in low- and middle -income countries, the high mortality rate is highest. This means that poor countries are more affected.
We must also take into account the inequality that exists between countries in terms of access to tests, vaccines and antiviral treatment.
we are lucky [au Canada] to get our third or even our fourth dose. We have access to antivirals. This is not the case for the poorest countries. Most countries in Africa have vaccinated less than 15% of their population with two doses.
The rich country has become stingy. It’s selfish, it’s short -sighted. But no one seems to be listening.
Can COVID-19 be endemic only to rich countries?
PM Yes, the disease will be endemic for these countries, but not for those with few resources and among the most vulnerable. Thus, COVID-19 will be added to the list of diseases that kill in low-income countries, such as malaria, tuberculosis and HIV.
In COVID-19, we see that things are happening exactly as in the past. When a disease that affects white people, the rich, the privileged groups stops, we go on and the disease becomes invisible.
For example, for tuberculosis, the same vaccine has been used for 100 years. How many vaccines have we done against COVID-19? The amount invested in resistance to COVID-19 is 1000 times higher than that invested against tuberculosis.
50 to 100 years ago, there was still a lot of tuberculosis in Montreal, there was even a sanatorium. But rich countries have been able to move on because they have the resources. However, even today, we have a high rate of tuberculosis among the Inuit and we do nothing.
For several thousand years, malaria has been a global threat. By 2020, nearly all of the 627,000 deaths from this disease will occur in sub-Saharan Africa. The first malaria vaccine was only made in 2021! And it’s still hard to access in places that need it the most.
If malaria continues to affect richer countries – if malaria is present in Canada – I guarantee you that this vaccine will be developed faster.
As for HIV, not so long ago, [attraper la maladie] it is a death sentence. When effective antiretroviral drugs first became available in the early 1990s, they were expensive and often accessible to people in high-income countries. It took a decade before they reached Africa and it took India to start producing generic antiretrovirals to make them accessible and affordable for less wealthy countries. How many people died before that?
” It shows how little we care about these other diseases [endémiques]. And there’s no reason to believe that won’t happen again in COVID-19. “
Can we wait 10 years for the COVID-19 vaccine to be available to everyone? How many deaths are we willing to accept? How can we justify the loss of so many lives if we have the tools and science at our disposal?
Will COVID-19 increase the burden of poor countries, already struggling with various diseases?
PM Yes, and we are already seeing the impact. The incidence of other diseases (malaria, tuberculosis, HIV) has worsened due to the pandemic. The fight against tuberculosis has undergone a devastating decline over the past two years. We lost a decade of development because so many people could not get treatment because of the pandemic. The death toll from tuberculosis is rising. HIV testing is down in Africa. Primary immunization in children has dropped. Measles is coming back.
All care is delayed and with each wave, health systems are disrupted. If COVID-19 continues to spread in low-income countries, health care workers will continue to be too busy fighting COVID-19; they cannot focus on other diseases and basic immunization.
In addition, inflation is out of control, as are gas and food prices. An estimated 100 million people will be pushed into extreme poverty, forcing them to live on less than $ 2 a day. And we know that poverty is associated with tuberculosis, HIV, malaria ... and now COVID-19.
What is the risk of letting COVID-19 become endemic in some areas?
PM If at any time the next variant is more deadly, we are all in a very bad place. A pandemic is a transnational catastrophe: you can’t contain it in one part of the world.
Instead of investing now to avoid such a situation [et vacciner plus de personnes]we will pay billions of dollars [pour vaincre un nouveau variant].
And if there is a new variant and a new vaccine or treatment, rich countries will buy everything and others will wait again.
This myopia is why we are in the third year of the pandemic and I can guarantee you that I will repeat the same things to you next year…
What is the solution?
PM I had no hope [qu’on réussisse à rattraper les retards] if we cannot control COVID-19. And I’m convinced we can’t do that without fair vaccination against COVID-19.
We have all the tools, give them to people. This is not rocket science. Science during the pandemic made extraordinary advances, but these advances only benefited the wealthy.
The real obstacle to ending this worldwide COVID-19 crisis is not science or resources, it is us.
But I am discouraged because I see that the momentum to vaccinate the world has weakened over the past few months.
" Rich countries, including Canada, want and will continue to, because they can. We are going to leave the rest of humanity ... Supporting him should be our priority. "
I am not satisfied with what Canada has done [en matière d’approvisionnement de vaccins aux pays pauvres]. We could have done more. Canada has promised 200 million doses to poor countries; We only gave 15 million. We continue to take millions of doses for ourselves that are about to expire and we have no plans to offer them in other countries.
The most important thing we have learned from this pandemic is that low-income countries no longer rely on the generosity of rich countries because they no longer believe in it. These countries want to be self-reliant and take care of their own people.
Our lack of unity frightens me. Politicians are blind to geography, they cannot think beyond their borders. They can’t think beyond the next election. But topics like climate change and the fight and prevention of pandemics require serious long-term thinking.
Source: Radio-Canada
