Vaccinating The World Requires More Than Just Doses
It's imperative that people everywhere also have access to COVID-19 vaccines. But shipping and sharing the vaccine doses is only half the battle.
BRUSSELS / CONARKY — Chances are that your social media feed already features plenty of freshly #vaxxed friends and family proudly showing off Band-Aids on their biceps or signed certificates indicating that they're now protected against COVID-19.
Throughout Europe, the vaccination campaign has indeed begun to take off. And yet, the sad reality is that in the rest of the world, one in four people will likely have to wait until at least 2023 for access to a vaccine.
Because of this disparity, many are demanding solutions: Either vaccine patents must be lifted or more contributions made to the COVAX program, the international vaccine-access campaign being co-led by the World Health Organization.
Should we be fighting for greater vaccination equity? Absolutely. It goes without saying that everyone should have access to vaccines. But we also need to make sure people are willing to get vaccinated. For that to happen, there's a crucially important factor that has unfortunately been neglected in fragile and conflict-affected countries: how much — or how little — citizens tend to trust their governments.
Our organization, Search for Common Ground, is dedicated to peacebuilding in conflict-affected countries, and we have conducted several surveys on the links between coronavirus and conflict in places where we work. We have found that only 36% of respondents responded "satisfied" when asked about their government's handling of the pandemic. Even more telling is that 50% rated their government as employing a "discriminatory approach" (i.e. failing to consider the needs of various segments of the population equally) in their coronavirus response.
For persecuted minorities or those living under authoritarianism and corruption, distrust in government is to be expected. But during a global pandemic, when trust in the state, particularly in its vaccination plan, is absolutely essential, this can be deadly.
This distrust is already unfolding with troubling ramifications. While the media celebrates the delivery of vaccines to certain parts of the Global South, the coverage of this trust factor is lacking. A case in point is the Democratic Republic of Congo, which has just returned 75% of its COVAX vaccines — the equivalent of 1.3 million unused doses.
Meanwhile, health authorities in Ivory Coast worry that 500,000 doses of vaccine will expire because there are not enough people on the vaccination lists. What links these two countries? A history of conflict and low trust in the government.
Getting vaccinated in North Kivu, Democratic Republic of the Congo — Photo: UNICEF in RDC.
Skeptics might argue that fear of the vaccine is widespread, that wild rumors are spreading even in Europe. While this is a valid observation, it is a false comparison. When distrust in government has been built from years of war, persecution and discrimination, citizens are left feeling that at best their government does not care for them, at worst it wants them dead. Such a level of distrust will surely influence national vaccination plans.
In order to end the pandemic and ensure that citizens in post-conflict societies benefit from the vaccine, we must focus, therefore, on building trust.
Our teams of mediators and analysts work in some of the most challenging areas of the world. We know that there are two key variables for ensuring trust in a vaccination campaign. The first is how the information is communicated and the second is who is communicating that information.
This is why it is essential to carefully consider who will be the face of the vaccination campaign, and how this must be adapted to different communities. Everything must be thought out, down to the radio stations chosen to broadcast messages, the locations of vaccination centers and the ethnicity or religion of the nurses who will administer vaccines. Every detail is crucial for ensuring that various communities feel respected, safe and understood. These are issues that should be central to the planning process, not an afterthought.
While the COVID-19 pandemic remains first and foremost a public health challenge, it goes without saying that there will be no sustainable global progress without seriously considering these complex social dynamics. Yes, vaccine distribution is essential. But let's face it: Investments in the COVAX program will only yield real results if we put the issue of trust at the center of immunization efforts. People in post-conflict countries deserve to see the light at the end of the tunnel too.
*Charline Burton is Executive Director of the NGO Search for Common Ground, based in Brussels; Allassane Drabo, based in Conakry, Guinea, is the organization's West-Africa Director.
**This article was translated with permission from the authors.