What's In Blue

Posted Tue 16 Feb 2021

Open Debate on COVID-19 Vaccines in Contexts Affected by Conflict

Tomorrow (17 February), Security Council members will hold a videoconference (VTC) open debate on “ensuring the equitable access to COVID-19 vaccines in contexts affected by conflict and insecurity”. UK Foreign Secretary Dominic Raab will chair the meeting, and at the time of writing, ten other foreign ministers (China, Estonia, India, Ireland, Kenya, Mexico, Norway, Tunisia, the US, and Vietnam) and one prime minister (Saint Vincent and the Grenadines) were expected to participate in the meeting. Secretary-General António Guterres is expected to participate. Henrietta Fore, Executive Director of UNICEF; Seth Berkley, CEO of GAVI, the Vaccine Alliance; and Jagan Chapagain, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC), are also expected to brief.

The concept note for the debate identifies the destabilising effects of the COVID-19 pandemic, such as the global economic crisis, the potential for an uneven and fragile recovery, and education and health costs, among others, that are exacerbating conflict drivers. In this context, it notes the critical role of vaccines for ending the global health crisis, and “both moral and practical” reasons to make sure vaccines are available to everyone. This will require, according to the concept note, the international community’s collaboration; otherwise vaccine rollouts will be uneven and risk worsening inequalities, conflicts and tensions.

The stated objective of the meeting is to “discuss the role of the Security Council, Member States, and the UN in ensuring that COVID-19 vaccines are made available equitably in contexts affected by conflict and insecurity”. Challenges for vaccine distribution in such situations, according to the concept note, will be to close funding shortfalls to secure both supplies and the delivery of vaccines in complex environments. There are operational challenges with logistics and managing vaccine storage in conflict areas, as well as the overall challenge of humanitarian access. The concept note says that local ceasefires are likely to be essential for the vaccine’s administration. It also flags the likely need to counter misinformation that could provoke insecurity and put health care workers at risk. Moreover, delivering COVID-19 vaccines should not displace other vaccination programmes and life-saving humanitarian work such as famine relief.

The concept note highlights the importance of the COVAX Facility, created last year as the main multilateral mechanism to promote the development of the vaccine and manufacturing capacity, and to support the vaccine’s distribution. Through what is called the COVAX Advance Market Commitment (AMC), there are plans to distribute at least 1.3 billion vaccine doses this year to low- and middle-income countries. As noted in the concept note, to provide sufficient vaccines for humanitarian deployments and other emergency situations, 5% of COVAX doses are reserved as a “humanitarian buffer” to be deployed where there is an avoidable gap in coverage or when other options have been exhausted.

At the debate, Berkley is likely to provide an overview of COVAX, which is co-led by GAVI, an organisation that works to secure vaccines for poor countries, the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations and UNICEF. He may provide more details on plans to distribute the vaccine, and address issues around funding and vaccine supplies. COVAX estimated at the end of last year that it needed to raise at least an additional $6.8 billion to achieve its targets during 2021. On 3 February, COVAX released an interim distribution forecast to provide 330 million vaccine doses in the first half of 2021, mostly to low- and middle-income countries. Fore is likely to add insights about UNICEF’s experience as the world’s largest single procurer of vaccines and in conducting immunisation programmes.

Chapagain is expected to offer further perspective on administering the vaccine in conflict zones, including on engaging and building trust with local communities, which is important for successful campaigns. He could speak about lessons responding to other health crises, such as the Ebola outbreaks in 2014 in West Africa and since 2018 in the conflict-ridden Democratic Republic of the Congo (DRC). Just this week, the WHO announced the start of an Ebola vaccination campaign in the eastern DRC city of Butembo. According to today’s daily press briefing by the Office of the Spokesperson for the Secretary-General, Guterres will make brief remarks, which will include a proposal to increase vaccine solidarity.

In July 2020, the Security Council adopted resolution 2532 to support the Secretary-General’s global ceasefire appeal to fight the pandemic. According to the concept note, “[t]he availability of approved vaccines now being delivered through COVAX means that it is appropriate and timely for the Security Council to consider the role of the United Nations in facilitating vaccine delivery in fragile and conflict affected regions”. It adds that Council action “is now needed to call for further conflict pauses specifically to enable COVID-19 vaccinations to be carried out in areas affected by conflict”, and recalls the Council’s responsibility to promote access for humanitarian and medical personnel and their equipment, and to protect humanitarian and health workers.

A list of questions is set out in the concept note to guide interventions at tomorrow’s debate:

  • How can we ensure that people living in conflict and fragile settings receive safe and effective COVID-19 vaccines, and are not left behind by national and international vaccination programs?
  • How can we overcome the main barriers to vaccine delivery in highly unstable and conflict-affected settings, including the control of some areas by armed groups, logistical challenges, the flow of funds and the safety of health workers?
  • How can we ensure comprehensive access to vulnerable populations in conflict and fragile settings to deliver vaccines safely?
  • What role is there for the UN Security Council, within a wider UN system approach to the problem?
  • How can we prevent misinformation spreading, and overcome vaccine hesitancy?
  • What can we learn from ongoing immunisation campaigns in conflict settings, and ensure that these critical campaigns continue alongside COVID-19 vaccinations?

In their statements, Council members are likely to express concern about the disparity in vaccine access to date between wealthy and poor countries. It is an issue that both UN officials and members raised during Council members’ 25 January VTC briefing on the implementation of resolution 2532. Members may appeal for poor and conflict-affected countries not to be left behind, as other governments push to obtain vaccines for their citizens, and could echo the Secretary-General’s warning against “vaccine nationalism” and his call for the COVID-19 vaccine to be a global public good.

Council members are likely to call for humanitarian access and ceasefires to administer the vaccine. Some could note the need to vaccinate UN peacekeepers. At last month’s briefing, Under-Secretary-General for Operational Support Atul Khare said the UN intends to vaccinate peacekeeping personnel through host countries’ national vaccine programmes, and where that is not possible, the UN would seek alternative arrangements in coordination with resident coordinators, designated officials and partners in COVAX.

Council members may also draw attention to how the economic impact of an uneven rollout of the vaccine will be much more costly than the donor funding required to vaccinate everyone. One study, commissioned by the International Chamber of Commerce, found that the world economy would experience losses of $9.2 trillion this year if populations in developing countries are largely excluded from vaccination programmes, with nearly half these costs borne by wealthy countries.