What's In Blue

Posted Fri 8 Apr 2022

Briefing on COVID-19 Vaccines in Conflict and Humanitarian Settings

On Monday afternoon (11 April), the Security Council will convene a briefing on equitable access to COVID-19 vaccines in conflict-affected areas or in humanitarian crisis situations. The briefing will be chaired by Lord (Tariq) Ahmad of Wimbledon, the UK Minister of State for South and Central Asia, North Africa, the UN and the Commonwealth, and the Prime Minister’s Special Representative on Preventing Sexual Violence in Conflict. The expected briefers are Ted Chaiban, the Global Lead Coordinator for COVID-19 Vaccine Country-Readiness and Delivery; Dr. Esperanza Martinez, the ICRC’s Crisis Operations Manager; and a civil society representative. The UK is co-organising the meeting with France and the United Arab Emirates. The co-organisers have proposed a press statement, which Council members are still negotiating.

Since the start of the COVID-19 pandemic, the Security Council has adopted two resolutions on the global health crisis. On 1 July 2020, the Council adopted resolution 2532, endorsing the Secretary-General’s March 2020 call for a global ceasefire to combat the health crisis. This was followed by the adoption of resolution 2565 in February 2021, calling for greater international cooperation to facilitate equitable and affordable access to COVID-19 vaccines in armed conflict situations, post-conflict situations and complex humanitarian emergencies. According to the concept note for Monday’s event, this upcoming briefing is intended to build on resolution 2565 and discuss how to improve the delivery of COVID-19 vaccines to communities in conflict-affected areas or in humanitarian crises.

COVAX—co-led by the World Health Organization (WHO), the Gavi Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations—is the main multilateral mechanism for promoting vaccine distribution to low- and middle-income countries. While it has distributed 1.4 billion vaccine doses to more than 145 countries and territories, concerns persist about the lack of equitable access to vaccines. As at last month, according to UN data, only about 13 percent of people in low-income countries had been vaccinated, compared with almost 70 percent in high-income countries. COVAX has set the ambitious goal of achieving 70 percent vaccination rates in every country by the middle of this year.

Vaccination rates in conflict-affected countries and countries facing humanitarian crises tend to be particularly low, as they face additional challenges in delivering and administering the vaccines. As at 24 March, Burundi and Haiti have received enough doses to cover only three percent of their populations; the Democratic Republic of the Congo and Yemen, four percent; Cameroon, six percent; and Mali and South Sudan, eight percent, according to OCHA and the Centre for Humanitarian Data. Among other countries, Syria had received enough doses to vaccinate 35 percent of its population, and Nigeria, 17 percent. Within such countries, however, areas that are affected by conflict, controlled by armed groups, or have displaced persons have had less vaccine access.

Such settings have limited logistical capacity, humanitarian access challenges, weak or decimated healthcare systems, and a shortage of healthcare workers, along with other pressing health priorities and needs. Moreover, the COVAX humanitarian buffer—which is meant to prioritise reaching the most vulnerable populations, such as refugees, asylum seekers and stateless people that risk being neglected by national vaccination campaigns or where unavoidable gaps may arise—has faced difficulties in becoming fully operational. Other challenges for countries affected by conflict and humanitarian crises include vaccine hesitancy in communities where there are often low trust levels and limited access to information. As the concept note states, the meeting is an “opportunity to signal [the Council’s] continued focus on vaccine equity in conflict-affected areas and raise awareness of the specific delivery challenges in conflict-affected areas”.

Another key issue for tomorrow’s meeting is considering the pandemic’s socio-economic impacts that have aggravated political tensions and economic challenges. As highlighted in the concept note, countries affected by conflict and humanitarian crises are especially vulnerable to these secondary impacts, which also increase humanitarian needs.

Chaiban’s position, to which he was appointed in February, was established to support vaccine country readiness and delivery, coordinate inter-agency efforts to forecast vaccine needs and facilitate financial and technical assistance to overcome bottlenecks in country-level implementation. Members are likely to be interested in hearing how the COVAX vaccine delivery partnership is addressing the difficulties facing conflict situations.

Martinez, of the ICRC, may recall that under international humanitarian law, healthcare facilities and workers—including those administering vaccines—are specifically protected from attacks. She is also expected to recall the stresses on health care systems in areas affected by armed conflicts. This includes responding to urgent needs, such as treating war wounded and maintaining minimal health services, which shifts focus from vaccination campaigns. Martinez could call for COVID-19 vaccination efforts to be integrated into broader health strategies in order to strengthen healthcare systems in conflict-affected countries. She may also highlight the importance of community engagement, which can improve the safety of health workers, promote local ownership, and facilitate the spread of information.

Council members’ interventions may address the guiding questions from the concept note:

  • How can the Council encourage countries in conflict or humanitarian crisis to prioritise Covid-19 vaccination, including vaccination of particularly vulnerable groups?
  • What role can the COVAX Vaccine Delivery Partnership and the COVAX Humanitarian Buffer play?
  • What more can Council members do to ensure parties to conflicts uphold their obligations under international humanitarian law to provide humanitarian access for Covid-19 vaccination?
  • How can UN representatives and country teams work with governments to prioritise Covid-19 vaccination and meet national coverage targets?
  • How can the Council better monitor the global impact of vaccine inequity on peace and security, and manage those risks?

Members are likely to stress the need to build up health delivery systems of conflict-affected countries and to support humanitarian actors. They are also expected to call for resolving the reported legal issues that have hindered the effectiveness of the COVAX humanitarian buffer. Some members may further stress the importance of waiving intellectual property protections for COVID-19 vaccines to increase their availability. Last month, the US, the EU, India, and South Africa reportedly reached a tentative agreement to waive patent rights for COVID-19 vaccines. Any agreement would still need approval by the World Trade Organisation’s member states to enter force. In a May 2021 presidential statement on post-pandemic recovery in Africa, the Council acknowledged the ongoing discussions related to waiving intellectual property protections for the vaccines. Members could also reference the work of the Peacebuilding Commission (PBC) in advocating for vaccine equity. At the time of writing, PBC members were preparing a letter to be delivered to the Council ahead of the meeting with suggestions for promoting vaccine distribution and mitigating pandemic conflict risks.

China and Russia often reiterate their view that unilaterally imposed sanctions should be waived, as they can undermine countries’ capacity to respond to the pandemic. They and some other members may reflect this perspective on Monday. Council members may also highlight their contributions to funding or distributing vaccines. Earlier today, a high-level COVAX donor conference, hosted by Germany, raised a total of $4.8 billion.

*Postscript: Over the following days, members were unable to agree to the UK-proposed draft press statement, apparently due to differences about how to reference World Trade Organization discussions around waiving intellectual property protections.

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