As news circulated of a worrying new virus spreading in the Chinese city of Wuhan in the early days of 2020, experts worried that infections would quickly reach South-East Asia and overwhelm the region’s health-care systems. Thailand was one of the main destinations for Chinese tourists; the first case outside China was reported there on January 13th, 2020. The first known death from covid-19 outside China occurred in the Philippines. A Chinese tourist who had visited Indonesia from Wuhan tested positive on returning home, suggesting he took the virus on holiday with him.
Yet it was Iran and Italy that became the first global hotspots. America, the rest of Europe and Brazil were soon engulfed. India got walloped. All through 2020 and the early part of this year, South-East Asia remained relatively unscathed. By the start of June, the region of 668m people had reported fewer than 77,000 deaths from the disease. Britain, with a tenth as many people, had chalked up more than 128,000. South-East Asia, it seemed, had escaped the worst of the pandemic.
The supply to poorer countries is low mostly because the majority of the available vaccines have been purchased or promised to richer countries in North America and Europe. To address this vaccine inequity, a coalition of international organizations, including the World Health Organization and governments, created a nonprofit called Covax in April 2020.
The idea was to create a global supply of vaccines for 92 low- and middle-income countries. In December, the nonprofit announced that it had secured access to some 2 billion doses for 2021 through donations and commitments from some manufacturers, but it is unclear how many of those will actually be delivered this year. The problem becomes more complicated because many countries are both working through Covax and trying to secure deals with drug makers themselves—making it more challenging for Covax to make deals with those manufacturers at the same time.
The group aims to vaccinate about 20% of the people in the world, focusing on hard-to-reach populations in Africa, Latin America, and Asia. To do so, it needs another $4.9 billion in addition to the $2.1 billion it has already raised. But there are other problems. The cheaper and easier-to-transport vaccines like the ones pledged by AstraZeneca have been slower to gain regulatory approval. Meanwhile, other companies seem less interested in pitching in: Doctors Without Borders found that only 2% of Pfizer’s global supply had been granted to Covax, and Moderna is still “in talks” with the organization.
At the same time that covid-19 was devastating New York, cities in western Europe were also suffering severe outbreaks. Britain, Spain, Italy and Belgium have some of the highest national excess-death rates in the world, after adjusting for the size of their populations. France and Portugal locked down comparatively early, given the number of positive tests at the time. However, a second wave of covid-19 in winter has caused excess mortality to rise again across the region. (Some countries also recorded a small spike of non-covid fatalities during a heat wave in August.)