Open letter: Addressing inequities in access to COVID-19 vaccination

Dear Ms. von der Leyen,

As a community-based member-network led by people living with or affected by HIV and associated infections (mainly viral hepatitis, TB and other STIs) and morbidities across Europe and Central Asia region, the European AIDS Treatment Group (EATG) is concerned about inequity in access to COVID-19 vaccines globally, in the Europe- Central Asia region and within countries. Today, we add our voice to the #PeoplesVaccine call and outline essential measures we believe should be taken by the European Commission, governments and pharmaceutical companies to reverse the tide of social injustice and health inequalities exacerbated by the COVID-19 crisis.

EATG represents people living with HIV and comorbidities, people living with HIV with weaker immune systems and people not having access to HIV antiretroviral treatment that are exposed to severe COVID-19. We also represent people in precarious situations that are at heightened risk of HIV and COVID-19 co-infections whilst facing limited access to prevention tools and care. We are concerned that the slow and unequal roll-out of COVID-19 vaccination will result in worsening health outcomes and deaths of many.

We have witnessed the lethal and long-lasting impact of inequity in access to life- saving medical technologies, such as anti-retroviral treatment for HIV/AIDS globally, and therefore find it unacceptable that so many will not be able to receive the COVID- 19 vaccine in 2021.

We welcome the COVAX initiative to accelerate the availability of COVID-19 vaccines in poorer countries and distribute 2 billion doses by end of 2021. Yet, wealthier countries have purchased and secured – not to say hoarded – vaccines, thus limiting the source of supply for COVAX. Moreover, COVAX, in any case, would only be able to provide a limited number of doses, well below the specific needs of single countries. Some countries not eligible for the COVAX facility are likely to pay a high price for their doses.

In this context, we call upon the European Commission, governments in the EU/EEA and EECA regions, as well as pharmaceutical companies to take the following steps:

1. Treat COVID-19 vaccines and medical tools as a public good: enable TRIPS
waivers as proposed by India and South Africa to lower their price.

2. Solidarity and collaboration with other countries: a) stop hoarding vaccine
doses and reserve 25 % for export (re-sell or donate) to countries with access
challenges globally and in Europe and Central Asia, and b) make vaccines
available to vaccinate healthcare workers in countries that experience a peak
in the pandemic.

3. Boost the vaccines supply: as well as intensifying production in Europe,
companies should also share knowhow on vaccine production with
manufacturers conforming with Good Manufacturing Practice (GMP) and
invest in facilities in other parts of the world. Relying on expanding production
in Europe will not solve global supply issues.

4. Strengthen COVAX: create a humanitarian buffer stock, with an allocation
system based on medical needs.

5. Increase transparency over vaccines contracts negotiated between the
European Commission/ governments and companies.

6. Put in place ease of access and outreach vaccination programmes for
populations that have less or no access to the formal healthcare system.

We thank you in advance for your attention and hope that the European Commission and other relevant stakeholders will mobilise all necessary to ensure equity in access to COVID-19 vaccination in line with their commitments to universal health coverage.