Vaccines for Refugee Populations

Despite the efforts of UN vaccine donation schemes such as COVAX, refugees around the world stand naked in the gale of this pandemic. We should heed the words of UNHCR spokesman Andrej Mahecic, who this week warned: ‘The pandemic will be defeated only when vaccinations become available everywhere on an equitable basis.’ Equity is proving hard to achieve.

More than 80 per cent of refugees are hosted by developing countries, which are struggling to vaccinate even small proportions of their own citizens. Almost 30 per cent of refugees are in camps in the world’s least developed states, with healthcare systems that barely function even for regular citizens.

Refugees are typically last in the line in any crisis, but most particularly in this one. Confined to camps or corralled in remote border areas where they’re prevented from moving on by pandemic protocols, it’s hard even to estimate their numbers. In many places (South Sudan, Tigray/Ethiopia, Central African Republic) aid agencies are struggling to gain sufficient access. Conflict, pandemic regulations, and geographical hurdles hobble their efforts.

Those fleeing conflict and climate blight are a forgotten meta-population who should be front and centre in our humanitarian efforts. They personify our failures and malignancies as a species fatally attracted to power, and wealth, and ideologies that make us surrender our humanity. The violent among us destroy living communities as well as the ecology gracious enough to host us. The corrupt and the violent will in the end make all of us refugees.

As vaccine manufacturers fight to keep their taxpayer-subsidized ‘intellectual property’ in their bespoke pockets, UNHCR is appealing for more donations to COVAX. With 80,000,000 refugees and displaced persons worldwide, even a lower-than-median Covid mortality of 1.2 per cent would cause a million deaths. Covid-19 mortality is far higher than this in the camps, however.

Of the states hosting the most, only Turkey and Uganda have lower than one per cent mortality, with Lebanon and Ethiopia around 1.5 per cent. Iran and Pakistan are each reporting mortality of well over two per cent. The seriousness of the Yemen crisis for its traumatized population is reflected in mortality of almost 20 per cent (down from a shocking 30 per cent some months ago).

A new study in the Lancet [paywall] focuses on Lebanon, which has the highest refugee population in the world relative to its own population (1.7m out of 6.85m). The authors argue that even in a state whose health system is crumbling, failing to vaccinate its mostly Syrian and Palestinian refugees would precipitate a catastrophic public health crisis. Covid mortality among displaced people in Lebanon is more than three times the country average (1.43 per cent). Without a major push by aid agencies, the camps in Lebanon will see thousands of deaths. Lebanon has secured vaccine supply for less than a third of its population, which means millions there are vulnerable to whatever new Covid wave washes ashore.

UNHCR needs support for COVAX. Governments need to clean out their ears and listen.

John Clamp writes for Maqshosh.