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Tough months lie ahead, but the rollout of the first vaccine in record time and the likely imminent approvals of others, is a turning point for wealthy countries that can afford vaccines.

But for public health officials in the developing world, it is a harsh reminder that the race to end this deadly pandemic will separate the world’s haves and the have-nots.

Rich countries have been on a vaccine shopping spree for months. A continuously updated database compiled by the Duke Global Health Innovation Center shows bilateral deals worth billions of dollars by a handful of countries for emerging vaccines.

Several countries and regional blocks have preordered vaccines that could cover far more than their entire populations. The People’s Vaccine Alliance, an international vaccine watchdog that includes Amnesty International and Oxfam, said this past week that rich countries have bought enough Covid-19 vaccine doses to immunize their populations three times over.

The Canadian government alone has secured enough inoculations to vaccinate their citizens five or even six times over, though not all the vaccine candidates it preordered may be approved for usage.

The Alliance’s data shows that while the world’s wealthiest nations are snapping up deals, nearly 70 poor countries will only be able to vaccinate one in 10 people at best during 2021.

“It is disappointing that despite the intent to get equity across the globe, that vaccine nationalism rules supreme,” said the University of Cape Town’s Professor Gregory Hussey, who is on the ministerial committee to advise the South African government on access to a Covid-19 vaccine.

Speaking to CNN on Thursday, the head of the Africa Centres for Disease Control and Prevention John Nkengasong said the inability for poorer countries to access vaccines would be “catastrophic.”

“The moment that we have all talked about, of global solidarity and global cooperation, is now. The litmus test is actually now. It makes absolutely no moral sense to have excess doses of vaccines in certain countries and absolutely no doses of vaccines in other areas of the world,” he said.

Solidarity, in theory

As the novel coronavirus ripped through countries and filled up hospitals earlier this year, a global effort emerged to roll out eventual vaccines for everyone.

The compact is called COVAX and is led by Gavi, the Vaccine Alliance. It runs on two tracks. High and middle-income countries have committed substantial funding to ensure access to vaccines and vaccine manufacturing in an equitable fashion. Poorer countries, mostly on the African continent, have signed up to a separate COVAX facility to secure vaccines. These vaccines will be funded by development agencies and donations from groups like the Bill and Melinda Gates foundation.

So far, 189 countries and territories have signed up to the two facilities. Notably absent are the United States and Russia.

This past week Dr. Anthony Fauci, the top US infectious diseases expert who said he was speaking in his personal capacity, stated that his country has a “moral responsibility” to ensure that Covid-19 vaccines are fairly distributed, contradicting the outgoing President Donald Trump’s largely symbolic executive order calling for Americans to get vaccines first.

Equitable access to vaccines isn’t necessarily just an issue of money. A spokesperson for Gavi said the alliance has raised more than $2 billion to purchase vaccines for the poorest countries and need to raise more than $5 billion by the end of next year.

“Our priority remains securing the financing needed to ensure these countries receive rapid access to Covid-19 vaccine candidates through the COVAX Facility,” the spokesperson told CNN.

But money can’t buy vaccines that have already been sold.

Here's what we know about Pfizer's vaccine -- including who could get it first

And key contributors to COVAX, like the EU, UK and Canada, have done some of the largest bilateral deals with pharmaceutical companies. The People’s Vaccine Alliance argues that these deals could undermine the COVAX pact they have been funding.

In fact, Canada is one of the largest donors to the COVAX program to allow equitable access to poorer countries.

In an interview on Friday, Canada’s Minister of International Development Karina Gould said her country needed to hedge its bets because most vaccines are still in development and thus only theoretical.

“We have entered into agreements with a number of different vaccine companies, just like the COVAX facility is doing, recognizing that not all of these vaccines might be successful,” she said, adding that the government is committed to equitable and affordable access to the vaccine.

“We are not a country that is isolated from the world. We have friends and family and business partners in every region of the world. We could just vaccinate Canadians and make them safe, but we don’t want to be disconnected from the world,” Gould said.

Dr. Richard Mihingo, the coordinator of Immunization and Vaccine Development at the World Health Organization (WHO) Africa region, said he understood that countries needed to ensure that their own citizens get vaccinated. He called the bilateral deals a “sad reality.”

“It is one thing to raise money, it is another to get access to the product. The funding is not enough if there is no supply. This complicates the situation,” he said.

The goal of WHO is to vaccinate 20% of the population in the Africa region by the end of 2021, but more meaningful coverage could take two to three years.

Mihingo believes the public health impacts could be severe if the virus festers in regions that fail to secure a vaccine.

Bitter memories

African public health officials and scientists still remember the years-long tooth-and-nail fight to access life-saving drugs to combat HIV/Aids long after they were available in the West. More recently, despite similar talk of solidarity, the H1N1 flu vaccine arrived on the continent months after the peak of the epidemic in 2009.

Hussey believes that the Covid-19 vaccine debate will revive these painful memories. “This is not a new phenomenon. It has played itself out many times in the past,” he said.

There are numerous other historical and contemporary examples of life-saving drugs made available to the wealthy but not to the poor.

If the moral argument can’t win over solidarity, officials on the continent hope the public health argument will do so. Stamping out Covid-19 everywhere is an epidemiological necessity.

The mind-boggling logistics of transporting one of the most important vaccines in history

“Until everybody is protected, nobody can be safe. We are living in an interconnected world and even if those countries can protect themselves, they will be living on an island. We need a world where we can interact. Not just socially, but economically,” Mihingo said.

The long-term impact of any vaccination lag in poor countries will widen global inequalities, he believes.

Mihingo said that as rich countries vaccinate their citizens, it is likely that vaccine passports will become necessary for travel, study and commerce. This has already been tested by the Australian airline Qantas.

It would be just one way that developing countries could be locked out as the rest of the world opens up. “It reminds me of the old apartheid days where a black African needed a pass to get out of his ghetto and get into the city. The notion of no one left behind, it is a lot of balderdash at the end of the day,” Hussey, the University of Cape Town’s professor, said.

A window to get it right

Despite the extreme squeeze on vaccine supply, the goal of COVAX is to deliver nearly 1 billion vaccine doses to lower-income countries by the end of 2021.

Public health officials who spoke to CNN hope that wealthy countries will shift their unused orders into COVAX.

Gould said it’s too early to make those assurances, but that the Canadian government is in active discussions with COVAX on what a donation mechanism would look like.

Even if vaccines are shared, not all of them are suitable for low-income countries. The Pfizer/BioNTech and the Moderna vaccines are expensive and require extreme cold storage, a challenge for countries with limited health infrastructure.

The Chinese Sinopharm vaccine efficacy data is yet to be shared publicly, but Chinese officials are pushing it hard as a possible solution for low-income countries.
A vaccine will be a game-changer for international travel. But it's not everything

And while Johnson and Johnson has done a deal with South African pharmaceutical company Aspen Pharmacare to manufacture its vaccine, there is no guarantee those doses will go to the continent.

Perhaps the most promising early solution for low-income countries is the University of Oxford/Astrazeneca vaccine, the only one to date to have its efficacy and safety peer-reviewed.

The vaccine can be transported using basic refrigeration and 1 billion doses of the vaccine will be manufactured by the Serum institute in India and should be provided at manufacturing cost to poorer countries through COVAX.

Despite those commitments, billions more doses of the Oxford vaccine have already been committed elsewhere through bilateral deals.

Mihingo says the next few months will be critical to ensure that most of the world’s population isn’t left behind in the biggest vaccination drive of our time — for everyone’s sake.

“We must provide the minimum supply to low-income countries to ensure they can not only protect the lives of the most vulnerable, but also open up to opportunities to commerce and help lift themselves out of poverty,” he said.

A previous version of this story incorrectly stated when WHO aimed to have vaccinated 20% of the population in Africa. Its goal is to do so by the end of 2021.

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Pelosi to move forward with impeachment if Pence doesn’t act to remove Trump

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“In protecting our Constitution and our Democracy, we will act with urgency, because this President represents an imminent threat to both,” Pelosi said in the letter to Democrats on Sunday night laying out next steps.

The House will try to pass a measure on Monday imploring Pence to invoke the 25th Amendment, through which he and the Cabinet declare Trump “incapable of executing the duties of his office, after which the Vice President would immediately exercise powers as acting president.” If Republicans object, as is virtually certain, Democrats will pass the bill via a roll call vote on Tuesday.

“We are calling on the Vice President to respond within 24 hours,” Pelosi wrote. “Next, we will proceed with bringing impeachment legislation to the Floor.”

But it’s not clear when exactly the Senate will take up the House’s measure. The Senate isn’t scheduled to return until Jan. 19, but will hold pro forma sessions on Tuesday and Friday. In theory, a senator could try to pass the House resolution by unanimous consent, but as of now it appears unlikely that it would pass.

On Monday, multiple House Democrats plan to introduce impeachment resolutions that would become the basis of any impeachment article considered by the House later this week.

Rep. David Cicilline (D-R.I.), who will introduce an article of impeachment against Trump on Monday, said on Sunday that roughly 200 Democrats have co-sponsored the measure.

Currently, 211 voting members (plus three nonvoting members) support Cicilline’s legislation, and they are hoping to reach 217 voting members by Monday morning, enough for the House to impeach Trump, one Democratic source familiar with the matter told POLITICO.

A small number of Democrats have opted not to co-sign the bill, but privately say they will vote to support the resolution on the floor, the source added.

The impeachment effort in the House is likely to be bipartisan, with Democrats expecting at least one GOP lawmaker — Rep. Adam Kinzinger of Illinois — to sign on. A handful of other House Republicans are seriously weighing it, according to several sources, though those lawmakers are waiting to see how Democrats proceed, and some are concerned about dividing the country even further.

Among the GOP members whom Democrats are keeping an eye on are Reps. John Katko of New York, Brian Fitzpatrick of Pennsylvania, Fred Upton of Michigan, Liz Cheney of Wyoming and Jaime Herrera Beutler of Washington.

Across the Capitol, at least two Republicans — Sens. Pat Toomey of Pennsylvania and Lisa Murkowski of Alaska — have called on Trump to resign. On Saturday, Toomey told Fox News, “I do think the president committed impeachable offenses,” but told CNN the next day that he does not believe there is enough time to impeach.

Sen. Ben Sasse (R-Neb.) has also said he would consider articles of impeachment.

Another option has emerged among some Republican and moderate Democratic circles — censuring Trump — though it remains highly unlikely to advance.

A censure resolution would gain far more support in the GOP than impeachment. Some Republicans have privately been pushing for that route and are trying to get Biden on board, according to GOP sources. That group of Republicans is also warning that impeachment could destroy Biden’s reputation with Republicans.

But censure is considered a nonstarter in an incensed House Democratic Caucus, where members see it as a slap on the wrist that gives Republicans an easy out.

The Democrats’ enormous step toward impeachment on Sunday comes after Pelosi and other top Democrats held a private call on Saturday night in which they discussed the potential ramifications that a lengthy impeachment trial could have on Biden’s presidency.

Democratic leaders discussed several options to limit the political effects on Biden’s first 100 days, with one option — floated by House Majority Whip Jim Clyburn (D-S.C.) — for the House to delay the start of an impeachment trial in the Senate by holding on to the article of impeachment.

Senate Majority Leader Mitch McConnell (R-Ky.) has sent out a memo to senators explaining that the Senate could not take up impeachment until Jan. 19 at the earliest, absent unanimous consent.

A final decision has not been made, and House Democrats will discuss the matter on a 2 p.m. caucus call on Monday.

Lawmakers are already privately expressing concerns about returning to the Capitol for multiple days this week, worried about both a potential coronavirus outbreak and whether the building is secure, given how easily an armed pro-Trump mob invaded on Wednesday.

The Capitol physician urged House lawmakers and staff to get tested in a memo Sunday, saying they might have been exposed to someone who had the virus while huddling for safety in a large committee room for hours on Wednesday. During the hourslong lockdown, several Republican members refused to wear masks despite being offered them by Democrats worried about the spread of the deadly virus.

Melanie Zanona, Olivia Beavers and Marianne LeVine contributed to this report.

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Matt Hancock Scraps “Unnecessary Training Modules” Blamed For Slowing Vaccine Rollout

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Matt Hancock has agreed to remove some of the training modules required for volunteers to sign up to deliver the Covid-19 vaccine (PA)

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Matt Hancock said people will no longer need to undertake training including an anti-terrorism course to give the coronavirus jab after MPs said “bureaucratic rubbish” was delaying mass vaccination.

It comes as MPs called for the government to produce targets for the number of people given immunity before lockdown can be lifted.

The health secretary said a series of “unnecessary training modules” are being scrapped to speed up the process of getting people qualified to deliver the jab.

Speaking in the Commons, Sir Edward Leigh said he was shown by his fellow the Tory MP, a qualified GP, the “ridiculous form” he had filled out to start delivering the vaccine.

“When he’s inoculating an old lady, he’s not going to ask her if she’s come into contact with Jihadis or whatever, so the Secretary has got to cut through all this bureaucratic rubbish,” he said.

In response Mr Hancock said: “I am a man after Sir Edward’s heart and I can tell the House that we have removed a series of the unnecessary training modules that had been put in place, including fire safety, terrorism and others.

“I’ll write to him with the full panoply of the training that is not required and we have been able to remove, and we made this change as of this morning and I am glad to say it is enforced.

“I am a fan of busting bureaucracy and in this case I agree with him that it is not necessary to undertake anti-terrorism training in order to inject vaccines.”

Dr Fox had earlier challenged Boris Johnson to drop the “bureaucracy” and “political correctness” of the forms vaccine volunteers must fill out.

He told MPs: “As a qualified but non-practising doctor, I volunteered to help with the scheme and would urge others to do the same. 

“But, can I ask the Prime Minister why I’ve been required to complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation in order to give a simple Covid jab?”

Mr Johnson said he had been “assured by the Health Secretary that all such obstacles, all such pointless pettifoggery has been removed”.

The government has been attempting to recruit thousands of volunteers to help with a mass vaccination programme, and with the recent approval of the more easily deliverable Oxford/AstraZeneca version has today revealed the location of seven mass vaccination centres set to open next week.

The Prime Minister’s official spokesman told journalists at a briefing they would be at Robertson House in Stevenage, the ExCel Centre in London, the Centre for Life in Newcastle, the Etihad Tennis Centre in Manchester, Epsom Downs Racecourse in Surrey, Ashton Gate Stadium in Bristol and Millennium Point in Birmingham, and it is expected they will be run with a combination of NHS staff and volunteers.

But so far the government has not said how many people need to be inoculated before it has an impact on the coronavirus restrictions.

Mr Hancock was asked by a number of MPs if the measures could be eased once the top few tiers in the vaccine priority list had been clear.

Former Conservative chief whip Mark Harper said once the top four groups, which includes care home residents and staff, frontline NHS workers, the clinically extremely vulnerable and everyone over 70 “we’ve taken care therefore of 80% of the risk of death”.

Adding: “What possible reason is there at that point for not rapidly relaxing the restrictions that are in place on the rest of our country?”

The health secretary replied: “We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope that we will see at that point, and so that is why we will take this – an evidence-led move down through the tiers, when we’ve broken the link, I hope, between cases and hospitalisations and deaths.”

The ex-Tory minister and another doctor, Andrew Murrison, said: “The logic of anticipating what is going to happen in two or three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse.

“That is to say, when we have a sufficient number of people vaccinated up we can anticipate in two or three or four weeks’ time how many deaths have been avoided. 

“That means, since it cuts both ways he will be able to make a decision on when we should end these restrictions.”

Mr Hancock replied: “The logic of the case that Dr Murrison makes is the right logic and we want to see that happen in empirical evidence on the ground.

“This hope for the weeks ahead doesn’t take away, though, from the serious and immediate threat posed now.”

The Cabinet minister said the challenge for the government is to increase the amount of doses available, claiming “the current rate-limiting factor on the vaccine rollout is the supply of approved, tested, safe vaccine”.

He added: ”We are working with both AstraZeneca and Pfizer to increase that supply as fast as possible and they’re doing a brilliant job.”

But Labour’s shadow health secretary Jonathan Ashworth called for the government to ramp up its vaccination programme to six million doses a week.

He told the Commons: “The Prime Minister has promised almost 14 million will be offered the vaccine by mid-Feb. That depends on around two million doses a week on average.

“Both [Mr Hancock] and the Prime Minister have reassured us in recent days that it’s doable based on orders.

“But in the past ministers have told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million of Pfizer doses by the end of 2020.

“So, I think people just want to understand the figures and want clarity. Can ministers tell us how many of the ordered doses have been manufactured?”

Mr Ashworth added: “Two million a week would be fantastic but it should be the limit of our ambitions, we should be aiming to scale up to three, then five, then six million jabs a week over the coming months.”

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How South African police are tackling pangolin smugglers


Quiet, solitary and nocturnal, the pangolin has few natural enemies, but researchers believe it is the most trafficked mammal in the world. The tough scales covering its body are sought after for use in Chinese medicine, in the erroneous belief that they have healing properties.

The animal has also been of interest to researchers during the coronavirus pandemic. Related viruses have been found in trafficked pangolins, though there is continued uncertainty around early theories that pangolins were involved in the transmission of the virus from animals to humans.

After South African police seized a pangolin from suspected smugglers, BBC Africa correspondent Andrew Harding witnessed how vets tried to save the animal’s life.

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