Most covid19 vaccine doses are used in middle-income countries (not the rich)

Vaccine rate in July (so-far) still close to 1bn/month

Notes on the progress of the global vaccination programme:

Vaccination pace is being kept close to the 1bn/month pace. In the period 1-15th of July, there were ~430m doses, which would correspond to a slight decrease in pace compared to 1bn/month before, but not a major slowdown. The world is still on track to no longer be limited by dose availability at a global level by year’s end (or close to it).

Most doses are given to middle-income countries. It just is not true that the “rich countries are hogging all the vaccine doses.” People in low-income countries are still not getting vaccines, but most of the doses are going to the middle income countries, not the richer ones.

There have been issues that should be called out,¹ but high-income countries have consumed about ~⅓ of total doses and, recently, their consumption is lower (~¼ of doses in July). In this NY Times piece, one lobbyist is quoted as saying “The blame squarely lies with the rich countries”, but three sentences down, they point to the export restrictions imposed by India² (not a rich country) as a major problem.

On a per capita basis, high-income countries did use a disproportionate fraction of the vaccine (slightly less than 20% of the population lives in a high-income country), as did upper middle income countries.

This is mostly about China (high middle income) and India (low middle income). But those are also the two most populated countries. In the same vein, “high-income countries” is mostly USA and EU, so we are comparing a small number of polities here rather than broad trends.

This is, in many ways, the story of the last few decades: the rise of the global middle. Individually, people in India and China are still poor relative to the West. However, collectively, they cannot be ignored as having limited impact.

Any individual’s “appetite” for vaccines is very limited. A lot of discourse around vaccine inequality does not account for the simple fact that once people are vaccinated, they do not keep consuming vaccines no matter how wealthy they are (Jeff Bezos is not going to be consuming 837,000 vaccine doses even though he could easily afford to).

Even booster shots do not change this calculus by a lot. There are ~1.4bn people in high-income countries, even at 3 doses per person, that’s at most ~4.2bn doses (ignoring children). At the current pace, that’s 4 months of vaccination and then no more doses will go to high-income countries. Alternatively, even if you want to get everyone in the world 1 booster shot per year, you only need 7 months of shots at the current pace.

These discussions should have been had last year. When the USA was setting up Warp Speed and the EU haggling for vaccine prices, that was the moment for the public to pressure for (1) faster and (2) bigger scale-up of manufacturing. I’m not sure if this lesson has been learned, however.

As usual, the culture is over-focused on social competition (who is getting what?) and missing the point that we should have had 1bn/month ready in November³ and vaccine availability would not be a problem by now.

Links of the Week

• Some internal Microsoft history. A nice anecdote about the importance of truly dogfooding your products: “Executives, it turned out, were insulated from the product performance challenges because their mail was hosted (dogfooded) on a special dedicated server named OXYGEN, that had far more capacity per user than the typical employee experienced. Execs were also running some pretty beefy hardware and did not routinely experience the memory pressure that most would on 8MB PCs.” As I wrote before, “Code developers for major websites should be using the best selling laptop of a few years prior instead of machines which cost 5x that.”

Tweets of the Week

Noah Smith 🐇 @Noahpinion

We are happy to inform you that due to recent advances, nuclear fusion is no longer perpetually 50 years away. It is now perpetually 20-30 years away

Will Jack @willwjack

Humanity is on the cusp of practically limitless energy via nuclear fusion and basically nobody is talking about it, which is nuts. I left working in fusion because I was skeptical of the field's ability to progress, but my mind has totally changed (1/n)

Alec Stapp @AlecStapp

In 1974 the US Army surveyed soldiers on their food preferences. To make sure soldiers were reading closely & not giving fake answers, they added a fictitious food item to the survey called “Funistrada” It scored higher in popularity than eggplant, lima beans & cranberry juice.

Nuno Palma @nunopgpalma

In 1750 Portugal had an output per head higher than France or Spain. One century later it was Western Europe's poorest country. Why? Find all about it in this new working paper, joint work with the extraordinary @dkedrosky (watch this kid, he's going far):

warwick.ac.ukThe Cross of Gold: Brazilian treasure and the decline of Portugal574/2021 Davis Kedrosky and Nuno Palma

Ben Collins @oneunderscore__

Antivaxxers are calling themselves something, anything else on Facebook. Once they change their group name, the adapt their whole vocabulary to fit it. Here’s a list of codewords for the group of people who don’t “go dancing” — or won’t get the vaxx. Pizza. Beer. Moana.

Photos

Bourscheid Castle (all photos this week are from here)

1. The USA holding on to millions of AstraZeneca doses for months even though it was not approved for its citizens was a particularly morally egregious behavior.

2. Arguably, for all its egregiousness, the USA has in 2021 simply been following the policies and principles of the previous administration which had not set any expectations that it would help the world. India, however, reneged on bona fides expectations that it would factories in its territory to produce for export.

3. Even if this was over-optimistic, it’s clear that there was under-investment in 2020 which would have enabled faster scale-up.