Vaccine inequality is hurting Asia's poor and the rest of the world

By the end of 2020, Thailand and Vietnam had reported fewer than 200 deaths between them, and Cambodia and Laos didn't report any at all.

But that changed this spring as many parts of Asia battled stubborn Covid-19 outbreaks that have infiltrated factories and other businesses critical to the global supply chain, threatening to disrupt the already strained flow of international trade.

The surge in cases has forced manufacturing plants throughout the region — from Thailand, Malaysia, Vietnam and Cambodia to China and Taiwan — to halt production while thousands of their workers get tested and quarantined.

The spread of Covid in countries that had been praised for their early success in containing the virus has exposed the gaps in their vaccination rollouts, affecting vulnerable migrant workers who work long hours in close quarters to support families back home.

Mass outbreaks in major businesses are putting pressure on the workforce and straining supply, just as demand is increasing around the world.

The Covid clusters that have cropped up in Asia's manufacturing and transport industries differ sharply from what is happening in wealthy Western economies. The United States and Europe are celebrating a gradual return to daily life, with many triumphantly declaring the pandemic is "over," even as health officials warn of the infectious Delta variant posing a possible new risk.

Most US adults already have at least one dose of a vaccine — and tens of thousands of shots are even going to waste.

Wealthy nations have banded together to provide more resources and vaccines for poorer countries battling the renewed surge. But health experts warn these efforts are not enough to vaccinate the majority of the world's population — the only way to truly end the pandemic.

"Around the world, many countries are now facing a surge in cases and they are facing it without vaccines," said World Health Organization Director-General Tedros Adhanom Ghebreyesus last month, at a G7 media briefing in the United Kingdom. "We are in the race of our lives, but it is not a fair race."

Migrant workers hit hard

For nearly all of 2020, Thailand's coronavirus cases rarely surpassed a dozen a day. Though the country experienced a mild wave this January and February, by March it had largely been contained and fell back to double digits.

Then cases began climbing in April, exploding into a massive second wave that far eclipsed the first with thousands of cases a day.

One 30-year-old migrant worker who contracted the virus in Thailand told CNN Business he was put into a makeshift government quarantine facility alongside children and the elderly. More than 100 workers at his factory in the country's Samut Prakan province were infected during the latest wave, he said.

The man — who is from Myanmar and requested anonymity for fear of losing his job — said the facility didn't have enough food, water and medical supplies. All the while, he and other workers have fretted about their families and livelihoods, since they can't work or earn money in quarantine.

He is one of thousands in Thailand who have been hit by factory outbreaks, where Covid has swept across industries from seafood and electronics to clothing.

Workers are at risk because they stand very close to each other — just under two feet apart — on assembly lines, said Suthasinee Kaewleklai, a project manager at the Migrant Workers Rights Network in Thailand.

"There are no real measures to contain the spread of the disease," she said, adding that some factories have "exploited" the situation by unfairly terminating employees or closing workplaces without offering compensation. She added that some workers asked their employers to arrange Covid tests but that didn't happen.

Infections are rampant: A factory for computer parts maker Cal-Comp Electronics recorded more than 2,100 positive cases by the end of May among workers, more than half of whom were migrants, according to public broadcaster Thai PBS.

By the end of May, Bangkok had recorded 34 separate clusters including an ice factory and a cargo warehouse. As of Monday, the health ministry said it was monitoring 111 clusters across the country, including an air conditioner factory and garment factories.

The workers in Thailand — many of whom are migrants — were for months given little protection, say activists and non-profit organizations. Thailand's vaccine rollout began in February, but for months it was only available to health care workers, government ministers and other limited groups.

Many of the Asian countries swept up in the outbreaks "haven't necessarily really gone out on the marketplace and secured adequate pre-purchased vaccines," said Stephen Morrison, senior vice president of the Center for Strategic and International Studies and director of its Global Health Policy Center.

And some of them — including Thailand and Malaysia — aren't eligible to receive vaccines at a low or subsidized rate from the worldwide vaccine initiative COVAX.

That lack of vaccine supply, combined with a devastating second wave of coronavirus in India, left the region "shaken really badly," Morrison said.

Thailand scrambled in recent months to procure more vaccines. But it wasn't until June, as the severity of the factory clusters became clear, that the Thai government gave manufacturing workers priority in a mass rollout that included vaccination venues at industrial locations, according to the government's official news site.

The country's prime minister and national Covid committee apologized June 15 for delays in supply and distribution. But the virus was already out of control: A day later, the committee disclosed that it had identified seven new clusters, including one at a candy manufacturing company and another at a factory that makes equipment for water supply systems.

Economic blow

The outbreaks in Asia may spell trouble for the global flow of trade, particularly if companies and governments can't thread the needle of controlling outbreaks while also keeping factories humming.

As the world emerges from the worst of the pandemic, demand for everything from cars to electrical appliances has soared. That's already put pressure on supply chains, as companies have been caught off guard by the rebound and forced to contend with shortages of labor and critical components.

Taiwan, for instance, has seen infections spread across its all-important semiconductor manufacturing sector, with more than 200 staff infected at one leading supplier. On June 7, the government launched a special vaccination program to inoculate tech workers and "protect Taiwan's supplies in the global industrial chain." It struggled for months to secure vaccines, though the United States donated 2.5 million doses in late June.

Semiconductor shortages predate the latest outbreaks, part of an ongoing global supply crunch caused by the pandemic, extreme weather and the surge in demand. A disruptive Covid outbreak in major chip factories could exacerbate the issue.

Factory activity in some countries has already taken a dive as the Covid surge takes its toll. Manufacturing output in Malaysia and Vietnam contracted sharply in June. A survey of factory activity in Taiwan dropped from 62 in May to 57.6 in June — still above the 50-point level indicating growth from the previous month, but a sharp slowdown all the same. Thailand's reading recovered a bit, though activity is still in contraction.

Southeast Asia has been "enormously successful in competing in the global economy, finding that niche, and producing high-value goods in global supply chains," said Morrison. "So if the second wave hits and disrupts their manufacturing sectors, it knocks them back economically and has knock-on effects on the supply chain."

Malaysia's manufacturing sector, for example, has seen more than 95,000 confirmed cases to date — the highest number of cases in any workplace environment, said government news agency Bernama, citing health officials.

The outbreak forced the country back under a nationwide lockdown May 12. But large parts of the manufacturing sector were deemed essential, and employees kept working despite the rising danger, Reuters reported. The government reduced workforce capacity during the lockdown, but the defense minister said last month "there are employers who force their workers to [go to] work, more than the 60% allowed."

Still, industry leaders complained that the restrictions were too stringent.

"The extended lockdown period will certainly cripple the entire manufacturing sector and their contribution to global supply chains," said Tan Sri Dato' Soh Thian Lai, president of the Federation of Malaysian Manufacturers, in a statement last month. "With companies in the US and EU starting to operate at full force, it is imperative that Malaysia, as a key manufacturing hub, has to support these markets as part of their global supply chains."

Even as they kept working, Malaysian workers were largely unable to access vaccines. The country's vaccination rollout officially began in February, but throughout the spring, state leaders complained that a promised supply of vaccines wasn't arriving, or not in high enough amounts to cover workers, according to local media.

In June, the country's Ministry of International Trade and Industry launched a vaccination program for the manufacturing sector, acknowledging that the industry was "critical in supporting the supply chain of essential products and services."

'The global failure'

Because wealthy and powerful countries — including some in Asia, like Singapore — have cornered the vaccine market during the initial rollout, poorer countries with scarcer resources are left with fewer options.

"The inequity, the disparity between the wealthy and the low and middle income countries have been outrageous and striking," Morrison said.

More than half of all high and upper-middle income countries have administered enough doses to fully vaccinate at least 20% of their populations, according to Tedros, the WHO director general. Only three out of 79 low and lower-middle income countries, as designated by the World Bank, have reached the same level of vaccination.

Morrison said the supply issue will likely ease by the end of the year as demand eases and a surplus of vaccines builds up.

But that doesn't mean the problem is solved, and it still leaves the question of how to protect vulnerable workers in poorer countries in the short term.

"We have a very, very short window of time to get our most vulnerable protected, and we haven't done it," said Dr. Michael Ryan, the head of WHO's emergency program, during a recent press conference.

As long as countries are struggling to vaccinate their populations, outbreaks may also continue cropping up and disrupting the global economy.

"Continued vaccine scarcity and the related threat of dangerous new viral variants are the top risks to the rebound in global economic activity and trade," said Ngozi Okonjo-Iweala, director-general of the World Trade Organization, in April. "Nobody will be safe until everyone is safe."

Taiwan, Vietnam and Thailand have enough public health care infrastructure and fiscal capacity to avoid being "permanently vulnerable to devastating consequences," said Morrison. But they still need to distribute vaccines quickly, and convince their population to get the shot. A recovery will be even harder and take longer for poorer countries, including the Philippines and Cambodia, he said.

Richer countries have promised greater cooperation and aid in the past month, most notably at the G7 summit, where member nations pledged more than one billion vaccine doses for the rest of the world, either directly or through funding to COVAX.

But it's still far from enough, Tedros said after the summit. To end the pandemic, the WHO is aiming to vaccinate at least 70% of the world's population by next year, when the G7 nations meet again. That means 11 billion doses. But only about 3 billion vaccine doses have been administered so far, mostly in high-income countries.

"Vaccines donated next year will be far too late for those who are dying today, or being infected today, or at risk today," Tedros said. "The global failure to share the vaccines equitably is fueling a two-track pandemic that's now taking its toll on some of the world's poorest and most vulnerable people."

-- Eric Cheung contributed to this report.

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