Covid-19 in India and South Africa – Back of the queue or leading the world?


“Vaccine inequity – The world is on the brink of a catastrophic moral failure, and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”    Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

The availability of effective vaccines for the prevention of covid-19 has led to an unseemly competition as countries rushed to sign deals with manufacturers, often outbidding each other for access, to the exclusion of poorer countries. In high income countries 60% of people have received at least one dose of Covid vaccine, while in low income countries the figure is 3%.

Towards the end of 2020 Europe and the Americas were struggling with high rates of disease, while low- and middle-income countries appeared to be escaping with relatively few cases.  On November 13, 2020 India and South Africa had similar rates of disease, less than 1/10 the rate in US or UK. Since then both countries have had major surges in cases, India reaching a peak in early May and South Africa enduring two peaks in early January and early July 2021.  Both countries are now showing signs of controlling the disease.  In India most cases are occurring in one state, Kerala, which has traditionally enjoyed a high standard of health. We will discuss these countries asking the question, “What can the rest of the world learn from India and South Africa?”



Professor Gagandeep Kang is Professor of Microbiology, at the Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences at the Christian Medical College (CMC) in Vellore. She has worked on the development and use of vaccines for rotaviruses, cholera and typhoid, conducting large studies to define burden, test vaccines and measure their impact. Prof Kang is on several advisory committees for the WHO, related to research and use of vaccines. She has served on the scientific advisory or strategic committee of several national and international institutions, including the Wellcome Trust, UK, the DBT-Wellcome Trust India Alliance, the International Vaccine Institute and the International Centers for Genetic Engineering and Biotechnology. Professor Kang has published over 375 papers in international and national journals. She is the first woman working in India to be elected a Fellow of the Royal Society. She is also the first Indian woman to be elected to Fellowship of the American Academy of Microbiology and the only physician-scientist to receive the Infosys Award in Life Sciences.

Professor Kim Mulholland is a global health epidemiologist and vaccine researcher.  He holds appointments at MCRI where he runs the pneumococcal microbiology and immunology laboratories, along with major field research programs in Vietnam, Fiji, and Mongolia.  He has researched pneumonia and pathogens for nearly 40 years and covered every aspect.  He also leads HPV, RSV, and typhoid research programs.  He has been involved in the oversight of many vaccine trials, serving on steering committees or DSMBs for a range of vaccines including Hib, Pneumococcal, Dengue, RSV and Covid-19 vaccines.


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