Dr. Onyimbo Kerama, lead consultant and executive director at Motire Occupational Health and Safety Solutions In Thika, Kenya, uses a LumiraDx diagnostic instrument to test for COVID-19. (Bill & Melinda Gates Foundation Photo)

As people in the United States debate COVID-19 vaccine mandates, a new report from the Seattle-based Bill & Melinda Gates Foundation is a reminder that many people around the world still can’t get the shot even if they want it.

“The lack of equitable access to COVID-19 vaccines is a public health tragedy,” says Bill Gates in a statement accompanying the release of the Gates Foundation’s annual Goalkeepers report, which has tracked the world’s progress toward the United Nations Sustainable Development Goals for the past five years.

The latest report, released Monday night, was authored by Bill Gates and Melinda French Gates as co-chairs of the foundation. They are continuing to lead the Gates Foundation in those roles for a two-year trial period following their divorce.

COVID-19 is a central topic of the report, which cites the “unprecedented” development of multiple vaccines in less than a year, vs. the normal timeline of 10 to 15 years. At the same time, the report notes, more than 80% of COVID-19 vaccines so far have been administered in high-income and upper-middle-income countries.

“Some have secured two to three times the number of doses needed to cover their populations, in case boosters are needed for increasingly infectious variants,” write Bill Gates and Melinda French Gates in the report. “Meanwhile, less than 1% of doses have been administered in low-income countries. These inequities are a profound moral outrage—and raise the very real risk that high-income countries and communities will begin to treat COVID-19 as another epidemic of poverty: Not our problem.”

Bill Gates warned repeatedly about the risk of inequitable vaccine distribution last year as vaccines were being developed.

“We can’t put the pandemic behind us until everyone, regardless of where they live, has access to vaccines,” he said in his statement released along with the latest Goalkeepers report.

The Gates Foundation has committed about $1.7 billion to efforts to fight COVID-19 and distribute vaccines globally in the last 18 months.

An additional 30 million people fell into extreme poverty in the past year, reversing many recent gains, according to statistics cited in the report. In addition, the report underscores the impact of the pandemic on education and gender equality around the world.

Mark Suzman, the Gates Foundation CEO, told reporters in a conference call that now is the time not only to address current inequities in COVID-19 vaccines but also to prepare for the future through initiatives such as genomic surveillance that cuts across different countries.

Suzman cited the need for “global instead of national and regional infrastructures that make sure we never face this kind of crisis again.”

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