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The Guardian view on low Covid vaccination rates: not just North Korea | Editorial

When Covid-19 first emerged, the “Hermit Kingdom” lived up to its nickname – shutting its borders in January 2020, long before most of the world had taken real heed of the disease spreading in China. With healthcare already on its knees and a malnourished population, North Korea was exceptionally badly placed to cope with any serious outbreak of illness.

For more than two years, it insisted that it had no cases whatsoever. Then, last week, it announced its first cases, of Omicron. The country’s leader, Kim Jong-un, warned of “great turmoil”. Now it has reported almost 2m cases of unspecified “fever” – probably because it can’t test for the virus – with 741,000 still being treated, and 63 deaths. Mr Kim, due to celebrate his 10th anniversary in power this year, has blamed officials for an “immature” response. But underlings can hardly be blamed. Closing the country off for so long, when it is heavily dependent on China and ordinary people were already struggling to survive, has left many in even direr straits. Yet the leadership failed to use the time to vaccinate the population, ignoring offers of doses from the Covax pooling scheme. For years, it has impoverished its people and allowed healthcare to deteriorate, while pouring money into a weapons programme, the chief function of which is to safeguard the regime. Within hours of announcing the Covid outbreak, the country had launched yet another missile test.

Since admitting the outbreak, it has stonewalled offers of help from South Korea and the World Health Organization, although it has accepted basic medical supplies from China. Not only are medicine and oxygen supplies scarce, even power is limited, with blackouts frequent. The country needs medical equipment, fridges, generators and fuel as well as vaccine doses. Humanitarian waivers to sanctions will be necessary, as well as persuading Pyongyang to accept help. North Koreans must not suffer further for the regime’s actions.

The wealthier world should also remember that North Korea is not alone in its lack of protection. Other countries are not much better covered. The more than 12bn vaccine doses delivered globally have overwhelmingly gone to richer nations. More than 75% of people in upper- and middle-income countries have received at least two doses. For low-income countries, the figure is just 13%. Across Africa, only 16.7% have received two doses or more.

There is now sufficient supply. But by hogging doses initially, richer countries held up delivery in poorer countries that lack the capacity to carry out mass vaccination at speed. And many of those places – where the vaccine drive may face problems ranging from inadequate infrastructure to military conflict – will need additional help to ensure that vaccines reach people, and that people want them. Treatments for Covid must also be made widely available. The $4.8bn committed to funding vaccine programmes last month is good news. But making progress on a patent waiver is also essential, and beyond that, prioritising broader knowledge-sharing and diversification of supply.

As WHO officials noted, when asked about North Korea and Eritrea – which has also snubbed offers of vaccines – unchecked transmission could spur the emergence of new variants. Though wealthier countries are far better protected, they too could still be at risk from the pandemic – or new diseases in future. Self-interest, as well as a sense of responsibility, should persuade them to do the right thing.


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