North Korea and Eritrea are the only two countries without vaccines

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North Korea admitted the inevitable this week — that Covid-19 had finally reached its population. But for global health experts, there’s one particularly worrying detail: It’s one of only two countries without vaccines.

North Korea and Eritrea — both poor and led by brutal governments — have refused to join global vaccine-sharing initiatives, leaving their populations vulnerable to rapidly spreading variants of the virus.

In Pyongyang, authorities on Thursday attributed the outbreak to the highly contagious BA.2 ommicron subvariant. On Friday, state media reported that one person had died and some 350,000 people were showing fever symptoms.

Many health experts were already skeptical that North Korea had not yet reported a single case of coronavirus — more than two years after the pandemic. Eritrea, for its part, has admitted about 10,000 confirmed cases of coronavirus and 103 deaths, numbers far lower than those of its neighbours.

North Korea admits coronavirus outbreak for the first time

“North Korea, which has a huge immunity gap — no protection gained with vaccines or previous infections — is an open field for uncontrolled transmission, maximizing the chance of new variants,” said J. Stephen Morrison, director of the Global Health Policy Center on the Center for Strategic and International Studies.

John P. Moore, a professor of microbiology and immunology at Cornell University’s Weill Cornell Medicine, said in an email that unless North Korea can limit transmission through a lockdown, “a very high percentage of the population” will soon would be infected.

“The carnage could be terrible,” he said. “To the extent that it could affect the regime’s hold on the population.”

Rumors are circulating in both countries that political elites have already been vaccinated — and that rejecting foreign-made vaccines is just for show.

Eritrea, under former president and strongman Isaias Afwerki, has ignored requests from other African countries to join Covax, the global vaccination effort supported by the World Health Organization. Some activists say the country is full of propaganda that portrays Covax as a Western tool to destroy Africa.

In December, the head of the African Centers for Disease Control, John Nkengasong, said Eritrea was the only African Union member not to join the family of 55 member states making progress with vaccination, but we are not giving up. †

As the world reopens, North Korea is one of two countries without vaccines

In North Korea, the government turned down doses of the AstraZeneca vaccine out of apparent concern about possible side effects. It also turned down deliveries of nearly 3 million doses of China’s Sinovac vaccine, saying the shipments should go to other countries suffering from more severe outbreaks.

Last month, a panel of experts convened by the Center for Strategic and International Studies advised North Korea to offer a large supply of mRNA vaccines. But the vaccines previously assigned to North Korea under the Covax plan are no longer available.

Morrison said Covax and other donors had “got tired” of North Korea’s unresponsive nature during the pandemic. “That doesn’t rule out having to rethink what to do in the event of a crash,” he added.

A spokesperson for Gavi, a nonprofit that helps Covax coordinate, said the initiative “has not currently committed any volume for” North Korea. But, the spokesman said, if Pyongyang makes progress with a national vaccination program, Gavi could work with Covax to help North Korea meet immunization goals.

Pyongyang may not have a choice. Even in partially vaccinated places like China or Hong Kong, omicron subvariants have spread incredibly quickly among groups of unvaccinated people — with lethal consequences comparable to the first wave of cases in other parts of the world.

China, North Korea’s main ally, is fighting a BA.2 outbreak and has imposed a strict lockdown on its commercial hub, Shanghai.

“China is struggling with the spread of the omicron variant itself, so I’m not sure it has strong incentives to help North Korea fight covid,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Affairs. Relations.

A model released as a preliminary this week estimated that if China relaxed its ‘zero covid’ policy, the virus could kill up to 1.5 million people.

In North Korea, it would be “much worse,” Moore said, “because of the minimal uptake of vaccines there.”

Michelle Lee contributed to this report.

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