The past seven days has been a picture of two pandemics. Among the world’s richest nations, lockdowns and well-resourced vaccine campaigns, which have monopolised the early global supply of doses, have brought down infections and deaths. Economies have slowly opened. Restrictions have been lifted. Life has crept closer to normal, giving the false impression of an end in sight to the global pandemic.

In reality, as the head of the World Health Organization, Tedros Adhanom, pointed out, more cases have been reported in the past two weeks than in the entire first six months of the pandemic, with south Asia bearing the brunt.

This was echoed by the UN children’s agency Unicef on Friday. “The pandemic is far from over,” it said. “Covid-19 cases are rising at an alarming rate across south Asia, especially in Nepal, Sri Lanka and the Maldives. Entire health systems could collapse, leading to more tragic loss of life. Besides south Asia, we are also seeing alarming situations in other parts of the world.”

As India once again broke global records for new cases (414,188) and deaths (3,915), the question of how to characterise and respond to an emerging two-speed world has occupied international leaders.

At the forefront has been the vexed question of how to increase vaccine production and delivery to ensure a fairer distribution, with only 0.2% of the 700m vaccines distributed so far going to low-income countries.

Gordon Brown, the former British prime minister, speaking at a World Health Organization briefing at the beginning of the week, said: “This is a manmade catastrophe. By our failure to extend vaccination more rapidly to every country, we are choosing who lives and who dies.”

By the middle of the week the campaign to waive patents on vaccines, backed by Brown, had drawn the backing of Biden administration and, somewhat less forcefully, the EU.

The recent catastrophic resurgence of coronavirus in south Asia, and India and Nepal in particular, has been driven by more complex factors than simply a shortage of vaccines, not least in India, whose Serum Institute, the world’s biggest producer of vaccines, is already licensed to produce the AstraZeneca vaccine.

The spread of the virus at the national level and within countries has been dictated by multiple issues, including demographics, political decisions over prevention and mitigation measures, and the relative strength or fragility of health systems. In the developing world other factors have included the failure to distribute what vaccines have become available and vaccine hesitancy.

All of this has been underlined by a WHO warning that African countries were vulnerable to a similar coincidence of circumstances that has led to the current crisis in south Asia.

“The delay in the delivery of vaccine doses from the Serum Institute of India earmarked for Africa, the delay in the deployment of vaccines and the emergence of new variants, means that the risk of a new wave of infections remains very high in Africa,” the WHO’s Africa regional office said in a statement on Thursday. It said new variants, such as the ones that emerged in India and South Africa, could unleash a “third wave” on the continent.

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