North Korea and Eritrea are the only two countries without vaccines

North Korea and Eritrea are the only two countries without vaccines

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North Korea this week admitted the inevitable – that Covid-19 had finally reached its people. But for global health experts, there’s one detail of particular concern: It’s one of only two countries without a vaccine.

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

In Pyongyang, authorities on Thursday traced the outbreak to the highly contagious Omicron subvariant BA.2. On Friday, state media reported that one person had died and around 350,000 people had shown fever symptoms.

Many health experts were already skeptical that North Korea had yet to report a single coronavirus case — more than two years into the pandemic. For its part, Eritrea has admitted about 10,000 confirmed coronavirus cases and 103 deaths, numbers well below those of its neighbors.

North Korea admits the outbreak of the corona virus for the first time

“North Korea, with a huge immunity gap — no protection acquired from vaccines or previous infections — is an open field for uncontrolled transmission, which maximizes the likelihood of new variants,” said J. Stephen Morrison, director of the Global Health Policy Center at 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 “a very high percentage of the population” would soon be infected unless North Korea was able to stop transmission limited by a lock.

“The carnage could be terrible,” he said. “Insofar as it could affect the regime’s influence over the population.”

Rumors have surfaced in both countries that political elites are already vaccinated – and that their opposition to foreign-made vaccines is just for show.

Eritrea, under longtime president and strongman Isaias Afwerki, has ignored requests from other African nations to join Covax, the global immunization drive backed by the World Health Organization. Some activists say the country is full of propaganda portraying 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 member of the African Union that had not “joined the family of 55 member states that are pushing forward with vaccination, but we are not giving up.”

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

In North Korea, the government turned down doses of the AstraZeneca vaccine over apparent concerns about potential side effects. It also refused shipments of nearly 3 million doses of China’s Sinovac vaccine, saying 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 recommended offering North Korea a bulk donation of mRNA vaccines. However, the vaccines previously allocated to North Korea under the Covax plan are no longer available.

Morrison said Covax and other donors have “grown sorry” for North Korea’s unresponsive nature during the pandemic. “That doesn’t preclude reviving the question of what to do on a crash basis,” he added.

A spokesman for Gavi, a nonprofit that helps coordinate Covax, said the initiative has “currently not committed any volume to” North Korea. But, the spokesman said, if Pyongyang moves forward with a national immunization program, Gavi could work with Covax to help North Korea catch up with immunization targets.

Pyongyang may not have a choice. Even in partially vaccinated places like China or Hong Kong, Omicron subvariants have spread incredibly quickly into the pockets of unvaccinated people – with fatal consequences on a similar scale to the first wave of cases in other parts of the world.

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

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

A model released in advance this week estimates that the virus could kill up to 1.5 million people if China relaxed its so-called “zero Covid” policy.

It would be “much worse” in North Korea, Moore said, “because of the minimal vaccine uptake there.”

Michelle Lee contributed to this report.

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