As wealthy countries begin to consider whether to offer their populations a third covid-19 shot, African nations still waiting for their first gave this stark reminder to world leaders at the U.N. General Assembly on Thursday: "No one is safe unless we are all safe."
That message was repeated throughout the day as the inequity of vaccine distribution came into sharp focus. As of mid-September, fewer than 4% of Africans have been fully immunized and most of the 5.7 billion vaccine doses administered around the world have been given in just 10 rich countries.
Chad's president Mahamat Idriss Deby Itno warned of the dangers of leaving countries behind.
"The virus doesn't know continents, borders, even less nationalities or social statuses," Itno told the General Assembly. "The countries and regions that aren't vaccinated will be a source of propagating and developing new variants of the virus. In this regard, we welcome the repeated appeals of the United Nations secretary general and the director general of the [World Health Organization] in favor of access to the vaccine for all. The salvation of humanity depends on it."
Country after country acknowledged the wide disparity in accessing the vaccine, painting a picture so bleak that a solution has at times seemed impossibly out of reach.
South Africa's president Cyril Ramaphosa and others urged U.N. member states to support a proposal to temporarily waive certain intellectual property rights established by the World Trade Organization to allow more countries, particularly low- and middle-income countries, to produce covid-19 vaccines.
Earlier this year, U.S. President Joe Biden broke with European allies to embrace the waivers, but there has been no movement toward the necessary global consensus on the issue required under World Trade Organization rules.
While some nongovernmental organizations have called the waivers vital to boosting global production of the shots, U.S. officials concede it is not the most constricting factor in the inequitable vaccine distribution. Some privately doubt the waivers for the highly complex shots would lead to enhanced production.
Angola President Joao Lourenco said it was "shocking to see the disparity between some nations and others with respect to availability of vaccines."
"These disparities allow for third doses to be given, in some cases, while, in other cases, as in Africa, the vast majority of the population has not even received the first dose," Lourenco said.
The U.S is among the countries that have begun administering boosters or announced plans to do so.
Namibia President Hage Geingob called it "vaccine apartheid," a notable reference given the country's own experience with apartheid when neighboring South Africa's white minority government controlled South West Africa, the name for Namibia before its independence in 1990.
"There is a virus far more terrible, far more harrowing than covid-19. It is the virus of inequality," said the president of the Indian Ocean island nation of the Seychelles, Wavel Ramkalawan.
The grim consequences of covid-19 hit Tanzania especially hard when the East African country's then-president John Magufuli, who had insisted the coronavirus could be defeated with prayer, died in March.
The presidency went to his deputy, Samia Suluhu Hassan, who has since changed Tanzania's course on the pandemic but still sees great challenges ahead.
"We tend to forget that no one is safe until everyone is safe," she said during her speech Thursday.
During a global vaccination summit convened virtually on the sidelines of the General Assembly, Biden announced Wednesday that the United States would double its purchase of Pfizer's covid-19 shots to share with the world to 1 billion doses, with the goal of vaccinating 70% of the global population within the next year.
Moderna's chief executive says that the pandemic could be over in a year and that a boost in production will mean enough vaccines for "everyone on this earth" by then.
Producing enough booster shots should be possible, too, to some extent, and even babies will be able to get vaccines, Stephane Bancel told a Swiss newspaper in an interview published Thursday.
Asked whether that could spell "a return to normal" next year, he replied, "As of today, in a year, I assume."
With the vaccine industry as a whole expanding production, "enough doses should be available by the middle of next year so that everyone on this earth can be vaccinated," Bancel said.
Whether his predictions come true is likely to depend on narrowing the immunity gap between rich countries, which bid high in the contest to buy vaccines, and poorer countries, which rely on trickling donations.
"Without widespread vaccination and other public and social measures, the continent's fourth wave is likely to be the worst, the most brutal yet," said Benido Impouma, a program director with the WHO's Africa program.
Lack of access to vaccines is not just Africa's concern. Leaders of developing nations in different regions echoed the frustration.
In part because of supply problems and biotech firms such as Moderna's selling most early doses to rich countries, the level of first-dose vaccination falls to 20% in poorer parts of the world.
President Luis Arce of Bolivia, one of Latin America's poorest nations, told assembled diplomats that biopharmaceutical companies should make their patents available and share knowledge and technology for vaccine production.
"Access to the vaccine should be considered a human right. We cannot be indifferent, much less profit from health in pandemic times," Arce said.
Earlier on Thursday, Cuba's President Miguel Diaz-Canel stressed that "hundreds of millions of people in low-income nations still await their first dose, and can't even guess whether they will ever receive it."
The WHO says only 15% of promised donations of vaccines -- from rich countries that have access to large quantities of them -- have been delivered. The U.N. health agency has said it wants countries to fulfill their dose-sharing pledges "immediately" and make shots available for programs that benefit poor countries and Africa in particular.
Information for this article was contributed by Pia Sarkar, Carley Petesch, Zeke Miller, David Biller and Mallika Sen of The Associated Press and by Ellen Francis of The Washington Post.