The world stands at a critical juncture of the Covid-19 pandemic. Countries that lack the first round of vaccine coverage are extraordinarily vulnerable to the highly infectious Delta variant, and are also seedbeds for new variants that could quickly spread worldwide. The Lancet Covid-19 Commission, which I chair, is working urgently with the United Nations (UN) system to strengthen the multilateral response.

Governments of countries where vaccines are being produced — the US, European Union members, the UK, India, Russia and China — need to cooperate under UN leadership to ensure that a sufficient supply of vaccine doses reaches the poorest countries.

The high-income countries now have more than 50% of their population fully vaccinated. Yet the fully vaccinated population in Africa remains under 4%. This lack of vaccine coverage in Africa, and in low-income countries elsewhere, poses an imminent danger to these populations.

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