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Why a failure to vaccinate the world will put us all at risk

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Isabel Rodriguez-Barraquer currently works remotely from Colombia. As an epidemiologist, she has been watching from afar as her colleagues back at the University of California, San Francisco, have started receiving vaccines available to lab workers.

The situation is very different where she now lives. Colombia is suffering a massive covid-19 outbreak and is still waiting to see the first doses of vaccine arrive this month: 50,000 doses of the Pfizer and AstraZeneca vaccines are expected in February, and a couple hundred thousand in March. The country has been cutting deals directly with drug makers, including China’s Sinovac, and working through international partnerships to obtain more. But Rodriguez-Barraquer fears it will be too late.

The coronavirus vaccination programs for the world’s richest countries are now in full swing. Almost one-quarter of the UK’s adult population has now had a first dose. The US, while not quite at that pace, has now given at least one dose to more than 35 million people.

But for low-income countries around the globe, the picture is very different—and may be for some time. Many of the world’s poorest are still waiting for the first doses to reach them. Estimates by the Economist Intelligence Unit suggest that some 85 countries in the developing world may not be fully vaccinated until 2023 at the earliest. For example, in January, the World Health Organization warned that the West African nation of Guinea was the only low-income country on the continent to have started vaccinating: but only 25 people (all senior government officials, the AP reported) out of the country’s population of almost 13 million had received a dose at that point.

One of the big problems is there isn’t yet any global rollout, only talk of it, says Chris Dickey, who directs the global and environmental public health program at New York University’s Global Health School. Rodriguez-Barraquer agrees. “The burden of illness and death could be prevented if there was more global coordination in vaccine supply,” she says. 

This imbalance won’t just lead to more deaths. It will cause a raft of economic, social, and health effects—not just in the nations affected, but throughout the rest of the world. 

Addressing vaccine inequality

The supply to poorer countries is low mostly because the majority of the available vaccines have been purchased or promised to richer countries in North America and Europe. To address this vaccine inequity, a coalition of international organizations, including the World Health Organization and governments, created a nonprofit called Covax in April 2020.

The idea was to create a global supply of vaccines for 92 low- and middle-income countries. In December, the nonprofit announced that it had secured access to some 2 billion doses for 2021 through donations and commitments from some manufacturers, but it is unclear how many of those will actually be delivered this year. The problem becomes more complicated because many countries are both working through Covax and trying to secure deals with drug makers themselves—making it more challenging for Covax to make deals with those manufacturers at the same time. 

The group aims to vaccinate about 20% of the people in the world, focusing on hard-to-reach populations in Africa, Latin America, and Asia. To do so, it needs another $4.9 billion in addition to the $2.1 billion it has already raised. But there are other problems. The cheaper and easier-to-transport vaccines like the ones pledged by AstraZeneca have been slower to gain regulatory approval. Meanwhile, other companies seem less interested in pitching in: Doctors Without Borders found that only 2% of Pfizer’s global supply had been granted to Covax, and Moderna is still “in talks” with the organization.

“Covax is a critical starting point that—without a commitment from President Biden—had a high probability of failure. It’s looking better now, but could still fail if it doesn’t get money and vaccines,” says Barry Bloom, a global health researcher at the Harvard T.H. Chan School of Public Health. Biden officially directed the US government to join Covax in late January. 

If it can succeed, the international program has many upsides. It establishes a mechanism of fairness that doesn’t depend on colonial mentalities of quid pro quo, says Bloom. It also absolves individual rich countries from having to determine which countries get what percentage of the vaccines. “This is a way of saying somebody else will take the rap, especially for the delivery time,” he says. 

We’re not safe until we’re all safe

The motive for getting the vaccine to poorer countries more quickly is not just altruism: evolution will punish any delays. SARS-CoV-2 has already mutated into several worrying new variants, and this process will continue. If countries with large populations wait to be vaccinated for years, the virus will keep mutating—potentially to the point that the first available vaccines lose effectiveness. That will be bad for everyone, but poorer countries, with less access to updated vaccines, will again feel more of the impact.

“We get more mutants and they get more deaths,” says Bloom. 

Judd Walson, a global health researcher at the University of Washington, worries more about the indirect effects of the pandemic in the developing world, where in many places covid-19 doesn’t even rank in the top 20 causes of death. Health systems have directed a lot of personnel and resources to dealing with the pandemic—setting up quarantine centers, doing surveillance, and more. In addition, funders and ministries have been diverted away from diarrhea, malaria, and other killers. 

As a result, those other programs are suffering: rates of immunization for diseases such as measles, diphtheria, tetanus, and whooping cough are declining, both for lack of supplies and personnel and because people fear going to health centers. “All those other things that are killing people are being neglected, so not providing a covid vaccine stops governments from shifting back to their priorities before the pandemic,” says Walson.

And while virus variants can travel fast in a highly connected world, so can economic instability. That’s one takeaway from a recent paper published by the nonprofit National Bureau of Economic Research. Sebnem Kalemli-Özcan, an economist at the University of Maryland, and colleagues analyzed how delays in global vaccine distribution would affect the economies in countries whose populations had already been vaccinated.  

The economic cost of inequity

They found that a world where poorer countries have to wait to be vaccinated would see a global economic loss of about $9 trillion this year, with wealthy countries absorbing nearly half of those losses in declining trade and fractured supply lines. (A similar study by the RAND Corporation estimated that failure to ensure equitable covid-19 vaccine distribution could cost the global economy up to $1.2 trillion a year.) Ensuring equitable distribution is actually in the best interests of advanced economies. “Their hit will come back and hit you,” says Kalemli-Özcan. 

Yes, when the majority of the population in richer countries is vaccinated, restaurants and gyms may bounce back to life. But there are many sectors of the economy that buy from emerging markets—for example, retail, automotive, textiles, and construction. All will all be hurt by a slowdown in those markets. Also, those countries are often customers. “If the US improves and Europe improves and they want to sell goods, if those countries they want to sell to are still sick, they are not going to buy those goods,” says Kalemli-Özcan. “No economy is an island, and no economy recovers until every economy recovers.” 

Even though globalization amplified the pandemic, it’s also the only solution to the pandemic, Kalemli-Özcan argues. Rich countries cannot prevent economic pain by hoarding vaccines; rather, they must invest in initiatives to increase the supply and reinforce distribution. Canada, for example, has placed an order for five times more doses than its population needs. The country is considering donating the excess to Covax, but it’s not clear how those vaccines will be given back if unused.

The research assumed that wealthy countries would be vaccinated in 2021 and others would wait until 2022—but if the gap grows to several years, the economic pain will be much greater.

Vaccine nationalism, as hoarding doses for one country is known, would be likely to backfire politically as well as economically. People around the world are watching to see when vaccines are available. And what that means for the political perception of the US in the world is really important, says Walson: “Vaccine nationalism is going to fuel a tremendous sense that we are only out for ourselves, and that only adds fuel to the already-burning fire by some against the West,” he says. “I think there will be long-standing consequences to not addressing these inequities.” 

Other solutions

Funding Covax is the most immediate solution. There are also opportunities to license vaccine tech or ease intellectual-property rights so emerging countries can develop the capacity to either produce their own vaccines or complete the final steps of production, known as “finish and fill.” 

“I don’t see why South Africa and Kenya can’t produce vaccines and why Ethiopia and Botswana can’t finish and fill,” says Bloom. He says that early in the pandemic, there were only two places on the African continent that had the capacity to do covid-19 testing—and within a month, there were 11. African countries even joined forces to create a center for disease control for the whole continent, sharing information and best practices on covid-19 in a way that isn’t even done across all 50 US states. 

But time is of the essence. At the current rate of transmission, probably 50% of Colombia will be infected by the time mass vaccinations start. Rodriguez-Barraquer fears what that means for the country where she grew up: “The worry is that it will be too little, too late, and the epidemic is running its course.”

Lyron Foster is a Hawaii based African American Musician, Author, Actor, Blogger, Filmmaker, Philanthropist and Multinational Serial Tech Entrepreneur.

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Indonesian logistics startup SiCepat raises $170 million Series B

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SiCepat, an end-to-end logistics startup in Indonesia, announced today it has raised a $170 million Series B funding round. Founded in 2014 to provide last-mile deliveries for small merchants, the company has since expanded to serve large e-commerce platforms, too. Its services now also cover warehousing and fulfillment, middle-mile logistics and online distribution.

Investors in SiCepat’s Series B include Falcon House Partners; Kejora Capital; DEG (the German Development Finance Institution); Telkom Indonesia’s investment arm MDI Ventures; Indies Capital; Temasek Holdings subsidiary Pavilion Capital; Tri Hill; and Daiwa Securities. The company’s last funding announcement was a $50 million Series A in April 2019.

In a press statement, The Kim Hai, founder and chief executive officer of SiCepat’s parent company Onstar Express, said the funding will be used to “further fortify SiCepat’s position as the leading end-to-end logistics service provider in the Indonesian market and potentially to explore expansion to other markets in Southeast Asia.” SiCepat claims to be profitable already and that it was able to fulfill more than 1.4 million packages per day in 2020.

The logistics industry in Indonesia is highly fragmented, which means higher costs for businesses. At the same time, demand for deliveries is increasing thanks to the growth of e-commerce, especially during the COVID-19 pandemic.

SiCepat is one of several Indonesian startups that have raised funding recently to make the supply chain and logistics infrastructure more efficient. For example, earlier this week, supply chain SaaS provider Advotics announced a $2.75 million round. Other notable startups in the space include Kargo, founded by a former Uber Asia executive, and Waresix.

SiCepat focuses in particular on e-commerce and social commerce, or people who sell goods through their social media networks. In statement, Kejora Capital managing partner Sebastian Togelang, said the Indonesian e-commerce market is expected to grow at five-year compounded annual growth rate of 21%, reaching $82 billion by 2025.

“We believe SiCepat is ideally positioned to serve customers from e-commerce giants to uprising social commerce players which contribute an estimated 25% to the total digital commerce economy,” he added.

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InsurGrid raises pre-seed financing to help modernize legacy insurance agents

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Insurance agents spend hours handling paperwork and grabbing client information over the phone. A new seed-stage startup, InsurGrid, has developed a software solution to help ease the process, and make it easier for agents to serve existing clients — and secure new ones.

InsurGrid gives agents a personalized platform to collect information from clients, such as date of birth, driver’s license information and policy declaration. This platform helps agents avoid sitting on long calls or managing back-to-back emails, and instead gives them one spot to understand how all their different clients function. It is starting with property and casualty management.

The startup integrates with 85 insurance carriers, serving as the software layer instead of the provider. Using the InsurGrid platform, insurers can ask clients to upload information and within seconds be registered as a policyholder. This essentially turns into a living Rolodex that insurers can use to access information on the account, and offer quotes on a faster rate.

Image Credits: InsurGrid

There’s a monetary benefit in providing better service. Eden Insurance, a customer of InsurGrid, said that people who submit information through the platform converted at an 82% higher rate than those who don’t. Jeremy Eden, the agency owner of Eden Insurance, said they were able to show consumers that its plan was $300 cheaper than its existing rate.

At the heart of InsurGrid is a bet from the founding team that legacy insurance agents aren’t going anywhere. Co-founder/CEO Chase Beach pointed out that the majority of the $684 billion of annual property and casualty insurance premiums in the United States is distributed by approximately 800,000 agents working in 16,000 brokerages. So far, InsurGrid works with more than 150 of those agencies.

When asked if InsurGrid ever had plans to offer its own insurance, similar to insurtech giants Hippo, Lemonade and Root, Beach said that it is solely working on innovating around the sales process for now. He said that these big companies, which have either recently gone public or are planning to, still rely on agents to be successful.

“Instead of us replacing the insurance agent, what if we gave them that same level of technology of a Hippo or large carrier,” Beach said. “And provide them with the digital experiences so they can compete in 2021.”

As time goes on, he sees insurance agents taking the same role that financial advisors or real estate agents take: “very much involved in the process because they are that expert.”

Other startups that have popped up in this space include Gabi, Trellis and Canopy Connect. The differentiator, the team sees, is that Beach comes from a 144-year-old insurance legacy, giving him key insights on how to sell to agents in a successful and effective way. It is starting with sales, but expect InsurGrid to expand to other parts of the insurance process as well.

To help them compete with new and old startups, InsurGrid recently raised $1.3 million in pre-seed financing to help it fulfill its goal to be the “underdog for the underdogs,” Beach said. Investors include Engineering Capital, Hustle Fund, Vess Capital, Sahil Lavingia and Trevor Kienzle.

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Backed by Blossom, Creandum and Index, grocery delivery and dark store startup Dija launches in London

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Dija, the London-based grocery delivery startup, is officially launching today and confirming that it raised £20 million in seed funding in December — a round that we first reported was partially closed the previous month.

Backing the company is Blossom Capital, Creandum and Index Ventures, with Dija seemingly able to raise pre-launch. In fact, there are already rumours swirling around London’s venture capital community that the upstart may be out raising again already — a figure up to £100 million was mooted by one source — as the race to become the early European leader in the burgeoning “dark” grocery store space heats up.

Image Credits: Dija

Over the last few months, a host of European startups have launched with the promise of delivering grocery and other convenience store items within 10-15 minutes of ordering. They do this by building out their own hyper-local, delivery-only fulfilment centres — so-called “dark stores” — and recruiting their own delivery personnel. This full-stack or vertical approach and the visibility it provides is then supposed to produce enough supply chain and logistics efficiency to make the unit economics work, although that part is far from proven.

Earlier this week, Berlin-based Flink announced that it had raised $52 million in seed financing in a mixture of equity and debt. The company didn’t break out the equity-debt split, though one source told me the equity component was roughly half and half.

Others in the space include Berlin’s Gorillas, London’s Jiffy and Weezy, and France’s Cajoo, all of which also claim to focus on fresh food and groceries. There’s also the likes of Zapp, which is still in stealth and more focused on a potentially higher-margin convenience store offering similar to U.S. unicorn goPuff. Related: goPuff itself is also looking to expand into Europe and is currently in talks to acquire or invest in the U.K.’s Fancy, which some have dubbed a mini goPuff.

However, let’s get back to Dija. Founded by Alberto Menolascina and Yusuf Saban, who both spent a number of years at Deliveroo in senior positions, the company has opened up shop in central London and promises to let you order groceries and other convenience products within 10 minutes. It has hubs in South Kensington, Fulham and Hackney, and says it plans to open 20 further hubs, covering central London and Zone 2, by the summer. Each hub carries around 2,000 products, claiming to be sold at “recommended retail prices”. A flat delivery fee of £1.99 is charged per order.

“The only competitors that we are focused on are the large supermarket chains who dominate a global $12 trillion industry,” Dija’s Menolascina tells me when I ask about competitors. “What really sets us apart from them, besides our speed and technology, is our team, who all have a background in growing and disrupting this industry, including myself and Yusuf, who built and scaled Deliveroo from the ground up”.

Menolascina was previously director of Corporate Strategy and Development at the takeout delivery behemoth and held several positions before that. He also co-founded Everli (formerly Supermercato24), the Instacart-styled grocery delivery company in Italy, and also worked at Just Eat. Saban is the former chief of staff to CEO at Deliveroo and also worked at investment bank Morgan Stanley.

During Dija’s soft-launch, Menolascina says that typical customers have been doing their weekly food shop using the app, and also fulfilling other needs, such as last minute emergencies or late night cravings. “The pain points Dija is helping to solve are universal and we built Dija to be accessible to everyone,” he says. “It’s why we offer products at retail prices, available in 10 minutes – combining value and convenience. Already, Dija is becoming a key service for parents who are pressed for time working from home and homeschooling, as one example”.

Despite the millions of dollars being pumped into the space, a number of VCs I’ve spoken to privately are sceptical that fresh groceries with near instant delivery can be made to work. The thinking is that fresh food perishes, margins are lower, and basket sizes won’t be large enough to cover the costs of delivery.

“This might be the case for other companies, but almost everyone at Dija comes from this industry and knows exactly what they are doing, from buying and merchandising to data and marketing,” Menolascina says, pushing back. “It’s also worth pointing out that we are a full-stack model, so we’re not sharing our margin with other parties. In terms of the average basket size, it varies depending on the customer’s need. On one hand, we have customers who do their entire grocery shop through Dija, while on the other hand, our customers depend on us for emergency purchases e.g. nappies, batteries etc.”

On pricing, he says that, like any retail business, Dija buys products at wholesale prices and sells them at recommended retail prices. “Going forward, we have a clear roadmap on how we generate additional revenue, including strategic partnerships, supply chain optimisation and technology enhancements,” adds Menolascina.

Dija testing on Deliveroo

Image Credits: TechCrunch

Meanwhile, TechCrunch has learned that prior to launching its own app, Dija ran a number of experiments on takeout marketplace Deliveroo, including selling various convenience store items, such as potato chips and over-the-counter pharmaceuticals. If you’ve ever ordered toiletry products from “Baby & Me Pharmacy” or purchased chocolate sweets from “Valentine’s Vows,” you have likely and unknowingly shopped at Dija. Those brands, and a number of others, all delivered from the same address in South Kensington.

“Going direct to consumer without properly testing pick & pack is a big risk,” Menolascina told me in a WhatsApp message a few weeks ago, confirming the Deliveroo tests. “We created disposable virtual brands purely to learn what to sell and how to replenish, pick & pack, and deliver”.

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