The COVID-19 pandemic has shocked the world and brought business as usual to a halt, causing economies to dwindle and hospitals to be overrun with patients. The pandemic has also shed light on social, economic, and racial disparities not only in individual countries but in the global order itself. The announcement of a vaccine for COVID-19 was praised and seen as a light at the end of the tunnel – but not for everyone. While the EU, the UK, Canada, the US, and Israel have all been able to secure millions of doses and roll out vaccination plans, lower-income countries struggle to even get in the queue. Some are even solely dependent on international aid for a chance at accessing these vaccines.
Dr. Tedros Ghebreyesus, the head of the World Health Organization (WHO), explained the global distribution of vaccines as a “clear problem” in the fight against the virus. As of early January, 36 of the 42 countries with vaccine rollout programs are high-income countries. This means that as rich countries buy up the supplies and vaccinate their own citizens, those most vulnerable are left to fend for themselves. Jenna Patterson, the South Africa-based director of health economics at the Health Finance Institute, said “I would characterise the approach to global vaccine distribution as a massive failure.”
“Vaccine Nationalism” is a term used to describe the situation when a country solely focuses on its population with no regard for an equitable global vaccine rollout. The EU, Canada, and the US are being accused of such chauvinist negligence as they are buying up vaccine supplies that far exceed their population. According to numbers by Duke Global Health Innovation Center, the US through around six bilateral agreements has secured more than 1 billion doses, which clearly exceeds its current population of 328 million. Similarly, Canada has purchased enough doses to vaccinate the population five times over, the EU enough to vaccinate their population two times over, and Britain’s purchases could vaccinate their population four times over.
Their justification for securing this surplus is based on the uncertainty of effective treatments from different vaccine types. EU Health Commissioner Stella Kyriakides announced the possibility of redistributing the EU’s COVID-19 vaccine surplus to the Western Balkans, North Africa, and Sub-Saharan nations. While this could be viewed as a welcomed donation, the reality is that this may be the only way for these lower-income countries to even access these vaccines.
COVAX – a solution?
To address this inequity, COVAX was created – a global initiative created by the WHO, the Global Alliance for Vaccines and Immunization (GAVI), and the Coalition for Epidemic Preparedness Innovations (CEPI) – with the goal of coordinating a global vaccination strategy to ensure its fair distribution. Unfortunately, COVAX has already been met with some challenges: the WHO has been struggling to access sufficient supplies seeing as most vaccine manufacturers are prioritizing agreements with “developed” nations since engaging with such wealthy nations is more profitable. If this trend continues, it seems that many people’s chances at vaccination will be dependent on the graces of high-income countries.
WHO Director warns of “catastrophic moral failure”
WHO’s director-general warned that “The world is on the brink of a catastrophic moral failure and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.” 92 countries are most in need of support from COVAX, which are defined as countries unable to afford vaccines on their own such as Ethiopia and Afghanistan. COVAX claims that it is on track to reach its goal of having 2 billion doses distributed by the end of 2021 but, as it is still short of the necessary 2.8 billion USD for this year, not many are hopeful. South Africa’s president Cyril Ramaphosa, speaking on behalf of the African Union, warned that even if COVAX reaches its aims, it won’t be nearly enough. The total doses promised by COVAX to the African continent will cover 300 million people – only 20% of the continent’s population.
Oxfam International warned in a press release that 90% of people in poor countries will miss out on the COVID-19 vaccine in 2021. Steve Cockburn, Amnesty International’s Head of Economic and Social Justice also asserted that “By buying up the vast majority of the world’s vaccine supply, rich countries are in breach of their human rights obligations. Instead, by working with others to share knowledge and scale up supply, they could help bring an end to the global COVID-19 crisis.”
Countries seeking affordable access to the vaccine are desperate and with no support from Western countries and companies, many are turning to China, India, and Russia instead, despite legitimate concerns about the pharmaceutical quality. Indonesia, Pakistan, and Mexico have all already signed agreements to test and produce Chinese vaccines in their own countries. The African Union has also begun to negotiate with the Serum Institute of India to receive vaccines after Pfizer offered only 50 million doses for the entire continent. It should be noted these have not received regulatory approval from the WHO.
It is morally abhorrent that there is not more of a holistic approach to global vaccine distribution, but as the reality seems to be setting in that high-income countries are going to be prioritised, the question remains – what does this mean for the world?
The impacts of inequitable vaccine distribution
In an ironic turn, should wealthy nations hoard vaccines, the economic devastation which could follow may affect them the most. A study found that if the most extreme scenario were to happen, wherein wealthy nations are fully vaccinated by mid-2021 while poor countries are not, the global economy could suffer over $9 trillion in losses. However, the most likely scenario is that developing countries will be able to vaccinate half of their populations by the end of 2021. In this case, the global economy would still take a hit of $1.8-$3.8 trillion, and roughly half of those losses would be concentrated in wealthy countries.
COVID-19 has not only highlighted socio-economic inequalities but has made them worse. Research suggests that people in lower economic standings are more likely to catch COVID-19 and possibly die from it. Even if they survive the virus, they are more likely to suffer income loss, health care loss, and be hit harder by measures such as lockdowns. Described as a “mutually reinforcing cycle”, the connection between the virus numbers as well as socioeconomic divisions is alarming. People with low-income jobs or those who work in informal, unregulated economic sectors can’t count on social services to take time off to isolate or stay home, which forces them to put themselves at risk every day and increases their risk of transmission. With high inequality comes increased cost of living, forcing lower-income families to live month to month. Simultaneously, a decrease in labour unions and the rise of part-time work means that those who are more likely to be infected, also become the least protected. For example in the US, 90% of people in the top 25% of income have paid sick leave, compared to a mere 47% of those in the bottom 25%. From Italy to China to the US, these divides are worsening in this unprecedented time.
With the current system predicting that there will not be enough vaccines for the entire world’s population until 2024, the role that higher-income countries are playing should be more heavily scrutinised. Yes, countries should protect their citizens, but COVID-19 does not care about borders. In other words, vaccine nationalism is not a viable answer. The global disparities highlighted by the COVID-19 pandemic come as no surprise; they are a reflection of profound global health and wealth disparities upheld and only benefited from by wealthy countries. The possibility of having a grassroots distributor rather than a corporate one would go a long way in making the vaccine distribution much more equitable – but under our current capitalist system, gradual change is much more feasible than the rapid transformation of global public health norms. COVID-19 doesn’t care about man-made borders nor societal barriers keeping apart rich and poor.
One thing is clear: socioeconomic divides exist and are worsening – both within individual countries and between the Global North and the Global South. If COVID-19 isn’t a wake-up call, what will be?