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May 11, 2021
Written by Dana Justus
Vaccine nationalism, meaning that higher-income countries are buying up disproportionate amounts of vaccine doses for their own populations, has been a concern since the first COVID-19 vaccines entered clinical trial phases in mid-2020. Multilateral solidarity seems to have given way to competitive behaviour in light of what a recent RAND survey called the ‘arms race’ towards global vaccination. This will affect not only poorer regions, but also the global economy with expected losses of trillions (USD) in global GDP. While this behaviour might seem like a logical consequence of self-protection, there is a need for closer examination. For example, Germany alone has ordered at least 323 million doses from six different vaccines for a population of 83 million. The EU seems to find themselves in the middle of a fight of political wills by promoting global value chains and calling for global cooperation. At the same time, they are threatening vaccine manufacturers over ambiguous contractual obligations favouring EU citizens in a row that could threaten vaccine distribution.
Global immunity is seen as the primary means to end the worst of the COVID-19 pandemic and has substantial implications for global health governance. Yet, it would be a misconception to argue that the approval of several vaccines for rollout is equivalent to a cure-all solution. In addition to limited access for developing countries, there are problems of logistics and storage, not to forget widespread hesitancy to get vaccinated due to misinformation. Beyond humanitarian reasons to promote vaccines for all, the phrase “no-one is safe until everyone is safe” is more than just a campaign slogan for COVAX. The pandemic has shown by now that global cooperation is a necessary means for global recovery. More so, the crisis presents the international community with the opportunity to strengthen fragile health systems holistically. The pandemic has already complicated access to health care services around the world, resulting in setbacks for childhood immunisations in 70 developing countries. Additionally, treatments for non-communicable diseases and routine surgeries have become hard to come by with millions of patients affected worldwide.
Continued delays to the global vaccine rollout will result in substantial economic shocks and developing countries will likely see the worst of these effects. Prolonged exposure to physical distancing measures and public disinvestments will not only affect global supply chains but are already inhibiting progress on the Sustainable Development Goals (SDGs). Food insecurity was already rising before the emergence of this virus while continued restrictions and resulting threats to people’s livelihoods are active threats to food systems and efforts to alleviate global hunger. This adds to the problem of infrastructure. India and South Africa have high production capacities (India is home to the largest producer of vaccines worldwide), but also have high exposure and mortality rates, while the poor and rural populations are difficult to reach. The situation in India today is highly problematic; as the country is experiencing new daily totals of over 300,000 infections, immunisation efforts are seriously constrained by the struggling health system. Chile, on the other hand, has been impressively fast to vaccinate its mostly rural population but cases are rising nonetheless, resulting in significant problems for health services and political stability. Middle-income countries may find themselves in the difficult position of being neither too rich, nor too poor for receiving vaccines in the short term, especially problematic considering they are more susceptible to economic shocks than some high-income countries. Competition between buyers – in addition to companies’ manufacturing problems – are actively constraining public health campaigns for widespread rollouts, while resulting issues for health services are likely to induce setbacks for building back societies.
Middle-and lower-income countries not adequately recovering from the pandemic will lead to hundreds of billions in GDP losses for rich countries. Such numbers suggest significant economic incentives for affected nations to commit to equitable vaccinations. In the wordsof the International Chamber of Commerce (ICC), ‘a US$ 27.2 billion investment on the part of advanced economies – the current funding shortfall […] – is capable of generating returns as high as 166x the investment’. Thus far, COVAX is set out to distribute 1.8-2 billion doses to 92 lower-income countries. Despite these promising numbers experts claim that COVAX is insufficient, ‘wholly unequipped’ to meet the 70% target for global immunisation. Moreover, World Bank assessments of countries’ vaccination readiness show dramatic shortfalls when it comes to safety systems (68%), trained staff (30%), and social engagement strategies (27%) which are necessary to meet vaccine hesitancy.
Consequently, there is a clear need and opportunity to strengthen public health beyond borders, to invest in human capital and facilitate access to medical tools. Such efforts could build widespread resilience in those regions which are still most susceptible to public health emergencies. Research shows that this is not “just” a humanitarian mission or an ethical motivation; there are significant economic incentives for rich countries to open themselves up to equitable vaccine distribution. Calling on leaders to share unused vaccine doses is a start, but achieving global targets will nonetheless require a more widespread response to expand capacities in poorer regions in order to avoid gaps in time and prevent likely new mutations. If this pandemic has shown us something, it is that there is a clear discrepancy between economically-motivated and public-good policy-making. Given the unequal speed of vaccine rollouts and rapidly rising case rates in countries like Chile, Germany and India in spite of access to high quantities of vaccines, it should become clear that domestic immunisation is not the singular solution for recovery. It is time for global leaders to re-invest in existing global governance mechanisms as it has become obvious that this crisis is truly global – and thus requires a global solution to build capacities beyond national borders.
You can help by calling on pharma companies to donate more of their doses for free. Sign Amnesty International’s petition here.
Read more on COVAX rollout here.
Dana Justus is a Postgraduate student of International Security at Warwick and a volunteer research assistant for WICID. Her key research interests are global health, security, and development. She is currently working on her dissertation discussing how global health governance is framed in security and human rights-based discourse.