Vaccine Nationalism Goes Against a Sustainable Future For All

The global pandemic response has exposed an unsettling trend. Wealthier nations have been accused of hoarding vaccines — in some cases five times more than they need — while poorer countries could wait years for lifesaving immunization. A massive 90% of people in 67 low-income countries may not get immunized in 2021, largely due to higher-income countries taking more than they need. It reads like a dystopian novel.

While Europe and North America have carried out a combined 123 million vaccinations, the entire African continent has administered just under 3 million, with many African countries facing a long wait to receive any doses. This follows a stark address from the World Health Organization’s director-general, who noted in mid-January that only 25 doses had been given in one low-income country in Africa, and warned that the world is on the verge of “catastrophic moral failure.”

For richer countries, failing to look beyond their own interests is counterproductive and will delay the world’s victory against COVID-19. It would also precipitate another crisis — without equal and fast distribution of vaccines to the most vulnerable nations, we’re undoing decades of progress toward a sustainable future and a level playing field.

[MORE: An Opportunity to Improve Global Development]

While new coronavirus variants intensified pressure on governments to prioritize vaccinating their own populations, it doesn’t have to be an either/or scenario. Norway has shown the way to manage both simultaneously — setting out plans for its domestic program as well as donating surplus vaccine doses to countries in need.

The worldwide inoculation that we all want calls for immediate and multilateral action. That means a bigger push for cooperation between governments, industry bodies and Big Pharma to accelerate the equitable rollout of affordable vaccines.

Bridging the Widening Wealth Gap

Even before COVID-19, the Organization for Economic Cooperation and Development estimated an annual financing shortfall of trillions of dollars to reach the Sustainable Development Goals — a collection of global goals set by the U.N. intended to improve living conditions around the world — the goals were stymied by the pandemic’s impact on resources. Delayed vaccinations will impact the development of self-sustaining economies even more, widening the wealth gap and diminishing those states’ ability to navigate future crises.

The World Bank predicts as many as 150 million more people could plunge into extreme poverty this year. That’s a devastating step backward. In the battle against the pandemic, we can’t afford to forget our objectives to end poverty and ensure healthy lives.

While many countries publicly backed fair access to vaccines for all, this is yet to transition into solid action on a universal scale. There’s a funding gap to the sum of billions in the COVAX initiative, the UNICEF-led drive that aims to vaccinate at least 20% of people in poorer countries. The scheme did get a boon with the Biden administration committing the United States to join, but COVAX will only work with consistent and dedicated buy-in across all nations.

The pharmaceutical sector, too, has a big part to play in removing roadblocks to large-scale vaccination, as manufacturers have tended to seek approvals first in more affluent countries that represent the best commercial payoffs. For the same reasons, most have been unwilling to open up access to intellectual property. Some pharma companies, Johnson & Johnson and AstraZeneca among them, have pledged to sell their vaccines at cost to developing countries, signalling a move in the right direction.

Meanwhile, calls from South Africa and India for vaccine patent requirements to be relaxed temporarily have faced opposition from some. More can be done to break down IP barriers, such as the positive commitment from pharmaceutical company Moderna, to enable cost-effective and scalable production of COVID-19 vaccines locally, removing the reliance on shipments.

A Global Health Response Calls For Determined, United Action

There was tremendous investment from governments into pharmaceutical R&D to speed up the discovery of breakthrough treatments in record time. Given the nature of the crisis, quick action was necessary but it introduces another issue to consider. If the public deems development and approval times to be too short, or to have been rushed due to government or business influences, skepticism can be fueled. We saw this when questions were raised recently with India’s COVAXIN, which received the go-ahead for “restricted use” prior to the completion of all clinical trials. Similar feelings emerged over Russia and China — not just relating to test data for their vaccines but also over the perception that their “vaccine diplomacy” in committing to supply developing nations is intended to gain economic and political leverage.

Vaccine hesitancy poses a risk to the international health response, and it’s driven by concerns that the vaccine has become politicized and by a lack of full information and transparency. In the U.S., around 39% of people in December said they would refuse a coronavirus vaccination — but half of those surveyed admitted that they would do so once clear data was available as more people received the vaccine. In some emerging and poorer countries, anti-vaccine sentiment may be greater, exacerbated by national instabilities, and mistrust in governments and large corporates. And to a very large degree by insufficient health care systems that have been further weakened by the pandemic.

Therefore, it’s important to recognize that an effective and cohesive rollout strategy is about more than delivering jabs into arms. It must take into account the full spectrum of factors that may compound a mass immunization program. That includes fostering public confidence through openness with clinical trial findings; sharing information on the effectiveness and benefits of vaccines; technology transfer for local manufacturing capabilities; overcoming logistical obstacles with delivering and storing supplies; and ensuring an ongoing flow of investment into health care infrastructure and training.

Meeting all of these needs calls for an urgent, coordinated, and rigorously implemented roadmap. In a word — solidarity. Richer nations with the wherewithal to develop vaccines in the last year have given a real, and the only, solution to getting the world back on its feet. However, providing this lifeline is in vain unless it’s fairly distributed to all countries in tandem. If the virus persists in just one place, it can evolve into new strains and re-infect entire nations.

Ralph Waldo Emerson said that “the first wealth is health.” Tweaking his original meaning, if all economic powers look through a long-term lens, it’s clear that supporting the health of the most at risk in developing markets (home to 85% of the global population) will also have reverberations on the financial recovery of every other economy.

We can’t risk a future where national wealth dictates who is safe from a deadly threat and who isn’t. Apart from the obvious ethical considerations, failing to approach this with collective efforts will cause irreparable damage to global health and economy, and will reverse the positive steps taken towards the world’s ambitions for a sustainable future.

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