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Ending the Pandemic: Addressing Global Covid-19 Vaccine Inequality

A healthcare worker receives the COVID-19 vaccine in Accra, Ghana
Image via REUTERS/Francis Kokoroko

As the Covid-19 pandemic enters its second year, many countries are beginning to loosen some of their public health measures. Across Europe, governments are relaxing regulations. Even as Queen Elizabeth juggles the crown and the virus, England has ended its mask mandate and isolation requirements for positive-testing patients. Boris Johnson even suggested that we “learn to live with the virus.” In Denmark, the virus is no longer considered a “socially critical disease” and the country plans to retract remaining restrictions as other European countries follow suit.

The situation is no different in the United States. States are beginning to accept the virus as part of daily life—New York and California are the most recent states to drop their statewide mask mandates, amongst multiple others. Nationally, the Biden administration’s strategy has shifted towards adaptation, such as expanding rapid testing availability and helping hospitals cope with virus surges.

These Western and generally wealthy nations have resigned to the pandemic, opting to let the disease run its course. They seem to say that Covid-19 will be Covid-19, and there’s nothing they can do about it. They have witnessed the swift spread of the Delta and Omicron variants and appear all too ready to accept the next Greek letter.

But to end the pandemic, wealthier countries must address global vaccine inequality. The low vaccination rates in developing countries are driving the relentless mutation of the virus. Not only do these wealthier nations have a moral obligation to expand vaccine access in these countries, but they should also do so to better protect themselves and developing countries who lack the infrastructure necessary to relax public safety regulations.

Prior to vaccines being made globally available, countries like the US, the UK, and Canada vacuumed the supply. These richer nations reserved enough vaccines to vaccinate their populations many times over, leaving some poorer countries with only enough to immunize at most 20 percent of their populations. These more affluent states used their wealth to hedge an advantage, leaving developing countries far from the vaccination rate necessary for them to lower restrictions. Many in developing states are only just getting their primary doses as countries like the US begin to distribute booster shots. At the end of November 2021, only about 5.8 percent of the populations of low-income countries had received at least one dose. The current inequality is especially unacceptable considering the pandemic is a global issue that requires a global solution.

By the end of 2021, rich countries had a surplus of 1.2 billion vaccine doses that weren’t earmarked as donations. While politicians like President Biden claim that vaccinating people at home and abroad isn’t necessarily mutually exclusive, affluent countries clearly aren’t doing enough to increase global vaccine accessibility. Rich countries don’t use enough of their vaccines, wasting a chance to stop the pandemic. In a study published in Nature Medicine, the willingness to take vaccines in low and middle-income countries averaged 80.3 percent, while in the US it was 64.6 percent. Shifting excess vaccine supply to developing countries would surely be more effective than letting them stay idle and unused. Wealthy countries also pledged to send 1.3 billion vaccine doses to COVAX, a global initiative to support vaccine equity, but as of early March only around 37 percent of the pledged amount has been delivered. 

While a country has obligations to its citizens, there is also a moral imperative for vaccines to be made available to developing nations. Wealthier countries have much better infrastructure with which to handle a pandemic and plan around it; their citizens typically have access to better resources and social safety nets to prevent its spread. But in lower-income countries, high levels of poverty, unstable medical infrastructure, and disastrous wars all amplify the need for vaccines.

Understandably, politicians don’t act on altruism. However, low global vaccine accessibility is directly responsible for the longevity of the pandemic. Low vaccination rates give the virus more opportunities to mutate and resist public health efforts. Experts already say that the emergence of the Omicron variant was due to vaccine inequality. Countries where Covid-19 transmission is high, and with little immunity, offer the best grounds for variants, that incubate the virus and make it more dangerous. This phenomenon is why the WHO Director-General Tedros Adhanom Ghebreyesus concluded that “no country can vaccinate its way out of this pandemic in isolation.” UN Secretary-General António Guterres also holds this view, saying, “the only way out of a global pandemic—and out of this unjust and immoral situation—is through a global vaccination plan.”

It’s difficult to see a clear end to the pandemic when richer countries continue hoarding vaccines. WHO Vaccine Director Kate O’Brien remarked, “as we head into whatever the Omicron situation is going to be, there is risk that the global supply is again going to revert to high-income countries hoarding vaccines.” It’s as if wealthy countries haven’t learned their lesson: As soon as the solution for an emerging variant comes to the market, they will likely vacuum the supply again. Lower-income countries will suffer from high-rates of infection, and another variant will appear, starting the cycle all over again. While leaders point to Omicron being less lethal, it’s risky to play this sort of game with a virus that could spell the death of millions.

But why, then, should wealthier countries, whose populations are largely vaccinated and whose medical infrastructures are stable, care about vaccine equity? From their perspective, they don’t need to. They believe they have rightfully purchased their own vaccines, helped their citizens, and secured the situation within their borders. These countries think that they’ve done all that they are supposed to, but this reasoning could prove disastrous.

The greed over vaccines is likely to continue unless wealthier countries change their approach to the pandemic. The future of the pandemic rests in their hands, and they can change its course by improving vaccine equity. Put simply, it’s selfish for rich countries to keep vaccines to themselves, turning the other cheek to poorer nations’ struggles. But more than that, it is ineffective for addressing a pandemic that will rage on if they continue this strategy.