Over the past year, the developed world has seen rising Covid-19 vaccination rates and, subsequently, felt an increasing sense of security in the face of the global pandemic. Sixty-five percent of US citizens, 77 percent of French citizens, and 81 percent of Canadian citizens have been fully vaccinated. However, while Western nations have vaccinated enough citizens to begin lifting restrictions, only 13 percent of people in low income countries have received even one dose of the vaccine due—in large part—to imperialist legacies which ensure that Covid-19 vaccines are owned by richer nations and distributed as they like. While a more successful vaccine donation policy might temporarily aid developing nations during the Covid-19 pandemic, the true root of the issue stems from private ownership of vaccines generally, a problem that is only fixed by making medicine global public goods.
The low vaccination rate in African nations and South Asia has widely been blamed on vaccine hesitancy by Western media, but, in actuality, the problem primarily stems from lack of access. For example, Sudan only has enough vaccines to administer two doses to 10.48 percent of its population, Tanzania 7.64 percent, and the Democratic Republic of the Congo 4.99 percent. Moreover, data suggest that citizens of these states want to be vaccinated, a study of 15 countries conducted by the Africa Center for Disease Control and Prevention in Africa found that 79 percent of respondents want to be vaccinated. Another study showed that vaccine acceptance rates in all 10 low and middle income countries sampled were higher than that of the United States. There is some hesitancy, but that might stem from a history of companies such as Pfizer conducting unethical clinical trials in the developing world. In 1996, Pfizer tested its new antibacterial vaccine on Nigerian people during a meningitis outbreak, allegedly causing the deaths of 11 children. In 2004, a Tenofovir study led five Cameroonian women to be infected with HIV after they were inadequately informed of the risks of the trial. Western companies have an extensive history of treating citizens of developing nations like guinea pigs: They test drugs on people who are not informed of the risks in order to ensure the drugs’ safety for richer, whiter citizens back home.
So why, when there are large rates of vaccine acceptance throughout developing nations and the West has widespread access to the vaccine, do vaccination rates remain so low in the Global South? Simply put: Richer nations own the vaccine and have little care for the rest of the world. Despite Western pledges to donate vaccines, African nations have been forced to dispose of 450,000 vaccines because they were donated too close to the expiration date. Furthermore, countries such as the United States have historically used vaccines—a life-saving resource that should be available to everyone—as a form of political manipulation. In the early 2010s, the CIA used a fake Hepatitis B vaccination campaign in Pakistan to gather DNA from children to help in their search for Osama bin Laden, lying to the population for their own political gain. Any conditional distribution of the vaccine undermines the political autonomy of developing nations in addition to the health of the global community.
The ability to withhold and hoard vaccines only exists because pharmaceutical companies hold a monopoly on Covid-19 vaccines. Companies like Pfizer and Moderna are able to charge over five times what they need to because few other nations and corporations are able to produce the vaccine. As a result, distribution organizations such as COVAX have been unable to buy enough vaccines to distribute vaccines to the poorer nations that need them. Due to patent restrictions, developing nations are largely unable to make their own vaccines. Consequently, the cycle of inequity is reproduced over and over, no matter the virus, because the profits of a few companies are prioritized over the health, lives, and wellbeing of the rest of the world.
If, however, the vaccine were treated as a global public good, this disparity would be drastically diminished. Granting life saving medical technology status as a global public good would make vaccinations “nonrival” (people would not have to compete for access) and “nonexcludable” (everyone would have access). Essentially, the vaccine would no longer be privately owned. Some argue that making the vaccine a public good would decrease its production and minimize the private efforts that have led to its existence in the first place. This, however, is based on false perceptions of how the vaccination process works. According to one study, at least 97 percent of the funding for the Oxford-AstraZeneca vaccine came from public sources, and yet the vaccine is reaping a profit for the private firm. Vaccine manufacturers even offered to produce higher quantities of the vaccine—facilitating its distribution—but the select pharmaceutical companies that own the patent rights to the vaccines refused. There have been a number of calls from UN Secretary General Antonio Guterres, the World Health Assembly, UNESCO’s International Bioethics Committee, and the World Commission on the Ethics of Scientific Knowledge and Technology to treat vaccines as global public goods, but those who benefit from vaccine patents and their privatization continue to block any and all efforts to do so.
Certain developing nations have shown that, with the necessary resources, widespread vaccination is possible. Pakistan, for example, used the grassroot effort of 13,000 women-led teams to engage in a door-to-door campaign to vaccinate the people of the Sindh province. They succeeded in vaccinating six million people in just ten days. Similarly, the Philippines vaccinated 7.6 million people in three days by setting up 8,000 centers across the country.
These nations have demonstrated that, when the vaccine is made accessible, people in the Global South are eager and willing to receive it. Right now, and as long as private interests are placed above human health, that cannot happen.