Author: Dan TranA year into the COVID-19 pandemic, the development of several vaccines provided the promise of relief and hope in defeating a virus that has caused tremendous social and economic disruption globally. However, many countries remain in need of vaccines. According to the People’s Vaccine Alliance, a coalition of various advocacy organizations, 90% of people in 67 low-income countries are not expected to be vaccinated this year. This places these populations at a high risk of contracting and spreading the disease, turning COVID-19 into a disease of poverty: access to vaccines and treatment is limited by the ability to pay. Many words have been used to describe this inconsistency in vaccine availability, such as nationalism and apartheid. However it may be framed, the unequal distribution of COVID-19 vaccines worldwide reflects larger issues of global inequality.
The massive coordination needed to vaccinate everyone is an inherently time-consuming and expensive process, but several factors complicate this even more. Low-income countries do not have the necessary technical expertise and resources to make vaccines. Also, many companies have patents over the vaccines, which stops other companies from producing generic versions of those vaccines and selling discounted versions. From an economic perspective, vaccine development is a huge investment made into those companies that should provide a return in terms of profit. Moreover, the prices of different vaccines, which are usually set by negotiations between countries and companies, vary considerably with the result that some countries pay more per dose than others. Meanwhile, many rich nations are hoarding vaccines, further restricting access for poorer countries.
Another issue is that many countries do not have the necessary infrastructure to store and distribute vaccines. For example, many of the vaccines must be stored well below freezing point—the Pfizer vaccine must be stored at -70°C before use—which may prove to be challenging for communities that cannot access this special technology. It is estimated that 20% of the poorest nations do not have the resources needed to maintain the cold chain for storing the vaccine. Issues such as this complicate the logistics of delivering vaccines to the communities that need them.
One solution that has been developed in response to the discrepancies in accessing vaccines is the COVAX initiative, which was started in 2020 as a partnership between the World Health Organization and two other nonprofits, GAVI and the Coalition for Epidemic Preparedness Innovations. The concept behind it is that donors, primarily rich countries, would invest in the companies developing vaccines. After that, vaccines would be distributed to recipient countries, which tend to be low- and middle-income countries. The objective is to distribute vaccines quickly and provide alternatives should one be proven ineffective. COVAX would negotiate with pharmaceutical companies with the same buying power as wealthy nations. Initially, the goal was to distribute 2 billion doses by the end of 2021. However, COVAX has faced problems with securing access to supplies. For instance, when India, often regarded as “the world’s pharmacy” due to its large pharmaceutical industry, diverted COVID vaccines to meet domestic needs in response to a rise in cases there, the supply for African countries was affected. Despite being a promising project, the issues with COVAX highlight how more international coordination is needed in vaccinating the world.
The challenges and complications in the production and administration of COVID-19 vaccines, particularly in poorer nations, have led to renewed discussions about interventions to ensure that everyone can receive adequate healthcare, no matter where they live. For instance, some public health advocates are calling for other essential medicines to be distributed in a manner similar to COVID-19 vaccines, with an emphasis on international cooperation and ensuring accessibility for all. The ability to make broader changes into the international distribution of medical supplies would bring accessible care for all.
