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How Vaccine Nationalism Risks Prolonging the Pandemic

How vaccine nationalism could extend the pandemic’s run.

How Vaccine Nationalism Risks Prolonging the Pandemic
A pharmacist prepares a dose of the Pfizer-BioNTech Covid-19 vaccine at the Triboro Center nursing home in the Bronx borough of New York, U.S. (Photographer: Eric Lee/Bloomberg)

Early arrangements to secure supplies of Covid-19 vaccines are paying off for the likes of Israel, Britain, the U.S., and the European Union, the bloc’s relatively sluggish rollout notwithstanding. But much of the world is still waiting for anything beyond a trickle of the life-saving doses. Public-health specialists warn that uneven access to the vaccines will prolong the pandemic, bringing more suffering and economic pain in a way that exacerbates global inequality.

1. What’s at stake?

Health experts say the fastest route to controlling the pandemic would have involved deploying Covid vaccines in the most efficient way possible. In an ideal world, the first doses would have gone to groups at the highest risk -- such as medical workers, nursing-home staffers and the elderly -- everywhere across the globe before supplies were used by the most privileged countries to start vaccinating whole populations. Researchers at Northeastern University in Boston calculated that the monopolization of vaccines by wealthy nations -- what’s known as “vaccine nationalism” -- could result in almost twice as many deaths globally as distributing them equally. Allowing the SARS-CoV-2 virus to remain rampant in some parts of the world gives it more scope to develop additional dangerous variants, which will inevitably make their way elsewhere and may not be neutralized by existing vaccines.

2. Why were some countries first in line?

Israel assured supplies of the vaccine from Pfizer Inc. and BioNTech SE by agreeing to pay a premium and to share countrywide data in what amounts to a large-scale effectiveness study. The U.S., as part of its multibillion-dollar Operation Warp Speed program hastening the development of Covid vaccines, used wartime powers to require manufacturers to fill massive U.S. government orders first, amounting to a de facto ban on vaccine exports initially. The U.K. was the first country to authorize a Covid inoculation for emergency use apart from China and Russia, which deployed domestically developed vaccines before they’d undergone full testing. The EU was slower than Israel or the U.S. to lock down supplies, but faster than most. As inoculations were being developed, a number of wealthy countries signed contracts securing doses from a variety of companies. When multiple vaccines proved winners, some countries wound up with enough promised doses to cover their populations several times, leading to complaints of hoarding.

3. Where does this leave other nations?

A few dozen countries with modest populations have procured enough doses to inoculate significant portions of their people. They include the Seychelles, the Maldives, the United Arab Emirates, Bahrain, Malta and Chile. But the majority have vaccinated a small fraction. Because many low-income countries lack the financial clout to secure contracts for Covid vaccines on their own, they depend for supplies largely on Covax, an initiative backed by groups including the World Health Organization designed to provide fair access to the shots for every country. Additional doses have come from China and Russia, which were early to use vaccines as a tool of diplomacy.

4. How does Covax work?

Funded by governments and private organizations, Covax contracts with vaccine manufacturers and aims to distribute at least 2 billion doses, two-thirds of them to lower-income economies, by the end of 2021. But the initiative has struggled to get hold of vaccines, especially after India -- an important Covax supplier as home to the Serum Institute, the world’s biggest vaccine manufacturer -- pared back shipments so that more supply could be kept for domestic use after a new wave of infections emerged there in March. As of mid-June, Covax had shipped about 88 million vaccines, a figure equal to about 4% of the doses given worldwide.

5. Will countries with ample supplies share them?

Initial donations were modest, but in June leaders of the Group of Seven upped their pledges so that in all they’ve promised to provide 1 billion doses to developing nations this year. Health advocates noted that billions of doses are needed and that the speed of donations is as important as the number of shots.

6. What else could accelerate access to vaccines?

A group of countries led by South Africa and India has called for the World Trade Organization to lift intellectual property protections for makers of the vaccines, arguing that this would enable additional facilities to produce more shots. Vaccine companies argue that the move would have little if any practical effect. That’s because few countries have the capacity to produce more vaccines even if they know the formulas. There’s limited global supply of the materials needed, and building new factories with the necessary technology could take years. The U.S. has supported the idea of a waiver, but with countries including the U.K. and Germany opposed, odds are against its approval at the WTO.

The Reference Shelf

  • Related QuickTakes on the proposal to lift intellectual property protections on Covid vaccines, coronavirus mutations, vaccine reactions, comparing Covid vaccines, and the hunt for the origins of the coronavirus.
  • An article in Nature examines the challenges to increasing Covid vaccine supplies.
  • A commentary published in Nature suggests that rich nations tithe their vaccine supplies.
  • An article in the Atlantic examines vaccine nationalism versus vaccine diplomacy.
  • Articles in Foreign Affairs and the Harvard Business Review on the dangers of vaccine nationalism.

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