This is an original article written by Gawain Pek.
When the world approached the end of 2020, fatigued from a year of upheavals, it was met with one piece of good news: regulators from the United Kingdom have approved the use of one COVID-19 vaccine. Collectively, the world heaved a sigh of relief. The light at the end of the tunnel was now in sight.
Yet, a month later, World Health Organisation (WHO) Director-General Tedros Adhanom went on to declare that the world was “on the brink of catastrophic moral failure”. According to him, while 39 million vaccines doses have been administered in higher-income nations, only 25 doses were administered in lower-income countries. Sadly, while the pandemic revealed deep-seated inequalities within countries, its solution surfaced the inequality between countries.
One explanation for the inequity in vaccine distribution is profit-seeking behaviour by the pharmaceutical companies developing them. This was one of the criticisms levelled by Dr Tedros during the WHO executive board meeting. Leading up to the success of vaccine development programmes, countries such as the United States, struck unilateral deals with companies that exchanged guaranteed supplies of vaccines for funding.
Furthermore, as wealthier countries have stronger bargaining power — and no vaccine candidate has guaranteed success — they are able to diversify their basket and secure enough vaccines to vaccinate their populations a few times over. The lower-income countries are then left vulnerable and unable to hedge their vaccine bets.
Vaccines administered so far (Source: Bloomberg)
Global Wealth Distribution (Source: How Much)
Additionally, the Pfizer-BioNTech vaccine candidate had to be stored at temperatures as low as -70°C, which require advanced cold chain logistics equipment that is not available or accessible everywhere. As Time reports, it is likely that only large medical centres and urban centres will be well equipped and ready to receive the vaccine and this means longer waiting time before rural communities like those in Africa to get vaccinated.
COVAX Distribution Plan (Source: BBC)
Anticipating this, the WHO partnered with Gavi, the Vaccine Alliance and the Centre for Epidemic Preparedness Innovations (CEPI) to set up the COVID-19 Vaccine Global Access (COVAX) facility. COVAX’s main purpose is to participate in the funding and subsequent procurement of vaccines. Afterwhich with their secured supply, COVAX will distribute them to participating member countries. The facility aims to deliver 2 billion doses by the end of 2021, providing vaccines for 20% of the vulnerable populations in 91 low and middle-income countries.
For many, the COVAX facility is a lifeline to gain access to vaccines. However, funding issues threaten the sustainability of the programme. Furthermore, COVAX’s supply depends on cheaper vaccine alternatives, such as the ones formulated by AstraZeneca, Novavax and Sanofi. And of the three, only AstraZeneca’s candidate has been approved for emergency use so far.
Vaccine Market Flowchart (Source: BioCentury)
Undeniably, the development and distribution of COVID-19 vaccines remain highly complicated. For one, the unprecedented speed at which vaccine candidates went from research to clinical trials and subsequently, public use, was only possible due to the substantial influx of funding. To absolutely condemn the unilateral deals struck between countries and companies would be hypocritical.
However, we must not shy away from admitting that the inequitable distribution of vaccines is problematic. New and more contagious variants of the COVID-19 virus emerging across the world. The unfortunate delay in the Singapore-Hong Kong travel bubble demonstrated that clearly. Whilst domestic distribution of vaccines can bring respite for a country’s own citizens, life is unlikely to return to what was until more nations receive vaccine protection.
Integrated Economies (Source: IMF Working Paper)
Delayed public health recovery is also likely to slow economic recovery. With the increased integration of economies over the past decades, a slow down in one region will create ripple effects in the rest of the world. World Bank economist Douglas Zeng reports a positive correlation in trade between Africa, Asia, and the rest of the world. In other words, an economic slow down in Africa will implicate the global economy.
For the first time in 20 years, the pandemic is set to increase global inequality, a setback on the quest to eradicate poverty. Originally, the UN SDG 10 was designed with the purpose to reduce global and domestic inequality by the year 2030. However, by pulling the brakes on global economies repeatedly, the COVID-19 pandemic only further threatens countries already struggling with extreme poverty.
For us to fully recover and “build back better”, there has to be a united global response to face the global pandemic, requiring contributions and cooperation not just from governments but the non-governmental organisations, international institutions, and all businesses.
The COVAX will require help in 2021 requesting funding of an additional USD5 billion to secure vaccine doses for participating countries. There are reasons to be optimistic, with the United States announcing its intention to rejoin the WHO and participate in COVAX.
As news of successful vaccine trials emerges, we must not forget the duality of reality that they have brought. For many in the world, the long-standing problem of global inequality dulls the optimism. We must remember that the COVID-19 pandemic is not a unidimensional problem, but a wicked one. Although the pandemic shall come to an end eventually, global inequality will continue to persist, if not worsen. In the long-term, it is a greater threat to global well-being. We must not let our guard down.