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Vaccine equity: Why rich countries get lion’s share

The first COVID-19 vaccines were distributed in the U.S. on Dec. 14. To many, this marked the beginning of the return to normal life. Today, more states, including New Mexico, have been easing restrictions as more citizens get vaccinated. However, this sense of relief may be short-lived if the whole world is not able to receive the vaccine.

In order to fully return to life as it once was, the world must reach “herd immunity.” Herd immunity occurs when a population has formed a protective buffer against an infectious disease. With COVID-19, the best way to reach herd immunity is through vaccination. This may sound easy enough to accomplish, but there are major obstacles standing in the way.

In December the People’s Vaccine Alliance reported rich countries had bought 53% of all vaccines that seemed promising at the time. But where did this leave low-income countries? According to the World Health Organization, less than 1% of all COVID-19 vaccines have gone to poor nations. If the goal is to reach true herd immunity, the current global distribution of vaccines will have to be addressed first and foremost.

Distribution equality and distribution inequality of COVID-19 vaccines directly correspond to a country’s economic wealth. Amazingly, a mere 10 countries held over three quarters of the 191 million COVID-19 vaccinations that were distributed globally in February. In hopes of avoiding vaccine hoarding early on, the WHO and other multilateral organizations encouraged countries to buy vaccines through COVAX – a global alliance created to share vaccine doses with poorer countries included. Approximately 190 countries have joined the COVAX alliance; however about 36 high-income countries directly negotiated with vaccine manufacturers to secure doses for their own citizens, circumventing COVAX processes.

If we look at a world map, we can immediately distinguish a large disparity in the distribution of COVID-19 vaccines based on country wealth. Today, high-income countries are significantly further along in vaccination availability and coverage compared to lower-middle and low-income countries. This is unfair and morally questionable.

South Africa, the African country most impacted by COVID-19, has administered less than 0.01% to its people. As of May 16, India, the second-highest populated country in the world, has administered to approximately 13% of its population. The tragedy of India today directly relates to the inequitable access to and supply of vaccines to this vast nation. Important messages to take away regarding COVID-19 global vaccine distribution are the following: There are huge country-level inequalities in vaccine supply and thus achieving herd immunity; and, our efforts toward reaching global herd immunity are severely hindered by this tragic fact.

It should go without saying that to overcome a global pandemic, a universal vaccination response is necessary. One that does not prioritize the few over the many. This has not been the strategy thus far, and the attempts to implement a globally equitable vaccine response have already been undermined by rich countries who bought up, indeed hoarded, the global supply in the early stages of vaccine development and distribution. The United States has ordered four times the vaccines needed to fully vaccinate our population. Canada has more than 10 times the number of vaccines to fully vaccinate its population. This inequity is intolerable.

As responsible global citizens, we must ask: Why we are seeing such massive vaccine inequity throughout the globe? When science and the moral imperative are both signaling the need for more equity, why is the effort of fair vaccine distribution being neglected? To answer this, it is worth inspecting the history of inequality, exploitation and colonialism which has entrenched itself in the workings of today’s global politics. Only through understanding this history may we surmount the present challenge of global vaccine inequity.

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