United Nations Secretary-General António Guterres tweeted on January 3: “Vaccine nationalism is not only unfair, it is self-defeating. No country will be safe … until all countries are safe.”
Guterres’ words serve as a reminder to wealthy nations of their responsibility in creating “global vaccine apartheid” — the unequal distribution of COVID-19 vaccines on economic lines.
Global vaccine apartheid
Wealthy nations, such as the United States, Britain, Japan and the European Union, spent billions of dollars on deals with vaccine developers such as Pfizer, Johnson & Johnson and AstraZeneca, even before their efficacy was proven. Rich nations representing just 14% of the world’s population have bought up 53% of all the most promising vaccines so far.
Australia, Canada and Japan have less than 1% of the world's coronavirus cases. Still, they have pre-ordered more doses of vaccines than all of Latin America and the Caribbean — a region with more than 17% of global coronavirus cases.
Canada has signed deals to secure up to 414 million doses of various vaccines — up to five times more than its population requires. The US and Germany have contracted for enough doses of various COVID-19 vaccines to inoculate their populations several times over.
In the US, many vaccines are set to expire even before being distributed.
More than 12 million doses of vaccines have been distributed so far in 33 countries, but none of those countries are in Africa.
South Africa, the most badly hit country on the African continent, has been unable to procure vaccine from Moderna. The country’s government says it was unable to persuade the company to submit its vaccine to the South African Health Products Regulatory Authority, the agency that approves vaccines.
While Moderna has refused to sell vaccines to South Africa, it has agreed to sell 40 million doses to Canada, 100 million doses to the United States and 160 million doses to the EU.
Such an instance of monopolisation by rich countries was replicated in the case of the Pfizer COVID-19 vaccine. Within days of its announcement, Pfizer sold more than 80% of the vaccine doses it will be able to produce by the end of the year to a handful of countries of the Global North.
Nearly 70 poor countries will only be able to vaccinate 1 in 10 people against COVID-19 this year due to vaccine apartheid.
Most people in poor countries will be waiting until 2024 for vaccinations if high-income countries (HICs) keep engaging in monopolistic practices. In a report by Northeastern University, in Boston, researchers said this monopolisation of vaccines by wealthy nations could cause almost twice as many deaths as distributing them equally.
COVAX: an incomplete solution
The COVID-19 Vaccine Global Access Facility (COVAX) — led by the World Health Organization, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance — has been established to prevent unequal vaccine distribution. It aims to accelerate COVID-19 vaccine development, secure doses for all countries and distribute those doses fairly, beginning with the highest-risk groups.
COVAX, funded through donations from HICs, is insufficient for ensuring timely and equitable access to COVID-19 products. COVAX aims to procure 2 billion doses of vaccine and share them equally between HICs and low and middle-income countries (LMICs).
However, the COVAX Facility has reserved only 1 billion vaccine doses so far. By comparison, 35 countries have reserved 6 billion doses for themselves, through bilateral deals with pharmaceutical companies.
LICs, meanwhile, with a combined population of 1.7 billion people, have not yet signed a single bilateral vaccine deal.
COVAX has also been criticised for negotiating prices that prioritise profit over the consideration of vaccines as a global public good, the lack of transparency of contracts entered into with vaccine manufacturers, limits on civil society participation and failure to address potential impacts of intellectual property rights on vaccines.
Challenging the Global North
In October, South Africa and India called for the World Trade Organization (WTO) to suspend intellectual property rights related to COVID-19 to ensure that not only the wealthiest countries will be able to access and afford the vaccines, medicines and other new technologies needed to control the pandemic.
The pharmaceutical industry and many HICs — the US, Britain, EU, Canada, Switzerland, Norway, Australia, Brazil and Japan — vehemently opposed the move.
The proposed waiver would cover patents, copyrights, trade secrets and industrial designs — a measure that would allow poor countries to legally acquire and use proprietary technologies more easily than is possible under the current exceptions available for health emergencies under the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS).
The WTO proposal, Waiver from Certain Provisions of the TRIPS Agreement for the Prevention, Containment and Treatment of COVID-19 reads: “There are several reports about intellectual property rights hindering or potentially hindering timely provisioning of affordable medical products to the patients … Beyond patents, other intellectual property rights may also pose a barrier, with limited options to overcome those barriers.”
Angered by a Global South plan that threatened to destabilise imperialist architectures, the core capitalist countries organised the criminal act of blocking a global, patent-free vaccine.
India clearly exposed the predatoriness of these countries at the TRIPS Council Informal Meeting on November 20: “On one hand, these countries are buying up as much of the limited supply as they can, leaving no vaccines in the pie for developing and least-developed countries. On the other hand, and very strangely, these are the same countries who are arguing against the need for the waiver that can help increase the global manufacturing and supply to achieve not just equitable, but also timely and affordable access to such vaccines for all countries.”
As rich countries scramble to hoard vaccines, the Global South needs to create institutional arrangements that would allow it to get life-saving medical technologies to their people at the lowest cost, without the fear of being sued for infringing intellectual property rights.
No one should be blocked from getting a life-saving vaccine just because they live in a country subject to the forces of imperialism. All countries of the Global South need to come together to challenge the exploitative dominance of the Global North and support an agenda for a people’s vaccine.
[Yanis Iqbal is a student and freelance writer based in Aligarh, India, and can be contacted at firstname.lastname@example.org.]