It is more than a year and a half into the pandemic and nine months since the Covid-19 vaccines were first distributed. Despite great progress in preventing and treating the virus, the greatest failure has been that vaccines and other therapeutics are not equitably distributed. This human failure has meant that the pandemic may well continue as it spreads around the world and new mutations develop. As the current ‘charity’ model has failed, we now need a social justice approach to ensure everyone has access to vaccines.
A recent piece in The Guardian highlighted the latest development. More than 100 million COVID-19 vaccine doses are set to expire in the US, UK, and the EU by December and there is no concrete plan to share surplus supplies. This finding is based on research by Airfinity. Former Prime Minister Gordon Brown warns of an impending ‘profound and collective tragedy’ if there is no plan to distribute this vaccine surplus.
A two-track pandemic
Indeed, what has developed is ‘a two-track pandemic’ where high-income countries have vaccines and can reopen while low-income countries must rely on social and behavioural interventions, many of which have a high social and economic toll on vulnerable populations. To reach herd immunity, 11 billion doses are needed to vaccinate 70 per cent of the world’s population. Duke’s Global Health Innovation Center highlighted the current gap: high- and upper-middle income countries (1/5 of the world’s population) have bought around 6 billion doses while low- and lower-middle income countries (4/5 of the world’s population) have access to 2.6 billion.
There will be no broad-based recovery nor end to the pandemic without vaccine justice. The report “Covid-19: Make it the last pandemic” by the Independent Panel for Pandemic Preparedness and Response observed that “inequality has been the determining factor explaining why the Covid-19 pandemic has had such differential impacts on peoples’ lives and livelihoods.” What this situation highlights is the lack of a ‘global’ strategic and socially just plan to expand Covid-19 vaccine and therapeutics access particularly for the world’s low-income countries. While the World Health Organization has been vocal about expanded vaccine access, what is needed is a coordinated strategy and new financing to ‘vaccinate the world.’
Global access to vaccines?
Efforts are being made to address this challenge globally, but with varying success. Within the EU bloc, the vaccination rollout was slow but they have now reached 70 per cent of the population. Policymaking in the EU is more centralised than in the US, where a patchwork of federal, state, and local measures make it difficult to coordinate vaccination rollout. Both face challenges related to anti-government sentiment, concerns about vaccine safety, and individual freedom, including the ongoing debates on vaccine passports.
In the UK, the vaccine rollout has also slowed, particularly among those under 30 years of age. Against this backdrop, the recent G7 meeting failed to accomplish any meaningful progress on expanding vaccine access globally, although 870 million vaccine doses were pledged. One plan, authored by the International Monetary Fund, sets ambitious but achievable targets to vaccinate at least 40 per cent of the world’s population by the end of 2021, ensure widespread testing and contact tracing, improve access to therapeutics, and end the Covid-19 pandemic.
While vaccine uptake slows in high-income countries, in Uganda there is high demand and long queues as people wait for hours for scarce AstraZeneca vaccines. The country has received few doses through Covax, yet vaccines are needed to protect against the Covid-19 virus and future waves. Uganda’s recent wave of the Delta variant hit the country hard in June-July 2021.
Waiving intellectual property rights
One major barrier is the stalemate at the World Trade Organization (WTO) and a lack of progress in waiving vaccine Intellectual Property Rights (IPRs). Advocates have long called for a waiver of IPRs, which allow the pharmaceutical industry to make exclusive decisions on vaccine pricing and purchasing agreements. Under the Agreement on Trade-Related Aspects of IPRs (TRIPS), companies that own IPRs hold those exclusive rights without competing with generic products. India and South Africa led a proposal to temporarily waive IPRs on COVID-19 vaccines to allow for expanded vaccine access. However, this debate has been in limbo at the WTO.
What we need is renewed global leadership, shared commitments, and multilateral and multisectoral collaboration to end the pandemic. The world needs a temporary TRIPS waiver and an ambitious plan to end the pandemic. A focus on charity models or one-off agreements between pharmaceutical companies and manufacturers is not enough – we need vaccine justice for all.