More than 80 million Covid-19 vaccine doses have been distributed around the world so far. Only 55 \u2014 55! \u2014 have gone to people in low-income countries. In fact, just one country: Guinea. <\/p>\n
Those 55 doses in Guinea don\u2019t even represent \u201cthe start of a \u2018real\u2019 national vaccination rollout,\u201d said Edouard Mathieu, head of data at Oxford University\u2019s Our World in Data, which has been tracking the global vaccine effort. Rather, a few Guinean public officials were vaccinated at the end of December \u2014 with the Russian Sputnik V vaccine \u2014 on an experimental basis, the Associated Press reported.<\/p>\n
\u201cThen nobody was vaccinated after that,\u201d added Mathieu. (The Guinea health ministry has not responded to Vox\u2019s request for comment.) As a result, Our World in Data stopped tracking Guinea\u2019s rollout. <\/p>\n
As the coronavirus continues to spread around the world, with new, dangerous variants picking up pace, the vaccination campaigns in all the world\u2019s poorest countries haven\u2019t even begun. Meanwhile, wealthy nations already vaccinating have pre-purchased access to supplies that can more than cover their populations \u2014 about four times over, in the case of the US, according to a December New York Times analysis.<\/p>\n
This doesn\u2019t mean there are \u201cwarehouses full of extra vaccine doses\u201d sitting around in high-income countries, explained Andrea Taylor, a Duke University researcher who has been analyzing the deals. But the countries with deals have priority manufacturing slots for 2021, \u201cmeaning that even if other countries make purchases now, they may have to wait months or even a year for delivery.\u201d<\/p>\n
The result: \u201cHigh-income countries have 16 percent of the world\u2019s population but currently hold 60 percent of the vaccine doses that have been purchased,\u201d Taylor added.<\/p>\n
With this kind of vaccine access, the people in rich countries will start to see their epidemics slow down over the next year, and life may regain some of its pre-pandemic rhythm. People in poor countries, meanwhile, may experience no such benefit. In fact, it will likely take years for many low-income countries to even start fully fledged vaccine campaigns, said Agathe Demarais, of the Economist Intelligence Unit, in a recent briefing. \u201cMost developing countries will not have widespread access to the shots before 2023 at the earliest.\u201d <\/p>\n
\u201cThat\u2019s not just unconscionable,\u201d said Georgetown global health law professor Lawrence Gostin, \u201cbut it also is very much against the interests of high-income countries.\u201d <\/p>\n
This greed will help the coronavirus continue to spread globally, allowing more opportunity for variants that resist the vaccines to emerge and Covid-19 outbreaks to reignite, including in rich countries. This is a cycle that repeats with just about every disease threat: Rich countries benefit from new health technology first, while poor countries have to wait years, or decades, for it to trickle to them, as the New Yorker\u2019s Michael Specter wrote. But there are growing calls to break the pattern \u2014 and Norway is showing the rest of the world how it can be done. <\/p>\n
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How rich countries exacerbated the global Covid-19 vaccine scarcity <\/p>\n
As of January 27, the majority of the 80.2 million Covid-19 vaccine doses administered worldwide have gone to people in only a handful of high- and middle-income countries and regions (namely, the US, China, the EU, the UK, Israel, and the United Arab Emirates). <\/p>\n
Several middle-income countries \u2014 the poorest among them include India, Myanmar, Ecuador, and Indonesia \u2014 have doled out 2.3 million doses in total. Most \u2014 2.03 million \u2014 went to people in India. <\/p>\n
But the lowest-income countries \u2014 for instance, Zambia, Bolivia, Tajikistan, and Nepal \u2014 have not begun vaccinating at all.<\/p>\n
So why, in this pandemic, are such disparities allowed? It\u2019s pretty simple: Covid-19 vaccines aren\u2019t a public good. Capital rules who gets access first, and those with capital \u2014 rich and middle-income countries \u2014 have bought first dibs in the vaccine supply, through lucrative pre-purchase agreements with vaccine developers. <\/p>\n
\u201cThat\u2019s left a global scarcity and also resulted in a bidding war which has made the prices more expensive,\u201d Gostin said. \u201cAs a result, [for] countries themselves which are lower income, there aren\u2019t any doses to buy and they are too expensive.\u201d <\/p>\n
Because countries inked deals with manufacturers before clinical trials were complete, betting on which companies might come out with vaccines that work, they each signed multiple agreements, covering their populations many times over. <\/p>\n
The pre-purchase agreements \u201cmade sense in the world we lived in six months ago, because we didn\u2019t yet know which, if any, of the vaccine candidates would come to market,\u201d said Taylor. But the result was that, by November, high-income countries \u2014 along with a few middle-income countries \u2014 had already pre-purchased the rights to 3.8 billion vaccine doses, with options for another 5 billion, according to an analysis by Taylor and her colleagues at Duke. <\/p>\n
Yes, that\u2019s just about as many doses as there are people in the world. <\/p>\n
This vaccine hoarding happened in parallel with an unprecedented multilateral effort to support the development and equitable distribution of 2 billion doses of Covid-19 vaccines to the world\u2019s poorest countries before the end of 2021, called Covax. <\/p>\n
The initiative has two parts: a purchasing pool for higher-income countries, and a fundraising effort for poorer countries. By promising to buy a certain number of vaccine doses from manufacturers, countries that join get access to any vaccines that are approved in Covax\u2019s portfolio, while also creating a global market for the shots and driving prices down.<\/p>\n
More than 190 countries signed on \u2014 including rich ones. But the bilateral deals have undermined Covax. Rich countries \u201cwant to have it both ways,\u201d Gostin said. \u201cThey join Covax so they could proclaim to be good global citizens, and at the same time rob Covax of its lifeblood, which is vaccine doses.\u201d <\/p>\n
How to stop hoarding<\/p>\n
In the first quarter of the year, Covax is planning to begin delivering a first batch of 100 million vaccine doses. But vaccine distribution is already lagging in rich countries, where manufacturers have failed to deliver the doses they initially promised, and governments are struggling to set up systems to get millions of people through the door at once.<\/p>\n
The emerging disparity has prompted calls for rich countries to stop hoarding vaccines and share their excess supply with poorer countries through Covax. It\u2019s also stirring discussion about how countries and manufacturers can get creative and bolster supplies for the world. <\/p>\n
Right now, \u201cthe biggest constraint for everyone to get vaccinated is the number of doses,\u201d Nicholas Lusiani, at Oxfam America, told Vox. Instead of fighting over the crumbs, he said, Oxfam has suggested countries build regional vaccine production hubs to churn out vaccines at a lower price in the places they\u2019re needed (and where production costs are lower). <\/p>\n
The US, Europe, and other high-income countries could also push companies with effective vaccines to collaborate with other manufacturers on production, sharing their technology, or even waiving intellectual property rights. (AstraZeneca has already done so, sharing information with the Serum Institute in India.)<\/p>\n
Then there\u2019s simple donating of vaccines. Gostin and colleagues have called on the US to work with other high-income countries and inoculate only their most vulnerable groups \u2014 health workers, older adults \u2014 first, then give the excess supply to Covax, which could distribute vaccines to high-risk groups in the rest of the world. <\/p>\n
\u201cThere\u2019s a certain ethical and political justification for putting your own country first because every government\u2019s first duty is to its own population,\u201d Gostin said. \u201cBut that\u2019s to a point.\u201d <\/p>\n
Still, Taylor said, \u201cit is complex and there is no easy solution. … It would be a very hard sell for the leader of a rich country to start donating doses to other countries while still vaccinating their own population \u2014 this is what needs to happen, but it is hard to imagine.\u201d <\/p>\n
Norway has managed to do it. Much like the US, the Nordic country will have access to three times as many vaccines as it needs. \u201cThis allows us to redistribute vaccines to other countries,\u201d said Norway\u2019s minister of international development, Dag-Inge Ulstein. \u201cThe distribution will be started gradually and in parallel to the current vaccination of the Norwegian population as soon as relevant vaccines are approved.\u201d <\/p>\n
The Norwegian government decided it was both ethical and self-interested to ensure people in low-income countries can access effective vaccines as soon as possible. \u201cOtherwise,\u201d Ulstein added, \u201cit will be a long time before these countries are able to vaccinate a sufficiently large proportion of their populations. [And] that would not benefit anyone.\u201d Now it\u2019s time for other countries to follow suit. <\/p>\n