Home COVID-19 COVID-19 vaccine distribution highlights global inequality

COVID-19 vaccine distribution highlights global inequality

Andrew Hung
Global vaccine distribution for COVID-19 reiterates that the rich-poor divide is as stark as ever
Research Associate at StoneBench
An elderly person gets the COVID-19 vaccine amid a shortage of vaccines in Bangkok

Eighteen months and counting, COVID-19 continues to impact the world. At the time of writing, WHO reports more than 230 million confirmed cases of COVID-19, including more than 4.8 million deaths.

In the wake of the pandemic, countries struggled to cope with the sudden socioeconomic impact it had, on health and trade. Healthcare systems around the world buckled with the number of patients, while supply chains were severely tested.

The global GDP slid by 3.5% in 2020. Moreover, years of hard work in realising the sustainable development goals have now been thrown on the sidelines, especially in developing markets. For leaders of the world, vaccinating their populations is the only solution.

But, here’s the catch. There are not enough vaccines for everybody.

Rich nations have more vaccines than they need, while poorer countries are left at the mercy of developed nations for handouts. In fact, many developed markets have stocked up enough vaccines to vaccinate their entire population many times over.

This one-sided thinking has left millions of people in developing nations exposed to infection and imminent death. Even if these developing countries do manage to control the number of deaths from COVID-19, they will still be looking at years, if not decades to rebuild what they’ve lost.

The vaccine race

Scientists around the world are racing to develop enough vaccines that can halt the spread of COVID-19. Presently, there are 194 vaccine candidates that are in pre-clinical development, of which 117 are undergoing clinical trials.

Exhibit 1: COVID-19 vaccines under development

Source: Gavi The Vaccine Alliance

Regulations around vaccines differ from country to country. Some vaccines such as the ones being administered in China and Russia were approved for use even before completing their Phase 3 trials, while in some countries, vaccines have to undergo Phase 4 trials, before they are approved for mass use.

Technically, there are 21 vaccines being administered to the general population around the world. But the World Health Organization (WHO) has only approved 7 vaccines against COVID-19.

Exhibit 2: Vaccines approved for use by WHO

The hoarders

Let’s understand the vaccine crisis better. Rich countries—including the EU, US, UK and Australia—have brokered deals with vaccine manufacturers such as Pfizer and Moderna to secure billions of doses by 2023. These rich countries have hoarded enough doses to vaccinate their population four times over before many poorer countries, receive any at all.

By 2023, the EU would have secured 3 billion doses or 6.6 per person. The US has brokered deals for 1.3 billion doses so far – five per person. Canada would have secured 450 million doses for a population of less than 40 million. And Australia has ordered 170 million doses for its population of 25 million.

High-income countries have already secured 350% of the doses they need, while agreements reached by low- and middle-income countries for doses to be delivered up to 2023 cover only half their population, or less.

Together high- and upper-middle-income countries have administered 4.65 billion doses as of 27 September 2021, while low- and lower-middle-income countries together have only administered 1.52 billion doses to its population.

Exhibit 3: COVID-19 vaccine doses administered by country income group

Shortage of vaccines is just one side of the story. Another lurking problem is the fear of vaccine expiry. Airfinity, a science information and analytics company found that “the G7 and EU will have 1 billion more vaccines than they need by the end of 2021, 10% of these are expected to expire this year.”

What will further compound the problem of vaccine shortage is the wastage of many more vaccines. Low- and middle-income countries may not accept vaccine donations if these vaccines have approached their expiry date, since these countries require at least a few months to administer the vaccines. We may be looking at a potential waste of 241 million doses of vaccine, or 25% of G7 and EU combined surplus stock.

Donations are less

COVAX, a joint initiative co-led by CEPI, Gavi and WHO, alongside key delivery partner UNICEF aims to distribute enough vaccines to vaccinate at least 20% of the population in 92 low- or medium-income countries. Its initial goal of providing 2 billion doses of vaccines worldwide in 2021, and 1.8 billion doses to 92 poorer countries by early 2022, looks far from being accomplished.

In its recent statement, COVAX has reduced its delivery target to 1.425 billion doses of vaccine in 2021, while its initial goal of 2 billion doses is now pushed to Q1 2022.

As of 27 September 2021, the COVAX initiative has only been able to ship 311 million doses to 143 participants. And of the 290 million doses announced by the US to be donated for COVAX, only 80.8 million have been delivered as of 16 September 2021.

Exhibit 4: COVID-19 vaccines donated to COVAX

Urging rich nations to donate more vaccines, the People’s Vaccine Alliance commented that “only 13% of the 1 billion doses promised by G7 leaders in June have been delivered so far.”

Addressing the nations gathered during the 76th Session of the UN General Assembly on 21 September 2021, UN Secretary-General Antonio Guterres did not hold himself back in reprimanding the world on the inequitable distribution of COVID-19 vaccines, describing it as an “obscenity” and giving the globe an “F in Ethics.”

And later in the same meeting, US President Joe Biden promised to donate an additional 500 million vaccines pushing its overall donations to more than 1.1 billion doses in line with its goal of fully vaccinating 70% of the world’s population by 2022.

But these announcements may not bring much relief as 800 million of the 1.1 billion doses is only expected to be shipped next year by the US. And the target of vaccinating 70% of the world would require “2 billion doses for low- and lower- middle income countries, right now,” said WHO Director General Tedros Adhanom Ghebreyesus.

The world looks at the US for vaccine leadership

joint letter by over 50 humanitarian organisations urged US President Joe Biden to do more than donate vaccines. The global shortage of vaccines an only be addressed by increasing production. The letter identified four ways to achieve this:

  1. With an investment of $25 billion, US can help develop 8 billion highly effective doses of NIH-Moderna vaccine in one year – enough to cover 80% of the population in low- and middle-income countries.
  2. The US will also need to step up to facilitate the transfer of vaccine technology to other manufacturers. Without intervention, vaccine manufacturers are forcing nations to be dependent on them.
  3. Push for immediate redistribution of excess vaccines to low- and middle-income countries via COVAX or regional bodies, such as the African Union’s African Vaccine Acquisition Trust.
  4. The US will need to play a pivotal role in convincing its other allies – the EU, UK and Switzerland to support the temporary waiver of the TRIPS (Trade-Related Aspects of Intellectual Property Rights) agreement, to ensure a safe passage for COVID-19 health technologies to countries around the world that need them the most.

These actions if not taken immediately will expose the global population to new variants of COVID-19. Speaking at the 76th Session of the UN General Assembly, Colombian President Ivan Duque commented, “global immunity requires solidarity, so hoarding cannot exist in the face of others’ needs.”

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Research Associate at StoneBench

Andrew assists with and manages research on projects at StoneBench. Prior to joining StoneBench, Andrew worked in the information technology sector, managing different geographic area accounts for a global IT major; and helped in the business development of emerging technologies.

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