The i-value

HPHR Fellow Javaid Sofi

By Javaid Iqbal

How Vaccine Apartheid Hurts Global Health

The U.S. has vaccinated more than 50% of the population, while Sub-Saharan Africa has only administered eight doses per 1,000 people. Numerous developing countries have criticized the distribution of the Covid-19 vaccine as “vaccine apartheid.”


Rich countries have brought more vaccines than they need. The European Union could vaccinate its citizens twice. Britain and the United States could do so four times, and Canada six times over, while only 0.3% of doses have been administered in low-income countries. 

The European Union and more than two dozen wealthy nations have collectively purchased 6 billion doses through 2023 to vaccinate its citizens against new variants of the virus. The rest of the world has purchased only 3 billion doses of the vaccines. 


Wealthy nations in the Global North, representing only 13% of the world’s population, have already cornered more than half (61%) of the promised doses of leading COVID-19 vaccines, despite developing countries being more vulnerable to the effects of the pandemic due to lack of medical and economic infrastructure. The lack of collaboration in vaccine distribution among nations has resulted in prolonged health consequences, disproportionately affecting vulnerable populations. 


Covid-19 does not discriminate based on borders, skin color, or socio-economic status—treating the pandemic as an isolated event and expecting a quick recovery would be reckless. We live in a global economy, and no country is exempt from the pandemic’s consequences until all countries achieve herd immunity. If vaccination campaigns do not reach the developing world, it will cost the global economy U.S. $9 trillion. Covid-19 has already pushed 230 million in India into poverty and resulted in the deaths of hundreds of thousands. After initially getting Covid-19 under control, Taiwan is experiencing a second wave surge in the number of cases leading to curbing gathering and shutting down recreation venues. A doctors group in Japan is urging the Prime Minister to cancel the Summer Olympic games. 


To fight this pandemic, we need to remove intellectual property patents for all COVID-19 vaccines. U.S. President Joe Biden has decided to waive the patent protection for the American-made COVID-19 vaccines. However, the E.U. doesn’t support the policy, stating that developing countries may not maintain high-quality standards of vaccine production despite AstraZeneca manufactured in Pune, India. 

Both World Health Organization (WHO) and Doctors Without Borders support waiving patents to provide access to life-saving drugs to millions. The World Trade Organization (WTO) operates by consensus from member states, so the United States and developing countries cannot alter the global landscape. The issue at WTO will probably take months to resolve, and millions will die as a result. Patents for the Covid vaccine should have been removed from the onset of the vaccination drive. 


The developed countries also need to export extra vaccines they have bought. While the U.S. has decided to donate 500 million vaccine doses to the developing countries, with 200 million to be shared this year and the remaining 300 in the first half of 2022, we may need 11 billion doses to vaccinate the world. While this a step in the right direction, it is not enough; other developed countries also need to do more; otherwise, developing nations may not start widespread vaccination well past 2023


Millions of lives will be lost, while the economy may never reach the pre-pandemic level for many countries. If the virus is not brought under control, it will destabilize the livelihoods of millions of poor people in developing countries. According to Matteo Chinazzi of Northeastern University, if the first two billion doses of Covid-19 vaccines were distributed proportionally by the national population, worldwide deaths would fall by 61%. AstraZeneca has pledged to sell on a not-for-profit basis in developing countries to close the accessibility gap, but it can provide vaccines to only 18% of the population in developing countries due to logistical and financial constraints. At the same time, the entirety of Moderna’s supply and 90% of Pfizer’s supply has been secured by wealthy nations. 

Most vaccines are always made with the help of public institutions or public finance. Moderna’s work rests on the discoveries made by the University of Pennsylvania, and the pharmaceutical company received federal funding of $US2.5 billion from the U.S. government’s Operation Warp Speed program. Pfizer did not receive any money from the U.S. government but received $440 from the German government


Moderna and Pfizer/BioNTech’s successful mRNA vaccines are set to become two of the world’s three best-selling pharmaceutical products. The companies are projecting revenues of $33.5 billion in 2021 from their vaccines, despite a study from the Imperial College in London showing that the cost of producing new mRNA vaccines could be between 60 cents to $2 per dose. The United States is paying $19.50 for each dose, while Israel is paying $30 per dose. Since these vaccines are made from taxpayer’s money, it is only fair that we treat them as a public good and remove all the barriers to access. 


In the 1970s, WHO played the role of coordinator to eliminate smallpox. Countries like Bangladesh, Malaysia, Kenya went from minimal production to donating state-of-the-art vaccines back to the WHO to give it to other countries within a few years. They need to do the same now. During World War II, the U.S. government, when trying to make more antibiotics, specifically penicillin, made Pfizer give up its formula and shared it with Pfizer’s competitors and gave contracts to other manufacturers, which were all done by the War Production Board, which got a special dispensation to suspend antitrust law.


The world is amid a once-a-century pandemic, and it is morally wrong to stop vaccines from reaching people that do not have the money to pay for them. All the patents need to be revoked, and wealthy countries should donate all the excess stock they have—that is the only way to stop this pandemic. No one is safe until everyone is safe. 

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