Linta Nasim explores emerging vaccine nationalism and its implications on public health strategy and ending the coronavirus pandemic.
Ugly vaccine nationalism, as feared by the World Health Organisation (WHO), human rights and public health advocates worldwide, is here. As recently as September last year at the UN General Assembly, nations were united as the global death toll inched ever closer to a million. Wealthy countries learnt hard lessons from the hoarding of protective equipment, with promises made that the most vulnerable would be first in line when a vaccine was finally ready.
That solidarity has now frayed. For the past month, the EU commission has been in dispute with the British-Swedish pharmaceutical company, AstraZeneca, the creators of the Oxford vaccine creators, over delays to vaccines promised to the bloc. AstraZeneca has blamed delays on production glitches at plants in the Netherlands and Belgium and the late signing of contracts, meanwhile, the UK has been receiving it’s promised doses.
Regarding the delay in vaccines, AstraZeneca CEO, Pascal Soirot, openly stated the UK contract was signed first, with the UK stipulating “you supply us first”. In contrast, the EU contract did not legally bind the company to a particular schedule. EU health commissioner, Stella Kyriakides, denied this claim at a press briefing on January 27th, saying, “We reject the logic of first come, first served…That may work at the neighbourhood butcher’s but not in contracts and not in our advanced purchase agreements.”
After the bitter four-year Brexit negotiation process came to an end in January this year, tensions are understandably still high. Neither side wants to look like a failure in their vaccine rollout. Vaccine nationalism caused animosity to skyrocket on both sides of the Channel when the EU announced plans to impose a trade border on the island of Ireland. This attempt to prevent Northern Ireland from becoming a backdoor to European vaccines entering the mainland UK resulted in fury from Dublin and London. Although permitted under Article 16 of the Brexit protocol, the attempt has been lambasted by some British MPs who take it as proof that the EU is ready to weaponise this protocol and call for it to be scrapped altogether.
Eventually forced to U-turn on its decision to introduce the border, the EU ultimately compromised with the Irish government, who have agreed to report on the number of doses distributed to Northern Ireland to allay EU concerns over vaccines entering the UK.
Vaccine hoarding is not endemic solely to Europe, however. Though praised for its effective and efficient rollout of vaccines within the Israeli population, Israel has denied responsibility for the healthcare of citizens in the West Bank or the Hamas-governed Gaza Strip. A recent shipment of 2000 vaccines is the first of 5000 for frontline West Bank medical staff, with a previous 100 vaccines donated in January as a one-off humanitarian gesture for emergency cases. However, Israel has not avoided criticism from the UN’s and human rights groups’ for ignoring the vast majority of Palestinians in their vaccine rollout.
While a third of all Israelis have received the first dose of the vaccine, 75% of whom have received both doses, including Jewish settlers in the West Bank, whereas the only eligible Palestinians were residents of east Jerusalem. Although the Palestinian Authority made no requests for a public vaccination programme, a request for 100,000 vaccines made for frontline staff was rejected by Israel. However, health experts have advised the Israeli government to vaccinate Palestinians in the West Bank who travel into Israeli territory for work as they could be potential carriers of the virus if they remain unvaccinated.
In the meantime, some 2.78 million Palestinians in the West Bank and another 1.8 million Palestinians in the Gaza Strip await any news of a potential vaccine rollout. Palestinian Authority PM, Mohammad Shtayveh, said the PA expected 50,000 vaccinations from several sources, mainly the WHO’s COVAX programme.
In June last year, the COVAX initiative was established to make 2 billion vaccine doses available for distribution to regions that cannot buy or access vaccines themselves, mainly in the global South. However, COVAX will only cover around 20% of people in each eligible country. Indeed, poorer nations have an increased reliance on such initiatives, which may lead to a severely delayed rollout due to the slow arrival of supplies.
The majority of countries donating to COVAX are the same that are accused of hoarding, with many having bought up enough vaccines to inoculate their populations several times over. The EU has bought 1.6 billion, enough to vaccinate the bloc three times over, and Canada and the UK have both bought enough to vaccinate their populations four times over.
The governments of these countries have been criticised by not only the WHO but also leaders of countries still awaiting vaccines. South African President, Cyril Ramaphonsa, slammed rich nations for hoarding and urged them to share with the world’s most vulnerable, with the South African government labelling this phenomenon the new “global apartheid”.
The Prime Minister of Azerbaijan also criticised wealthy countries saying, “What should other countries think if developed countries cannot share these vaccines fairly and accuse each other? Who will help poor countries and people from developing countries?”
Leaders and public health advocates may be right in criticising wealthy countries for hoarding. A recent study by the International Chamber of Commerce, an international business lobby group, has found that hoarding vaccines could cost wealthy countries up to $4.5 trillion, indicating that vaccinating poorer countries against COVID-19 is not just a moral imperative but also an economic one. Currently, the WHO’s programmes to deliver COVID-19 vaccines and treatments to developing countries is $27 billion away from their 2021 funding targets. Researchers emphasised that no country is safe until all countries are vaccinated.
These findings echo the statements of the WHO director-general Tedros Adhanom Ghebreyesus, who stated during a virtual briefing, “if we hoard vaccines and we are not sharing, there will be three major problems. One… it will be a catastrophic moral failure,… two it keeps the pandemic burning and three, [it will lead to] a very slow global economic recovery.”
The consequences of global vaccine inequality are apparent. Studies such as the one carried out by the Economic Intelligence Unit indicate that 84 poorer countries may not have widespread access to vaccination until 2024. Countries suffering from political instability and conflict situations such as Libya, Yemen and Syria, may also be waiting for a long time, whereas oil-rich Gulf nations have bought up millions of vaccines already. There is also a concern regarding ethnic minorities refusing vaccinations within developed countries due to previous discriminatory interactions with the healthcare service. Those from BAME backgrounds are already at increased risk of contracting COVID with more severe complications and higher mortality risk.
Coronavirus has revealed the deep inequalities within society, indicating it is high-time for real and meaningful changes at institutional, corporate and governmental levels. The anticipation of the vaccine rollout as the messenger heralding the end of the virus is nothing more than a fantasy, unless countries work together to end these disparities once and for all, this pandemic will continue raging.
Written by Linta Nasim and edited by Samantha Cargill
Linta Nasim is a final year Medical Sciences student.