Dividing up Covid-19 vaccine: distribution based on countries’ weight

Ending the coronavirus pandemic is not only about the technical issue of vaccine development. The challenge is multidimensional, involving a global proprietary pharmaceutical system and an exclusive, nationalist tendency in wealthy, prosperous states.
Not enough vaccine is currently being produced to cover everyone in the world this year or even the next. [Bloomberg]

As of the beginning of February, some 105 million people around the world had been infected with the novel coronavirus and 2.3 million had died. Despite the mounting toll of the second wave of the global pandemic, government officials, especially in the West, have become more optimistic in recent weeks thanks to the rapid development of several vaccines that, preliminary studies suggest, provide immunity from the virus and protect against severe symptoms for at least six months after inoculation. But to what extent can we rely on the promise of vaccination to end the pandemic?

Thus far, five vaccines of varying effectiveness, prices, and ease of transport and storage have completed drug trials (although Russia has not released trial data for its Sputnik vaccine). The United Kingdom was the first nation to issue an emergency vaccine approval, to the Pfizer-BioNTech vaccine, and it initiated a rapid national vaccination campaign on 8 December 2020. The United States followed suit in late December and the European Union in early January. But production, planning and logistical issues have hindered vaccine manufacture and inoculation in Europe and the United States to varying degrees, setting off fierce competition for vaccine doses. Meanwhile, most of Asia, Africa and Latin America seem to be out of the race completely.

As of the first week of February, Israel had achieved the highest national coverage rates, having vaccinated 62 of 100 citizens (pointedly excluding the Palestinian population under its occupation). Vaccine coverage rates in other wealthy states ranged from 40/100 in the United Arab Emirates to 11/100 in the United States to 1.3/100 in Saudi Arabia. But according to the World Health Organization, on 5 February, 130 nations of 2.5 billion people had not yet vaccinated even one citizen, while three-quarters of available vaccine doses were distributed across just ten rich countries.

The reasons for the unequal distribution are many. Some states are unable to afford the available vaccines while others lack the technological and health infrastructure to carry out mass vaccination campaigns. In any case, not enough vaccine is currently being produced to cover everyone in the world this year or even the next. Production woes are in some cases compounded by intellectual property rights, which are directly hindering the transfer of vaccine technology to local firms in countries like India with a substantial pharmaceutical manufacturing base.

Ending the pandemic is therefore not only about the technical issue of vaccine development. The challenge is multidimensional, involving a global proprietary pharmaceutical system and an exclusive, nationalist tendency in wealthy, prosperous states. Although the virus does not discriminate, vaccination efforts and policies clearly do.

A vaccine remains humanity’s best hope for beating the virus and alleviating the enormous pressures the pandemic has placed on health systems, economies and societies around the world, but the limited supply of vaccine and the nationalism that is hindering broad, fair access to it mean that only a few countries will be able to bring Covid-19 under control this year. Most other countries must wait, and the pandemic, as a global condition, will continue.

There are additional reasons that the world should be prepared to live with the pandemic for some time: firstly, our uncertainty about the duration of immunity provided by the vaccines; and secondly, the rate of mutation of the coronavirus. Already, the South African mutation is cause for special concern, and if this or other coronavirus variants become widespread, it might require adjustments to vaccines. In turn, annual vaccination campaigns, much like annual flu shots, might be needed to beat Covid-19.

If the pandemic holds a lesson for humanity, it is the need to reconsider the obsession with economic growth engendered by capitalism and the industrial revolution, as well as the irrational association between GDP and prosperity. If the Covid-19 pandemic does not spur a search for new modes of living, humanity may come out of it having learned very little.

*This is a summary of a policy brief originally written in Arabic, available here.