Illustration: Ian Morris

How to fix worldwide vaccination

Rich countries must stop the hoarding and get the jabs to where they are needed
October 30, 2021

Nationalism is the ideology of the age. After the financial crisis, protectionism burst on to the scene—new tariffs and closed borders with tighter immigration controls. More recently, the aggressive variant that started with Donald Trump’s “America First” stance has gone global—with Russia First, China First, India First—leaving multilateral institutions, from the WTO to the WHO, disregarded.

Nothing defines this age more than vaccine nationalism, which is dividing the world amid a common medical emergency—the most lethal in a century, which has now infected 250m people and claimed five million lives. The containment of infectious disease is perhaps the purest example of a global public good. In a pandemic, nowhere is safe until everywhere is safe: it is in all our interests that the entire world is vaccinated against a virus as rampant as Covid-19. All countries have a stake in stopping beggar-thy-neighbour policies that restrict the flow of vaccines. 

But in the race to inoculate the world, we are losing badly. While 60-70 per cent of all western adults have been fully vaccinated, only 5 per cent of African adults and just 3 per cent in low-income countries have received the shots they need. The world is unjustly divided between the vaccine-rich, who are immune and currently safe (though with a large global reservoir of infections, new mutations could change that), and the vaccine-poor, whose lives still hang in the balance.

Right now, 1.5bn doses of vaccine are being produced every month, compared with 500m a month in April. Soon we will be manufacturing two billion every month, so the rich world’s betrayal of the global south cannot be excused by any shortage. 

The failure to airlift hoarded, unused doses to where they are needed raises profound moral questions about the international community’s ability to come together. If we can’t distribute surplus vaccines, then people are right to ask how we will respond to more complex global challenges, from climate change to nuclear proliferation.

Rich countries have made many promises. Hosting the G7 in June, Boris Johnson vowed that the west would ensure the vaccination of the world next year. At the global Covid-19 summit, which to his credit Joe Biden convened in September, a pledge was made to vaccinate 40 per cent of adults in low-income countries by the end of 2021, rising to 70 per cent by next September. America has led the way, offering a total of one billion vaccines by then, with the EU donating around 450m and other countries like Japan, the UK and Canada offering additional donations. 

Most of the pledges, though, are for 2022, not 2021: there is still no month-by-month plan. Global institutions—the WHO, WTO, IMF and World Bank—are making valiant efforts to maximise donations, but only the leaders of rich countries can release their unused stocks. 

There is a way forward. In addition to an immediate airlifting of the 240m surplus doses of vaccine available, another 360m unused doses can be sent by the end of this year, with 280m in January and 245m in February. Through Covax (the global bulk-purchasing facility) and Avatt (the African version) they can be distributed to countries that need them, and then World Bank support can and must build the local capacity to administer them. 

With the sharp pick-up in global production, the opportunity to vaccinate the world is there. As the science fiction writer William Gibson wrote: “the future is already here… it’s just not evenly distributed.” If we want to avoid a Gibson-esque dystopia unfolding, then we must act now and share vaccines equitably.