Vaccine Nationalism: A tale of two worlds

 

The COVID-19 pandemic has helped everyone build their vocabulary, new words like “furlough”, “social distancing”, “flattening the curve” and now there has been some context to Teenage Mutant Ninja Turtles with all this talk of “mutations”. Much like Shakespeare, the virus has not ceased in making us feel like the simplest of words may well not be within the reach of our understanding. There is now a new phrase; “vaccine nationalism”. What exactly is vaccine nationalism?, why is it happening and what does this mean about for a pandemic that has already ravaged our lives? Vaccine nationalism occurs when governments enter with pharmaceutical companies to supply their own populations with vaccines ahead of them becoming available for other countries. This means that before news of vaccines being produced hit our screens, many countries were already safe in the knowledge that they would secure vaccines for their own. And while the coronavirus may be the first pandemic to attract worldwide attention, other pandemics have occurred in modern time. These have solicited the same selfish response from almost the same actors.

In 2009, the H1N1 virus (swine flu) created an international scramble very much like the one we see now. With seasonal flu vaccines providing no protection, several rich countries moved quickly to pre-order H1N1 vaccines from pharmaceutical companies deemed likely to develop effective ones. Australia was the first country to discover a vaccine and decided to block vaccine exports until its order was fulfilled. The US went on to place orders for more than 600 million doses. It was only when the worst was over, that a handful of richer countries such as the US offered a fraction of their vaccines to smaller economies. Ten years later, and the zebra has not changed its stripes. All that has changed has been the name of the pandemic. For as long as you are still poor or at least in a poor country, your place and importance to the world has mostly remained the same. More than half of all vaccines against COVID-19 have been reserved for one-seventh of the world’s population. The UK alone has secured enough vaccines to give each of its citizens five doses. If orders are met, the EU and US could inoculate their populations three times over, while Canada would have enough to do so nine times.

In an age of increasing globalization, faced with a pandemic unlike any the world has seen before,” why!?”, is the million-dollar question. Why would countries that push a narrative of unity and global cooperation at the UN and in accords in Paris and Brussels throw this out of the window? For holier than thou nations, their behavior must never go unjustified. If it was unjustified, then they would cease to be the Police and Pope of the globe. 

Proponents of vaccine nationalism claim that, “the sense of an international race has accelerated progress, not hindered it,” that “there would be no vaccine salvation at all without western know-how and wealth,” and that the UK, for instance, “positively deserves to be prioritized; it’s suffered both the worst per capita death rate and the biggest economic contraction from COVID in the world.”  The problems with this argument might seem clear. First, it is vital to realize on the surface the despicable immorality of richer countries wanting to vaccinate their populations and quasi-populations at the expense of extremely vulnerable countries with poorer communities and key workers. Second, self-interest on that scale ignores the positive effects on richer economies of spreading vaccine coverage globally. The RAND Corporation has estimated that unequal access to vaccines – meaning a continued need for physical distancing in much of the world – could cost the global economy US$1.2 trillion (£880 billion) a year. Third, this vaccine nationalism could affect the vaccines being horded so much themselves. In 2006, when the world was confronted with a need to develop vaccines against avian flu, Indonesia stopped sharing virus samples with the WHO. The reason for this was simply because it felt abandoned and betrayed by the world body. Widespread condemnation followed as claims were made that Indonesia was scheming to gain financially, “Indonesia is endangering everyone.” This is true and with mutations cropping up left right and center, there is nothing stopping poorer countries acting in the same way this time round and endangering themselves and the countries at the forefront of vaccine nationalism. Lastly, bearing in mind the pace at which this virus mutates, if we were to vaccinate only those countries with the most vaccines, it would mean the virus would continue to spread in non-vaccinated countries. The more people it infects, the more likely it is that more mutations will happen and inevitably, an “escape” mutation will happen. This is a one that allows the virus to evade the immune response set out by vaccinations, which simply put means vaccines become less effective in preventing serious illness. The new mutation is then likely to become the dominant strain and will head over to these rich countries and their stockpiles of vaccines. Undoubtedly, this will set off a whole new set of infections in those vaccinated against only the old variants. This will take us back to zero and the cycle continues.

What does this mean for Africa?

Most African economies will continue to experience pandemic-related hardship for the foreseeable future. The IMF predicts aggregate growth of 3.2 percent in 2021 for sub-Saharan Africa which is a worse outlook than those of other emerging markets. Real GDP will not return to pre-pandemic levels until at least 2022 and as late as 2024 for oil exporters. There could also be devastating longer-term effects of the virus. According to the world bank, between 26 and 40 million Africans could fall into extreme poverty amid the pandemic. Almost half of African students lack access to remote learning, even as the region still lags on global education enrolment and completion rates. Other problems are likely to follow as well. Like in other parts of the world, debt means governments will not be ableto provide social assistance, inject stimulus like richer countries or procure medical supplies. Much attention has rightly focused on Angolan and Zambian debt to China. However, several African countries including Ethiopia, Ghana, Kenya, and Nigeria are also heavily indebted to both private and multilateral lenders such as the African Development Bank and the World Bank. Against this information, the cumulative impact of the pandemic could be so devastating as to result in another decade of failure for Africa. For African countries to ease restrictions safely, reach herd immunity, and revert to a sustainable trajectory of economic recovery, they will need to immunize a critical mass of people. 

However, this will not happen. 

Vaccine nationalism will prevent a COVID-19 vaccine reaching vulnerable people in certain countries. Even when they get it, it will most likely be after lower risk individuals in other countries, leading to preventable deaths. There needs to be a reckoning and greater sense of urgency in the Western world for vaccines to get to poorer countries, and Africa specifically. Investing in vaccine development and access would be beneficial in the long run. Current spending by leading economies on vaccine development and allocation is relatively small compared to the economic loss associated with COVID-19 and it makes business sense for them to invest more in vaccine development and distribution. This approach could form the basis for boosting the global cooperative effort. Enforceable frameworks for vaccine development and distribution should be implemented and managed by established international forums. Countries need to be bound by contract and not feel that they can limit supplies again when it suits them. This international effort to support vaccination distribution needs to be sustained for long periods into the future, probably extending beyond most political cycles. As such, global cooperation should take the short-term thinking out of decision-making and focus on the long-term aspirations for the health of the global population and economic development. The new leadership of Director General Ngozi Okonjo-Iweala should make it a priority of the WTO to coordinate the relaxation of IP protections for COVID-19 pharmaceutical technology. The United States should provide affordable access to the Johnson & Johnson COVID-19 vaccine, which is well-suited to Africa with its less strict storage and transportation requirements. 

For the sake of humanity and all that deserve to come out of this pandemic alive (which must be everyone), may we not simply see humans but see humanity as well. Otherwise, vaccine nationalism will prolong the virus, not shorten it.