Vaccine distribution and the harms of selective solidarity

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Photo: Moletjie, LimpopoSouth Africa (Mukurukuru Media / Shutterstock.com)

If you could describe the experience of the COVID-19 pandemic in one word, which would you choose? For a few months back in 2020, perhaps you might have chosen “solidarity.” We were reminded of our interconnectedness as we saw city after city go through lockdowns as the virus spread; we found joy in small things like playing music on balconies, and we applauded our essential workers every day when the sun set. Over and over, we heard the phrase: “No one is safe until everyone is safe.”

Two years on, our comparisons to the ambitious and transformative agendas required in the aftermath of the Second World War — times of coming together to rebuild our world — have been replaced with a much more striking reminder of what war actually looks like, and the horrors that come from divisions in society and geopolitical games being played out before our eyes. As calls for “solidarity” ring out once more, the term is likely being met with more bitterness than it should. As Europe confronts a war on its doorstep, the recent memory of how countries in the Global North handled the COVID-19 pandemic has rightfully left many around the world wondering what “global solidarity” really means — and if it ever existed.

Nowhere is this lack of solidarity more visible than on the issue of vaccines. Some countries are starting to provide fourth doses to their citizens, while only 15% of the people in low-income countries have received at least one dose. The “vaccine apartheid” we have created, however, is not just a matter of getting vaccines into people’s arms, but is also about the inequalities and exclusion that have fed into, and result from, the global approach to vaccine distribution. The vaccine-pooling scheme, COVAX, has struggled to deliver enough vaccines to meet its goals, while high prices and vaccine hoarding left many countries, particularly in Latin America and Africa, without alternative options to make up for the delays. COVAX has also been criticized for its exclusionary governance structure, which left recipient countries and civil society out of key processes and strategic discussions, in favor of high-income, donating countries.

We have been told time and again that failing to vaccinate the world would bring on new variants and jeopardize our global efforts for recovery. When South Africa reported the first cases of the Omicron variant, however, the response of closing borders and ignoring calls for ramping up vaccine production was, as described by President Cyril Ramaphosa, a “slap in the face of African excellence.” The closure of borders is just one of the most visible manifestations of a lack of solidarity and respect, and the perpetuation of global systems of exclusion that refuses to recognize the value of cooperation in responding to the pandemic.

Not only has the hoarding of vaccines by high-income countries been, “morally indefensible,” but the blocking of the TRIPS waiver that would allow other countries to produce their own vaccines has been repeatedly blocked by both pharmaceutical lobbies and governments. Many have argued that lack of production capacity in other countries would render a TRIPS waiver useless, but that is not necessarily the case. A recent study by Médecins Sans Frontières showed over 100 factories in countries capable of producing mRNA vaccines in countries including Egypt, Morocco, Tunisia, Senegal, South Africa, India, China, South Korea, Vietnam, Malaysia, Bangladesh, Chile, Argentina, and Brazil. As the report’s co-author, Achal Prabhala, describes it: “it’s a bit like being an Olympic runner, but not even being allowed to start the race because somebody’s tied your feet to the starting blocks.” Thanks to the tireless mobilization of groups such as the People’s Vaccine Alliance, negotiations have brought us closer to an agreement on the waiver, but the watered-down compromise is limited exclusively to vaccines, leaving out all the additional technology required to get vaccines into people’s arms, and falling short of the action required to truly achieve vaccine equity.

The sad part is that many, including Strive Masiyiwa, vaccine envoy to the African Union, were not surprised: “It’s the old movie again…” At a time when multilateral action is needed more than ever, perceived greed from those countries with the most resources is feeding into an increasing mistrust of our ability to cooperate and commit to helping one another. At least on vaccines, it was Russia and China who seemed more willing to donate or sell their own vaccines, part of a geopolitical game that is now having repercussions on countries’ attitudes towards other areas of global concern, most recently the war in Ukraine.

The invasion of Ukraine, and its spillover effects on food, fuel, and fertilizer costs, as well as on global financing for already cash-strapped countries, once again demands global solidarity. The geographical split showcased in recent General Assembly votes, as well as some of the fallout and pressure from the Global North on the rest of the world to vote with them, does not bode well. In many ways, these votes describe not the moral standing of one country over another, but the mistrust in a multilateral system that has failed to deliver, too often exhibiting double standards and on vaccines — bowing down to the profit-maximizing pharmaceutical industry. We were unable to come together on what former UK Prime Minister Gordon Brown describes as the single peacetime decision with the potential to, “save so many lives in such a short time.” From the looming food and energy repercussions of the war in Ukraine to the climate crisis, more difficult peacetime — and wartime — decisions are coming our way. Will the global community be playing “the old movie” once again — or will selfishness and profit finally be put aside in favor of true solidarity, respect, and cooperation?

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