COVID-19 vaccine nationalism vs equity, By Isaac N. Obasi




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National policy responses to the containment of the coronavirus (-19) as it ravaged the world in 2020 varied across nations particularly more markedly between what can be called high capacity performing governments and those of low capacity . But even at this, there were some exceptions. For example, a country such as the United States under former President Donald Trump is one such exception. Although the US belongs to the category of high capacity performing countries, its COVID-19 national policy response under Trump was a disaster to say the least. But even at this description, Trump nevertheless invested hugely in the search and race for a vaccine which ultimately paid off. The emergence of President Joe Biden consolidated the achievement of Trump in the area of vaccine investment and production, with his government’ effectiveness in procurement, logistics and administration of vaccines to US citizens. The history of COVID-19 devastation of the US has gradually changed for the better, as the US has restored its capacity to effectively address the challenges posed by the pandemic. The numbers are steadily going down under President Biden.

One common feature characterising all high capacity performing nations is their effective response to the pandemic particularly in the area of COVID-19 vaccine discovery, production, acquisition and its effective administration to their citizens. Some developed nations invested heavily in the race for the development of a vaccine. They followed this up with the signing of pre-purchase agreements with pharmaceutical companies to supply millions of vaccines for administration, to their citizens. Meanwhile, as all these were going on, many leaders of low capacity performing nations were helplessly watching and did practically nothing to invest in vaccine discovery and production. But as the success of vaccine acquisition and administration by developed countries became manifest critics started accusing leaders of high capacity performing nations of cornering all the vaccines for their citizens to the exclusion of citizens of low capacity performing nations. The next accusation that emerged was that these leaders were hoarding the vaccines for their citizens only. From this accusation emerged a new concept called vaccine nationalism.  

According to Amir Khan (in Aljazeera’s Doctors Note), vaccine nationalism “occurs when governments sign agreements with pharmaceutical manufacturers to supply their own populations with vaccines ahead of them becoming available for other countries” (See https://www.aljazeera.com/features/2021/2/7/what-is-vaccine-nationalism-and-why-is-it-so-harmful. And as Globalcitizens.com says, “the term has essentially been coined in the wake of dozens of governments in wealthy countries scrambling to sign deals with pharmaceutical companies directly, to secure vaccines for their own populations — limiting the stock available for others.” Seen in this light, vaccine nationalism is used in a pejorative sense. 

However, it neglects the fact that any serious leader of a country would endeavor to prevent the death of the citizens from the ravaging virus first, before thinking of other countries. This is a natural law of survival which in itself is not bad. It appears that the concept of vaccine nationalism was hastily used at a time when high performing governments were nationalistically and commendably struggling to do everything within their powers to prevent the alarmingly high COVID-19 related deaths among their citizens. Seen in this perspective therefore, their actions were justifiable as it makes sense to take care of national health problem first before going internationally.  

From criticisms of so-called vaccine nationalism and its concomitant vaccine inequality, the call for emerged with even greater force and passion. According to Concern.org.uk, vaccine equity means “distributing vaccines based on need first, regardless of someone’s nationality or wealth”. It goes to argue rightly that the pandemic will only end when everyone across the globe is protected”. Again, it added that “we know that no one is safe until everyone is safe”. Vaccinating those on the frontline and the most vulnerable everywhere – irrespective of their wealth or nationality – is not a choice but a necessity. It is the only way back to ‘normality’. (See https://www.concern.org.uk/news/vaccine-equity-what-does-it-mean-and-how-can-it-be-achieved). With this new concept in place, the World Health Organisation (WHO) began to champion vigorously for vaccine equity. Its director-, Dr Tedros Adhanom Ghebreyesus for instance, decried the ‘Me First’ attitude to vaccine distribution describing it as “catastrophic moral failure”. WHO then warmed that the world faces “catastrophic moral failure” because of unequal vaccine policies.  

Intensifying its campaign, the WHO released the Call to Action: Vaccine Equity Declaration which specifically calls for:

  • World leaders to increase contributions to the COVAX facility and to share doses with COVAX in parallel with national vaccine rollout.
  • Vaccine manufacturers to share know-how with C-TAP to scale up vaccine manufacturing and dramatically increase the global supply of vaccines for the coming years. Furthermore, we ask for leaders to prioritize supplying to COVAX over new bilateral deals.
  • Regulatory bodies to accelerate approval processes in a safe and deliberate way.
  • Ministries of Health to work with WHO and others to invest in and prepare their primary health care systems for distribution of COVID-19 vaccines to their health workers and to develop data systems on vaccine supply, distribution and uptake,  including sex- and age-disaggregated sub-national data, to drive delivery, equality and impact.
  • All governments to ensure that COVID-19 vaccines are distributed free at the point of care and without risk of financial hardship, starting with health workers and those people at greatest risk of COVID-19, to prioritise affected communities and the voices of essential workers in decision-making and ensure gender equality is central to all actions.

Furthermore, it says that “distributing COVID-19 vaccines quickly and equitably is essential to end this pandemic, restart our economies…”(See https://www.who.int/campaigns/annual-theme/year-of-health-and-care-workers-2021/vaccine-equity-declaration  

As we pointed out earlier, the accusation of vaccine nationalism and hoarding appears to be somewhat premature at the time it was being made. We say so because those accused of vaccine nationalism are the ones who are also in partnership with COVAX which is a “global scheme formed to ensure fair access to inoculations for low-and middle-income states”. The global partnership also includes CEPI, Gavi, and WHO – champions of vaccine equity. The point being made here is that the countries accused of vaccine nationalism were not oblivious of the fact that any COVID-19 infection in any part of the world is a threat to the entire world – the basis upon which vaccine equity is being canvassed. 

Yes we agree with the Director-General of WHO, Dr Tedros Ghebreyesus, that while the soc-called vaccine nationalism and its concomitant inequality may be a “catastrophic moral failure”, but we also stress the fact that leaders of developing countries should wake up to their responsibilities of strengthening their weak health systems. They should therefore stop being complacent and waiting for others to do the investment while they hide under the convenient slogan of vaccine equity as if it is part of their natural right to enjoy the fruits of such investment efforts. The point is that the huge investment in vaccine research and the eventual discovery is a product of tax payers’ money in some high capacity performing nations.  

Prof. Isaac N. Obasi of the of Abuja, is a Visiting (Adjunct) Research Professor at the Anti-Corruption Academy of Nigeria, (ACAN), ICPC, Email: nnamdizik@gmail.com.