As the coronavirus pandemic spreads and new cases continue to rise, the world is waiting for the vaccine that will help restore economies, prevent further deaths, and enable life to continue. An effective vaccine will hopefully end the coronavirus, but this solution may come with its own set of issues. Even once the world discovers a safe vaccine, it will take months to manufacture and distribute large supplies of it, bringing into question which countries, and which groups in those countries, will get first access. As the world grows more desperate, countries are beginning to shift away from global collaboration. Instead, they are competing to secure early access to a vaccine.
Although there is a growing urgency for a “my country first” mentality, vaccine nationalism is dangerous because it propels countries to participate in a global race, creates a harmful hierarchy for future distribution, and further endangers public health. The pandemic is a global problem that requires research to be collaborative and cooperative in order to facilitate the fair distribution of a vaccine around the world.
The Geopolitics Of A Vaccine
There have been three scenarios outlined as possibilities for distribution. First, the world would collaborate to manufacture and distribute a vaccine in hopes of getting it to the most people possible. The second option is that some countries would invest or make political negotiations to get first access, but then organizations such as the United Nations (UN) or World Health Organization (WHO) would help oversee fair distribution to the rest of the world. The last scenario is that each country would work individually to get access to a vaccine, most likely by investing heavily in private companies. Currently, global cooperation is becoming a distant goal as countries drift towards the second and third scenarios.
Countries have been investing in pharmaceutical companies in order to secure a vaccine for their population. The United States has given a $1.2 billion grant to AstraZeneca and they have agreed to pay $1.95 billion to Pfizer and BioNTech for 100 million doses if their vaccine is safe and effective. Operation Warp Speed outlines America’s goals of developing, manufacturing, and distributing a vaccine to Americans by 2021. China is currently developing at least four vaccines and is accelerating its search. The Netherlands, Germany, France, and Italy have a contract with AstraZeneca to buy 400 million doses of a vaccine once it is available. These large investments create a global competition where the winner, most likely from a wealthy country, would decide who gets first access to a vaccine. Other countries—who are either adversaries of the winner or cannot afford to invest these amounts of money—may be left waiting months for a replenished supply of vaccines.
Why “America First” Is Problematic
The United States has been particularly aggressive in securing first access. Under Trump’s “America First” influence, the U.S. intends to prioritize their own needs and will only share vaccine efforts with other countries once those needs are fulfilled. An official claimed that Operation Warp Speed, “. . .will cooperate with all nations deemed friendly to our national security in order to develop safe and effective COVID-19 countermeasures.” The Trump Administration also attempted to gain exclusive access to a vaccine by offering “large sums of money” to a German company. This nationalistic approach in multiple countries, but particularly the United States, is counter-productive and harmful.
Wealthier countries are potentially driving up the cost of a vaccine in their efforts to place themselves at the front of the line. These investments push lower-income countries to the back of the line and make the vaccine less accessible. Rather than treating it as a global public good, countries may only distribute early vaccines to allies or may place preferences on recipients within their own country, potentially overlooking healthcare workers and other vulnerable groups. It may become a powerful advantage for that country’s government, transforming a life-saving solution into a strategic political tool. This approach is dangerous because it continues to put lives at risk. One country cannot have a disproportionate amount of influence over distribution, because the pandemic cannot be solved efficiently without collaboration and coordination from all countries.
How Vaccine Nationalism Could Impact Public Health
By making a vaccine exclusive to one country’s population, moderately at-risk groups would be protected while high-risk groups around the world—such as healthcare workers, the elderly, and the immune-compromised—would remain vulnerable. Not protecting the groups who need this vaccine the most would result in unnecessary deaths. Jane Halton, a former board member of WHO and chair of the Coalition for Epidemic Preparedness Innovations, explains, “. . . that vaccine production should be globally distributed and initially target the most vulnerable in all nations.” By battling in the “every nation for themselves” competition, the world’s vulnerable groups are further endangered. Additionally, global public health could potentially worsen if governments submit to this intense need without taking the steps necessary to ensure a vaccine’s safety.
Populations that get first access to a vaccine will recover faster but also deplete early supplies. In response, other countries may feel pressured by their citizens to accelerate their own vaccine trials. While faster access sounds beneficial, this approach could encourage risky manufacturing and the potential release of an unsafe vaccine. If the public thinks the vaccine to be unsafe, or they distrust their government and health experts, it could be difficult to ensure people get vaccinated. Consequently, a rushed vaccine with negative health effects would only worsen this suspicion and further strengthen the anti-vax movement. Already polls are showing that only 50% of Americans plan to get vaccinated when one is released. Because of the potential for populations to resist a vaccine, governments cannot rush their trials in attempting to win the vaccine race. The public must have trust and confidence that a vaccine is safe and effective; otherwise, the coronavirus will continue to spread.
Collaboration Not Competition
A problem as global and devastating as a pandemic requires all countries to collaborate and coordinate the solution. Rather than work individually, they should work together to discover, manufacture, and distribute a vaccine. Through fair distribution based on international cooperation, nations can ensure their most at-risk populations get early access to a vaccine and that the disease will stop its rapid spread.
Around 165 countries, not including the United States, have expressed interest in joining the COVID-19 Vaccine Global Access (COVAX) Facility, which is, “. . . designed to guarantee rapid, fair and equitable access to COVID-19 vaccines for every country in the world, rich and poor, to make rapid progress towards slowing the pandemic.” By joining this effort, all countries involved—both lower-income and higher-income—get access to a vaccine once it is available. Specifically, higher-income countries increase their chances of getting an effective vaccine, because the total pooled funds of COVAX can invest more than an individual country. Once a vaccine is developed, COVAX will distribute the supply equally to participating countries (based on population) and will prioritize getting it to healthcare workers.
Issues Won’t End With A Vaccine
As the search for a solution continues, countries should participate in efforts that encourage global cooperation. In particular, the United States should recognize the danger of its nationalistic and aggressive approach, and should work towards joining collaborative efforts. The world has learned that the existence of this disease in one country is a threat to all. Therefore, until everyone can fairly access a vaccine, coronavirus will continue to impact the entire world’s economy, politics, and public health.