Equitable COVID-19 Vaccine Access

The rapid development of COVID-19 vaccines is an amazing achievement. It shows how much can be accomplished when human ingenuity, solid medical research capacity, and private-sector product development infrastructure are given extensive public support, from basic research to massive subsidies along the research and development (R&D) and manufacturing pipeline. However, this historic accomplishment is hardly a success if vaccines are not available widely and equitably. Eighteen months into the pandemic, nearly 1.5 billion vaccine doses have been administered in the world. Yet 75% of vaccine supply has gone to just 10 countries.1 Fewer than 25 million vaccine doses have been administered in the whole African continent, whose total population is 1.36 billion. While wealthy countries are competing to buy sufficient stocks to vaccinate their entire population multiple times over, many of the poorest countries are unable to procure enough vaccines to protect even their health workers. In high-income countries, children are being vaccinated, despite little likelihood of significant morbidity or mortality, while millions of vulnerable, often older, individuals in low-income countries are getting sick and struggling to find basic elements of care such as oxygen and hospital beds. This extreme vaccine inequity and injustice is not just a moral failure, as called out by World Health Organization (WHO) Director Tedros Ghebreyesus; it is also an economic and human rights catastrophe, and self-defeating. Scientists have warned that the pandemic is likely to be prolonged and worsened unless this disparity is overcome, and Tedros has recognized that a rights-based approach is essential.2 New variants of the virus are already emerging that could threaten the feeble progress made so far to contain the disease. Amidst this global challenge, we are encouraged by a growing mobilization, led by access-to-medicines and health rights activists, to demand solutions to overcome what has been called “vaccine apartheid” and to challenge the artificial vaccine scarcity resulting from pharmaceutical monopolies (namely in the areas of intellectual property and manufacturing capability) and vaccine nationalism. In this roundtable, HHRJ talks with leading health experts and activists about this battle, the challenges, opportunities, lessons learned from previous access battles, and progress being made.