In the wake of Friday’s decision by the European Union to introduce controls on vaccine exports, there has once again been much alarm about “vaccine nationalism.” This term is meant to pour scorn on governments that prioritise their own citizens’ access to vaccines over that of other countries. It points to the danger that richer parts of the world will squabble for first dibs on limited vaccine supplies – “fighting over the cake,” as a World Health Organisation official aptly described it – while leaving poorer countries trailing far behind in their vaccination efforts.
Wealthy nations undoubtedly have a moral obligation to minimize the impact of these disparities
Certainly, there’s a real danger that the EU’s export controls will end up hampering overall vaccine production by sparking a trade war over raw materials. This is somewhat ironic, given that few have been as outspoken about countries “unduly restricting access to vaccines” as the EU itself. As for global inequalities in vaccine access, make no mistake – they are shaping up to be very ugly indeed. It looks likely that poorer countries, having already faced an economic, social, and public health catastrophe, will struggle to vaccinate their most vulnerable citizens even as richer states give jabs to the majority of their populations.
Wealthy nations undoubtedly have a moral obligation to minimize the impact of these disparities. Nonetheless, wielding vaccine nationalism as a pejorative term is an unhelpful way to diagnose or even to address this problem. Given how the world is structured politically, the best way to ensure that vaccines reach poorer countries is for richer ones to vaccinate a critical mass of their own citizens as quickly as possible.
To condemn vaccine nationalism is to imply that, in the early summer of 2020 when governments began bidding for Advance Purchase Agreements with pharmaceutical companies, a more cooperative global approach would have been feasible. In reality, the political, bureaucratic and logistical structures to meet such a challenge did not exist. Some are still pointing to Covax, the consortium of institutions trying to facilitate global vaccine equality, as a path not taken. But Covax’s proposed strategy was neither realistic nor effective.
The bottom line here is that for governments around the world, whether democratic or not, legitimacy and political stability depends on protecting the welfare of their citizens – a basic principle that even critics of vaccine nationalism struggle to deny. Only slightly less important are the social unrest and geopolitical setbacks that states anticipate if they fall behind in the race to get economies back up and running.
In light of these pressures, Covax never stood a chance. Its task of forging agreement between an array of national, international and commercial players was bound to be difficult, and no state which had the industrial capacity or market access to secure its own vaccines could have afforded to wait and see if it would work. To meet Covax’s aim of vaccinating 20 per cent of the population in every country at the same speed, nations with the infrastructure to deliver vaccines would have had to wait for those that lacked it. They would have surrendered responsibility for the sensitive task of selecting and securing the best vaccines from among the multitude of candidates. (As late as November last year Covax had just nine vaccines in its putative global portfolio; it did not reach a deal with the first successful candidate, Pfizer-BioNTech, until mid-January).
But even if a more equitable approach to global vaccine distribution had been plausible, it wouldn’t necessarily have been more desirable. Seeing some states race ahead in the vaccine race is unsettling, but at least countries with the capacity to roll out vaccines are using it, and just as important, we are getting crucial information about how to organise vaccination campaigns from a range of different models. The peculiarity of the vaccine challenge means that, in the long run, having a few nations to serve as laboratories will probably prove more useful to everyone than a more monolithic approach that prioritises equality above all.
The EU’s experience is instructive here. Given its fraught internal politics, it really had no choice but to adopt a collective approach for its 27 member states. To do otherwise would have left less fortunate member states open to offers from Russia and China. Still, the many obstacles and delays it has faced – ultimately driving it to impose its export controls – are illustrative of the costs imposed by coordination. Nor should we overlook the fact that its newfound urgency has come from the example of more successful strategies in Israel, the United States and United Kingdom.
Obviously, richer states should be helping Covax build up its financial and logistical resources as well as ensuring their own populations are vaccinated. Many are doing so already. What is still lacking are the vaccines themselves. Since wealthy states acting alone have been able to order in advance from multiple sources, they have gained access to an estimated 800 million surplus vaccine doses, or more than two billion when options are taken into account.
There’s no denying that if such hoarding continues in the medium-term, it will constitute an enormous moral failing. But rather than condemning governments for having favoured their own citizens in this way, we should focus on how that surplus can reach poorer parts of the world as quickly as possible.
This means, first, scaling up manufacturing to ease the supply bottlenecks which are making governments unsure of their vaccine supply. Most importantly though, it means concentrating on how nations that do have access to vaccines can most efficiently get them into people’s arms. The sooner they can see an end to the pandemic in sight, the sooner they can begin seriously diverting vaccines elsewhere. Obviously this will also require resolving the disputes sparked by the EU’s export controls, if necessary by other nations donating vaccines to the EU.
But we also need to have an urgent discussion about when exactly nations should stop prioritising their citizens. Governments should be pressured to state under what conditions they will deem their vaccine supply sufficient to focus on global redistribution. Personally, not being in a high-risk category, I would like to see a vaccine reach vulnerable people in other countries before it reaches me. Admittedly the parameters of this decision are not yet fully in view, with new strains emerging and the nature of herd immunity still unclear. But it would be a more productive problem to focus our attention on than the issue of vaccine nationalism as such.
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