Coronavirus – Health and Governance Issues

How ‘Vaccine Nationalism’ could block vulnerable populations’ access to COVID-19 vaccines

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Not Much

Mains level : Vaccine nationalism

Hundreds of COVID-19 vaccine candidates are currently being developed. Many countries are securing priority access to doses of COVID-19 vaccine.

Practice question for Mains:

Q. What is Vaccine Nationalism? Discuss various ethical issues involved and its impact on vulnerable populations across the globe.

Vaccine nationalism during COVID-19

  • Vaccine nationalism occurs when a country manages to secure doses of vaccine for its own citizens or residents before they are made available in other countries.
  • This is done through pre-purchase agreements between a government and a vaccine manufacturer.
  • Vaccine nationalism is harmful to equitable access to vaccines.

US begins to secure

  • In India, the privately held Serum Institute is developing one of the leading COVID-19 vaccine candidates.
  • The Serum Institute signalled that, if the development of the vaccine succeeds, most of the initial batches of the vaccine will be distributed within India.
  • At the same time, India, alongside the US and Russia, chose not to join the Access to COVID-19 Tools Accelerator.
  • This was a WHO moves to promote collaboration among countries in the development and distribution of COVID-19 vaccines and treatments.

Vaccine nationalism is not new

  • During the early stages of the 2009 H1N1 flu pandemic, some of the wealthiest countries entered into pre-purchase agreements with several pharmaceutical companies working on H1N1 vaccines.
  • At that time, it was estimated that, in the best-case scenario, the maximum number of vaccine doses that could be produced globally was two billion.
  • The US alone negotiated and obtained the right to buy 600,000 doses. All the countries that negotiated pre-purchase orders were developed economies.
  • Only when the 2009 pandemic began to unwind and demand for a vaccine dropped did developed countries offer to donate vaccine doses to poorer economies.

Issues with such nationalism

  • The most immediate effect of vaccine nationalism is that it further disadvantages countries with fewer resources and bargaining power.
  • It deprives populations in the Global South from timely access to vital public health goods.
  • Taken to its extreme, it allocates vaccines to moderately at-risk populations in wealthy countries over populations at higher risk in developing economies.
  • Vaccine nationalism also runs against the fundamental principles of vaccine development and global public health.

Why it is unethical?

  • Most vaccine development projects involve several parties from multiple countries.
  • With modern vaccines, there are very few instances in which a single country can claim to be the sole developer of a vaccine.
  • And even if that were possible, global public health is borderless. As COVID-19 is illustrating, viruses can travel the globe.

Its impacts

  • If COVID-19 vaccines are not made available affordably to those who need them, the consequences will likely be disproportionately severe for poorer or otherwise vulnerable and marginalised populations.
  • Without broad access to a vaccine, these populations will likely continue to suffer more than others, leading to unnecessary disease burden, continued economic problems and potential loss of life.

Conclusion

  • Nationalism is at odds with global public health principles. Yet, there are no provisions in international laws that prevent pre-purchase agreements like the ones described above.
  • There is nothing inherently wrong with pre-purchase agreements of pharmaceutical products.
  • Vaccines typically do not generate as much in sales as other medical products.
  • If used correctly, pre-purchase agreements can even be an incentive for companies to manufacture vaccines that otherwise would not be commercialized.

Way forward

  • Equity entails both, affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
  • Contracts should not trump equitable access to global public health goods.
  • Developed countries should pledge to refrain from reserving vaccines for their populations during public health crises.
  • The WHO’s Access to COVID-19 Tools Accelerator is a starting point for countries to test collaborative approaches during the current pandemic.
  • International institutions — including the WHO — should coordinate negotiations ahead of the next pandemic to produce a framework for equitable access to vaccines during public health crises.
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