June 10, 2023

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Covid vaccine distribution must not deepen the divide between the global ‘north’ and ‘south’

The danger is that vaccine distribution will expose and accelerate the fault lines between the global haves and have-nots. After all, the pandemic accelerated existing fault lines of inequality worldwide.

The race for multiple Covid-19 vaccines seems to be nearing the finish line, but there is no time for a victory lap: the new race will be to vaccinate our world. Speed, it seems, is the new oil, and the pharmaceutical companies that raced for a vaccine demonstrated both hyper-speed, impressive collaboration and extraordinary competence. Now that the scientists have done their job, the question becomes: how will we distribute the limited amounts of vaccines fairly across the world?
The danger is that vaccine distribution will expose and accelerate the fault lines between the global haves and have-nots. After all, the pandemic accelerated existing fault lines of inequality worldwide. The poorest and the vulnerable middle got hit the hardest. They are not the fortunate ones who can do their job via Zoom. The World Bank estimates that up to 150 million people could fall into extreme poverty in 2021 – the first rise in poverty numbers in two decades.
What’s more, those who recently graduated from the poor across Asia and Africa into a precarious lower middle class have fallen back into poverty. Meanwhile, Zoom-ing knowledge workers maintained their jobs as they watched their investment portfolios inexplicably rise even amid a global pandemic. Wealthier families in advanced economies could afford the kind of broadband access and special tutoring required for children to maintain education standards amid shut-down classrooms, while others watched their kids fall behind.
The vaccines will go a long way toward returning us to a sense of normalcy, though the damage of the pandemic will last decades. The other key question: which “worlds” will be saved first?
We could face a situation by the end of 2021, as my colleague Hal Brands of the Johns Hopkins University School of Advanced International Studies put it in a Bloomberg opinion column, “in which Covid-19 has become far less menacing in most rich, advanced countries – which use their economic power to lock up early supplies of vaccine – but rages on in the so-called global south.”
The People’s Vaccine Alliance has noted that in 67 poorer nations, only one in 10 people will receive a vaccine by the end of next year. The alliance also notes that 14 percent of the world’s population – mostly Western, advanced economies – already have purchased more than half of the leading vaccines.
The Pfizer-BioNTech vaccine with 95 percent efficacy is already coursing through the veins of frontline medical workers in the United States and among the elderly in the United Kingdom. Pfizer has pledged 100 million doses to the United States. By the end of 2021, a large swathe of the US population will have received a vaccine, and the country will be well on its way to herd immunity. Similar mass vaccination efforts will be underway in Europe throughout the year. So, expect the traditional fault lines between “the West” and “the rest” to be pronounced.
On the other hand, several global “South” countries have handled the pandemic well, notably Vietnam, Taiwan and the United Arab Emirates, while many of the so-called global “North” countries floundered. Smaller, well-governed countries like Singapore, the UAE or Taiwan could be even better positioned than large Western countries since the numbers required to vaccinate entire populations are far lower, and their health care and government systems have proved adept at handling the pandemic. The Australia-based Global Response to Infectious Disease Index ranked all three among the top 10 countries worldwide for their response to Covid-19.
But what of the large swathes of Africa, Asia and Latin America that have been hit hard by the pandemic? Will China’s two top vaccine candidates – from Sinopharm and SinoVac – come to the rescue? China has already set out ambitious goals to vaccinate the world. Sinopharm says it can produce up to a billion doses next year, and other promising Chinese vaccines could add another 3 billion doses to world markets.
Both the Pfizer and US-based Moderna vaccines require super cold storage and complex supply chains. As such, both will be unsuited to mass distribution across the developing world even if countries could afford their higher prices. So, developing countries will be largely left with choosing Russia’s Sputnik V vaccine, one of China’s vaccines or the AstraZeneca vaccine that promises to be an affordable “vaccine for the world.”
In truth, by the middle of 2021, we are likely to see the vaccine “haves” and “have-nots” divide displayed starkly. Wealthier countries in the West and the more advanced and better-governed countries in Asia and Latin America will have inoculated large segments of their population, while other countries will simply be waiting in line. 
Sinopharm received a major global public-relations boost when the UAE approved use of its vaccine for the general public after testing proved it to be 86 percent effective. Across the developing world, the UAE is seen as a well-governed country with effective institutions. The UAE approval will send a signal to developing countries that the Sinopharm vaccine is safe and effective.
A clear lesson from the historic vaccine race has been the power of scientific and national collaboration across borders. The same spirit of collaboration will be needed in distributing the various vaccines. Morally, politically and economically, we cannot afford existing fault lines to deepen. Thus, effective distribution of vaccines will do far more than kill a raging virus.

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