Vaccine nationalism and global inequities: How has the distribution of vaccines during the pandemic exacerbated global inequalities and contributed to conflict? 

The COVID-19 pandemic has revealed the glaring inequities that exist in our world, especially when it comes to healthcare access. While vaccines have been developed and are being rolled out globally, their distribution has highlighted the stark divide between wealthy nations and those with limited resources. Vaccine nationalism has become a major issue, with countries prioritizing their own populations for access to vaccines, leaving lower-income countries struggling to obtain doses. This has led to a situation where many wealthy countries have vaccinated a large proportion of their populations, while many lower-income countries have been left with little or no access to vaccines.

Vaccine nationalism is driven by the belief that countries have a responsibility to prioritize their own populations first. Wealthy countries have been able to secure large supplies of vaccines, while poorer countries are forced to wait for donations or for vaccine supplies to become available. This unequal distribution of vaccines has had serious implications for global health and stability.

The impact of vaccine nationalism is evident in the global vaccination rates. While countries like the United States, the United Kingdom, and Canada have been able to vaccinate a significant portion of their populations, many low-income countries have not even been able to vaccinate their healthcare workers. The World Health Organization has estimated that more than 90% of low-income countries will not be able to vaccinate their populations in 2021, while high-income countries have already secured enough vaccines to vaccinate their entire populations.

A slower and delayed vaccination rollout in low and middle-income countries has left them vulnerable to COVID-19 variants, new surges of the virus and a slower recovery out of the crisis. High-income countries started vaccination on average two months earlier than low-income countries and vaccination coverage in low-income countries is still strikingly low.

The red line at the bottom of the graph is a stark depiction of the gap between rich and poor countries.

This unequal distribution of vaccines has resulted in a number of negative consequences. Firstly, it has contributed to the widening of the gap between rich and poor countries. Countries that are unable to vaccinate their populations will continue to suffer from the effects of the pandemic, while richer countries will recover more quickly. This will create significant disparities in economic growth and social development, which could ultimately lead to further conflict.

Secondly, vaccine nationalism has led to increased tensions between countries. Many low-income countries feel that wealthy countries are hoarding vaccines and prioritizing their own populations at the expense of the rest of the world. This has created significant diplomatic challenges and could lead to increased conflict if the situation is not addressed.

Thirdly, the unequal distribution of vaccines is likely to perpetuate the pandemic. As long as the virus continues to spread in some parts of the world, it will remain a threat to all. This means that vaccine nationalism is not only morally questionable, but it is also an ineffective way of managing the pandemic. The longer the virus remains a threat, the more likely it is that new variants will emerge, which could render existing vaccines ineffective.

Global disparities in vaccine access are stark. The first COVID-19 vaccines received emergency regulatory approval in December 2020 (3 ). Within the first year of distribution, HICs have been able to hit their targets and vaccinate 75-80% of their populations. During the same period, low-income countries (LICs) vaccinated <10% of their populations due to inequalities in vaccine access.

High-income countries across Europe and North America have hoarded many more vaccine doses than they need (4 ), tying up the global vaccine supply. There have even been reports of widespread vaccine wastage in HICs, with up to 15 million doses thrown away in the United States alone between March and September 2021 (5 ). The WHO Director General reported that, by November 2021, more than 80% of the world's vaccines had gone to G20 countries, whereas LICs had received just 0.6% of all vaccines (6 ). The pressure on global supply chains looks set to continue, with ongoing need for booster doses. International institutions, such as the World Health Organization (WHO) and global health advocates such as Médecins Sans Frontières (MSF), have called for a pause to booster programs to support a global effort to vaccinate at least 10% of every country's population (7 ), but booster vaccination programs across HICs continue.

To address the issue of vaccine nationalism and global inequities, it is crucial that the international community work together to ensure that vaccines are distributed fairly and equitably. This means that wealthy countries must do more to share vaccines with low-income countries, either through donations or by investing in the global vaccine distribution efforts. It also means that governments, international organizations, and pharmaceutical companies must work together to ensure that vaccines are affordable and accessible to all.

In conclusion, vaccine nationalism has exacerbated global inequalities and contributed to conflict. It is imperative that the international community works together to address this issue and ensure that vaccines are distributed fairly and equitably. This is not only a moral imperative, but it is also essential for managing the pandemic and preventing future conflicts.