Rich countries hoarding COVID-19 vaccines are making a mistake that could worsen their own death tolls, experts say

coronavirus vaccine unicef
A man receives a coronavirus vaccine in the Ivory Coast on March 1, 2021, with a vaccine secured through the WHO’s COVAX program.

  • Rich countries have acquired most of the world’s vaccines, leaving poorer countries with little.
  • Such unequal distribution risks higher death tolls, even in the rich nations, experts say.
  • New variants develop faster when infection is widespread — and those which emerge in poor nations are unlikely to stay there.
  • Visit the Business section of Insider for more stories.

Rich countries are hurrying to vaccinate their populations as quickly as possible as they fight to end their coronavirus outbreaks.

But doing that while leaving lower-income countries without vaccines of their own come back to bite them, as numerous public health experts have pointed out.

Dr. Tedros Adhanom Ghebreyesus, head of the World Health Organization, noted in February that rich countries with just 16% of the world’s population had purchased 60% of available vaccine supplies.

Tedros previously said the world faces a “catastrophic moral failure” because of this inequality. But there are pragmatic drawbacks as well.

Coronavirus vaccines COVAX
UNICEF employees are briefed as coronavirus vaccines arrive in Sudan on March 3, 2021.

The risk is that, even if a few countries fully vaccinate themselves, the virus can still spread elsewhere.

Allowing it to spread risks it mutating into a more dangerous variants that could resist existing vaccines and prolong the pandemic around the world.

Professor Ken Shadlen, professor of Development Studies at the London School of Economics and Political Science described this worry in an interview with Insider.

He pointed to “concern that if we don’t distribute the vaccine in a globally more equal way it’s going to potentially undermine the health benefits of all that we’re doing with lockdowns and vaccines.”

He said that the emergence of a vaccine-conquering variant is by no means guaranteed, but that “it would take a lot of confidence to believe that it’s not going to, if it keeps spreading.” 

“We’re gambling and it’s a bit of a race.”

Dr. Michael Osterholm, another expert, agreed with the concerns. He is an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, and also advised President Joe Biden on the coronavirus during his transition.

He told Insider that vaccine equality should already be a “top priority” to save lives around the world.

Coronavirus vaccine COVAX
A man gets a coronavirus vaccine in the Ivory Coast with a shot secured through the COVAX scheme.

He said that one of the biggest risks to ending the pandemic is “largely uncontrolled transmission in the low-and-middle-income countries,” even if wealthier nations have finished their vaccine drives.

He said: “We have got to have an immediate international plan to vaccinate the world as quickly as possible.”

The WHO is warning the pandemic won’t end until outbreaks end everywhere. Tedros said in February: “This is not a matter of charity. It’s a matter of epidemiology.”

Already fighting mutant strains

Variants of the virus are causing widespread alarm and changing the course of the pandemic.

A more-contagious strain first identified in the UK was blamed for surges across Europe, and in the US the CDC warned that it could become the dominant strain.

Some countries’ responses are already changing.

The UK has one of the most successful vaccination programs in the world – almost a third of the population has received at least one dose. There are ambitious plans to end all restrictions before the end of June.

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The number of people in the UK who had received the first dose of the coronavirus vaccine as of March 2, 2021.

But officials warn that mutations could harm that progress: politicians say the UK is in a “race against evolution.”

The UK is chasing down cases of variants, closely tracking small outbreaks of strains first found in South Africa and Brazil.

Most countries don’t have the resources to react as fast, and it only takes a few mistakes for a new strain to take hold.

Paul Hunter, professor of medicine at the University of East Anglia’s Norwich School of Medicine, noted that some now argue that lockdowns “should continue for longer than we might think” because of the risk from variants.

He noted that the evidence for that is not yet conclusive.

Existing efforts likely aren’t enough

There is one international effort aimed at reducing this inequality: The WHO’s COVAX scheme, which hopes to distribute 2 billion COVID-19 vaccine doses worldwide by the end of 2021.

Its first shots were delivered to Ghana in late February, with shots since arriving in countries like Senegal, Sudan, and Kenya.

But it has been battling underfunding and the problems of limited supply. Even with money to buy doses, COVAX has to contend with the reality that wealthy countries have already reserved almost all supplies for the near future.

The WHO has accused wealthy countries of hoarding doses and driving up prices, frustrating its progress.

That’s adding to the issues created by the shortage of supply globally, leaving it harder for poorer countries to get vaccines and leaving huge populations with little protection.

There’s another big problem with COVAX: Its aims are the “bare minimum,” as Shadlen put it.

It aims to vaccinate around 20% of the populations of 92 countries by the end of the year, far short of the ambitions of the US and others.

Osterholm described COVAX as “a start.” But, he said, “COVAX has never been designed to deliver a vaccine to the entire world in short order.”

COVAX coronavirus vaccine
Workers unload a shipment of Covid-19 vaccines secured through COVAX in the Ivory Coast in February 2021.

“Now we have new data, new information about this thing called variants, which is a game changer. So I think that we’re in a new place. And COVAX to me, while it’s a very positive development, it’s old thinking.”

Instead he called for a plan that involves “everyone, whether it’s Russia or China, or the United States or Europe. We all have the same interest here.”

Tamaryn Nelson, a health advisor to Amnesty International, put it bluntly to Insider: “No one is safe until everyone is safe.”

A big unknown

The key factor is how much risk larger countries are willing to tolerate. Osterholm, the expert who advised Biden, said that there is no way of knowing ahead of time if a new, scary variant will appear.

Researchers are doing what they can to counter this, working on booster on booster shots to fight specific variants. But the development takes time and money, and is itself not guaranteed to work.

The safer option is to get rid of the virus as widely as possible.

Osterholm said: “I always remind people we are a year into this pandemic, but the variants of concern have only been around for about three months.”

“All this has happened in three months: What’s it going to be like three to six months from now?”

“We’re in a chess match with this virus right now. It’s making moves we’ve never seen before.”

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The mad dash by countries trying to buy up as much of the COVID vaccines as possible will only drag out the pain of the global pandemic

Moderna vaccine
Biotechnology company Moderna protocol files for COVID-19 vaccinations are kept at the Research Centers of America in Hollywood, Florida, on August 13, 2020.

  • Vaccine nationalism, in which countries prioritize their domestic needs at the expense of others, will have significant global economic consequences.
  • As long as the COVID-19 virus is not under control in all regions of the world, there will continue to be a global economic cost associated with the disease.
  • Major economies actually have more to gain by helping to make an effective COVID-19 vaccine widely available globally.
  • Marco Hafner is a senior economist and research leader at RAND Europe working on employment, education and social policy research.
  • This is an opinion column. The thoughts expressed are those of the author.
  • Visit Business Insider’s homepage for more stories.

As more COVID-19 vaccines are approved by regulatory bodies, attention will undoubtedly turn to the rollout. Vaccine nationalism – which occurs when national governments sign bilateral agreements with pharmaceutical manufacturers to supply their own populations with vaccines first – seems inevitable. While this approach is, to an extent, rational and will undoubtedly have domestic political advantages, there could be not only human consequences, but also economic ones as well.

International institutions such as the World Health Organization, the United Nations and GAVI – the vaccine alliance – among others, are trying to support the multilateral option to globally coordinate the COVID-19 vaccine effort. But this approach is not supported so far by some of the world’s leading economies, such as the US, who have been reluctant to commit and instead pursued direct bilateral deals with vaccine manufacturers.

While true that a vaccine nationalism approach would help improve the economic situation of those countries that can inoculate their populations, their economies would still depend on the concurrent recovery in other regions that have not been able to sufficiently immunize their populations against the virus. For example, more than 4% of US exports go to low or lower-middle income countries, including the Philippines, Vietnam or El Salvador.

There are key sectors that will not be able to bounce back until the global population is vaccinated. Travel, tourism and transportation are just three examples of these sectors that rely on a globally connected world to be fully functional. Only vaccinating the populations of individual countries will not be enough to see them return to full financial health, thereby prolonging the economic cost of COVID-19 for the world.

A RAND Europe report analyzing the costs of vaccine nationalism has the numbers to back this up. The research shows that given the enormous costs of the current disruption to the global economy, the introduction of a vaccine, and shared global access to vaccines, would have substantial economic benefits. These benefits would be significantly reduced by vaccine nationalism.

For example, if the vaccine-producing countries, such as the US, EU-27, UK, China, India and Russia, can inoculate a sufficiently large share of their populations, the estimated loss for the world economy in GDP would reduce from 3.7% to 1.3%. However, the lack of access to vaccines for the rest of the world would still result in a GDP loss of up to $1.2 trillion per year, or about $103 billion a month.

The large number of bilateral deals between national governments and producers of current vaccine candidates has resulted in a patchwork of agreements which could affect the pricing of vaccines as wealthier countries bid for limited vaccine supplies. Eventually this could lead to the pricing out or denying, at least initially, of governments of less wealthy countries’ access to some vaccines.

In fact, there is a strong argument that the major economies have more to gain by helping to make an effective vaccine widely available globally.

Based on estimates by Oxfam International in 2020, it would cost $25 billion to supply lower-income countries with vaccines. The US, the UK, the EU and other high-income countries combined could lose about $119 billion a year if the poorest countries are denied a supply. But if these high-income countries would provide the finance for the supply of vaccines, there could be a benefit-to-cost ratio of 4.8 to 1. This means that for every $1 spent, high-income countries would get back about $4.80. This demonstrates the economic incentives to global coordination in vaccine production and distribution.

The costs of global vaccine development and distribution pale in comparison to the enormous cost of economic disruption globally, with governments spending trillions to support workers and sectors severely impacted by the pandemic. This speaks to renewed and substantially larger investment in supporting global vaccine distribution. Ultimately, it could be in the national economic interest to cooperate globally.

Marco Hafner is a senior economist and research leader at RAND Europe.

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