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A nurse at UC Davis Medical Center prepares to inoculate a staff member with the Pfizer-BioNTech COVID-19 vaccine, Dec. 15, 2020 in Sacramento, Calif.
Hector Amezcua/Pool/AP
Global Citizen ExplainsHealth

Vaccine Nationalism: Everything You Need to Know

Why Global Citizens Should Care
The United Nations’ Global Goal 3 is about ensuring that good health and well-being is accessible to all. It can be achieved thanks to initiatives that provide universal health coverage, that tackle infectious diseases, and more. Vaccine nationalism threatens progress on tackling the COVID-19 pandemic and risks exacerbating extreme poverty by making it harder for low-income countries to access vaccines and fight the virus. Join Global Citizen and take action now to ensure that everyone, everywhere can access quality health care and the tools needed to fight COVID-19.

The term “vaccine nationalism” has been on the lips of people who work in global health and social justice a lot recently. But what does it actually mean?

There have been numerous op-ed articles written in the past couple of months decrying vaccine nationalism — including one penned by Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization (WHO), who has described it as a “catastrophic moral failure.”

However, it’s a term that would likely never have made headlines before the COVID-19 pandemic hit. Like “furlough” and “flattening the curve,” it’s become a new part of our pandemic vocabulary.

So to clear things up, we’ve broken down what it means and what impact it could have on the course of the COVID-19 pandemic. 

What is vaccine nationalism?

The term has essentially been coined in the wake of dozens of governments in wealthy countries scrambling to sign deals with pharmaceutical companies directly, to secure vaccines for their own populations — limiting the stock available for others.

Dr. Tedros described it as a “me-first approach” when he spoke to an executive board meeting of the WHO in January.

And while “nationalism” is a wide-ranging political concept that can apply to different contexts, it generally relates to putting the interest of a single nation first, above others, for economic or security reasons — so that’s why the vaccine approach mentioned above has been described this way.

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There was an indication that vaccine hoarding might become an issue as soon as there were signs of a successful coronavirus vaccine, such as the ones created by Oxford/AstraZeneca, Moderna, and Pfizer/BioNTech, first appeared.

Now, according to the most recent data collected by Duke University's Global Health Innovation Center, high-income countries have secured 4.2 billion doses of COVID-19 vaccines, compared to only 670 million acquired by low-income countries.

The UK had secured 400 million doses in total by the start of February — more than six times its total population. Canada, which has a population of 38 million, had 362 million doses by the end of January, which would account for more than nine doses per person.

It’s not the first time vaccines made to combat a pandemic have been purchased quickly like this. It also happened in 2009 with the H1N1 pandemic, according to the New Scientist, when rich countries bought so many vaccines it left “virtually none for the rest of the world.” 

Who is affected by it?

The poorest people in the world’s poorest countries are most affected by a lack of access to vaccines, but vaccine nationalism has a knock-on effect for the whole world. In fact, the Organization for Economic Cooperation and Development (OECD) has warned that the global economy could lose $9.2 trillion if developing countries are left behind in the vaccine rollout.

With pharmaceutical companies signing up to produce tens of millions of doses in a matter of months, it might seem like there will always be enough vaccines to go around. But vaccine nationalism has made it harder for lower-income countries to procure doses, leading to a delay. 

A report from CNN on Monday highlighted the impact of the South African variant of COVID-19 on neighboring Malawi. Having avoided the worst of the impacts of the virus so far, Malawi’s hospitals are now becoming overwhelmed and health workers on the front lines are getting sick and dying of COVID-19.

Of the eight specialists working on COVID-19 in the Queen Elizabeth Central Hospital in Blantyre, Malawi’s second largest city, only three are well enough to be at work to tend the ward’s 80 coronavirus patients, the hospital reports, because they had caught the disease themselves. They said they were not sure when they would receive the vaccine.

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By contrast, health workers in high-risk roles began being vaccinated in the US at the start of January.

Looking at the data from the two continents, as of Feb. 9, North America had administered at least one dose of vaccine to 7.68 people out of every 100 people, compared to 0.05 out of every 100 people in Africa.

COVID-19, as we’ve already seen, rapidly spreads across borders. This means that the pandemic will only come to an end if the virus is tackled around the world — reinforcing the fact that equitable access to vaccines is essential.

What impact is vaccine nationalism having on the COVID-19 pandemic?

Vaccine nationalism ultimately impacts everyone — in both high- and low-income countries — as it hampers progress on tackling the pandemic. If some countries do not carry out enough vaccinations to build herd immunity within their populations, the pandemic will continue there and eventually impact everywhere else, too.

“The more people it infects, the more likely it is that further mutations will occur and it is inevitable that an escape mutation will eventually surface,” writes Dr. Amir Khan, a National Health Service medic, for Al Jazeera.

“The new mutation is then likely to become the dominant strain and will find its way back to our shores, setting off a whole new set of infections in those vaccinated against only the old variants,” Khan continues. “Vaccine nationalism, therefore, is incredibly shortsighted.”

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What impact does vaccine nationalism have on issues beyond health?

A slower rollout of vaccines in lower-income countries will accompany a hit to economic prosperity and development in those countries. The pandemic has already led the World Bank to warn last October that global extreme poverty is expected to rise for the first time in 20 years. In fact, it is predicted that a further 150 million people are at risk of falling into extreme poverty — living on less than $1.90 a day — because of the COVID-19 pandemic.

This will impact the whole world, explains Harry Kretchmer, writing for the World Economic Forum.

“Continued disruption to the world economy, through battered supply chains and weaker demand will continue to weigh on all nations,” he said.

It’s the same message that has come from the leader of the OECD, Angel Gurría, who recently said that ensuring developing countries are not left behind in the vaccine rollout is the “smart thing to do.”

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“It is ethically and morally right. But it's also economically right,” he said.

He refers to estimates from the International Chamber of Commerce (ICC), which points to a $9.2 trillion hit on the global economy.

“Advanced economies are tightly connected to unvaccinated trading partners which consist of a large number of emerging markets and developing economies. Thus, the devastating economic conditions in these countries under the ongoing pandemic can cause a non-negligible drag on the advanced economies as well,” the ICC report said.

These shockwaves in the global economy, which an uneven vaccine rollout looks set to exacerbate, puts middle- and lower-income countries in a more vulnerable position to deal with future shocks like climate change, too.

“The COVID-19 crisis may trigger cycles of higher income inequality, lower social mobility among the vulnerable, and lower resilience to future shocks,” the World Bank explains.

Who is tackling the issue?

Organizations and world leaders are looking to ensure vaccine equity in an effort to mitigate the global impacts of COVID-19.

The WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance, have collaborated to create COVAX, a vaccine-sharing scheme with the aim of securing doses through its own deals with manufacturers and distributing them fairly to countries around the world.

COVAX aims to secure at least 2 billion doses by the end of 2021 and to provide doses to 92 low- and middle-income countries that would not otherwise be able to secure vaccines for their populations.

All participating countries, regardless of income levels, will have equal access to these vaccines once they are developed, funded by donations from governments, businesses, and philanthropic organizations.

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What can Global Citizens do to help?

Encouraging world leaders to act is key, as is raising awareness of international efforts, such as COVAX, to distribute vaccines equitably. 

Global Citizen has a number of actions you can take to help with this — from encouraging the new COVID-19 advisors in the US to support efforts like COVAX to calling on European leaders to share the vaccines their countries have acquired. It is possible to change the course of the pandemic and ensure a just recovery for everyone, everywhere.