No State Left Behind: The Necessity of Prioritizing Low-Income Countries in COVID-19 Recovery

 

 

 

 

 

 

 

 

 

 

No State Left Behind:

The Necessity of Prioritizing Low-Income Countries in COVID-19 Recovery

 

 

 

 

 

 

 

 

Dayna Wilson – 300113188

8 December, 2021

Introduction to World Politics POLI 1103 – 050

Douglas College

Dr. Stewart Prest

Word Count: 1140

 

 

 

When the first COVID-19 vaccines became available in December of 2020, many breathed a sigh of relief. While there was no doubt that the pandemic and resulting economic strife were far from over, the development of a vaccine was seen as a concrete first step towards recovery from the virus that had been afflicting the globe since March of that year. And indeed, another year on, much is returning to some version of normal for the wealthier countries fortunate enough to have had unfettered access to vaccines. Those living in low-income countries have not been so lucky, however, with only 5.8% of individuals having received a first dose of a vaccine compared to the global average of 54.2% (Our World in Data 2021). While examples of such inequity in access to care are by no means a new phenomenon, COVID-19 has served to shine a light on the problematic nature of the global approach to lower income countries in times of crisis. Though wealthier states have been quick to pledge assistance to those in need, particularly through the development of the COVAX project designed to address logistics and infrastructure in vaccine access, concrete action has fallen far short of that necessary to adequately address the disproportionate impact of the virus felt by those in low-income states. Given the interconnectedness of the modern world resulting from globalization, successful global recovery from COVID-19 is dependant upon addressing these inequities exposed by the pandemic response.

              One of many by-products of the pandemic has been increasing demonstrations of nationalism, particularly among wealthy states such as the United States and facilitated by leaders such as former President Donald Trump. States quickly rushed to close their borders in attempts to safeguard their own populations, and supply chain disruptions led to hoarding of personal protective equipment and therapeutic treatments. In one particularly notable example, when Trump hailed the merits of malarial drug hydroxychloroquine (HCG) for treatment of Covid, sales of the drug soared and supplies dwindled; despite there being an empirical lack of evidence of any actual efficacy of its use (Singh et al. 2021). Meanwhile, the shortage of HCG meant reduced treatment options for malaria in Sub-Saharan Africa, and The World Health Organization (WHO) has reported that as many as 769,000 people will die from malaria as a result, at a rate more than double the standard (Nhamo et al. 2020). This strategy of overconsumption was mirrored in the US purchasing the entirety of the global stock of Remdesivir, a drug actually shown to reduce mortality from Covid (Khamsi 2020).

              This hoarding of medical resources reached a head upon the successful development of vaccines, with wealthy states quickly entering advance purchase arrangements with vaccine developers. COVAX was ideated with a goal of ensuring equal access to vaccines for all participating countries, obtaining doses through investment in companies with promising results. Ideally, wealthy, or “self-financing countries” purchase reduced price vaccines through COVAX, while allowing for nearly 100 unfunded low-income countries to receive jabs at no cost (Gleeson 2021). Countries with the resources to do so, however, were able to undermine the COVAX arrangement and secure doses directly from manufacturers, leaving the COVAX fund direly undersupplied. By the end of November 2021, COVAX had administered fewer than 576 million doses, falling far short of an initial goal of 2 billion by the end of the year (Gleeson 2021). This has resulted in a wide gap in vaccination rates between the wealthiest and poorest countries. It is particularly concerning given the fact that many of the wealthier countries with higher vaccine rates are now introducing third booster shots, a fact which is difficult to justify considering the deep inequities in vaccine rollout.

              Secondary to the medical nationalism interfering with vaccine supply are the logistical concerns involved in developing vaccine programs in states that, in many cases, lack the widespread infrastructure required for the development and transport of doses. This is compounded by the fact that COVID-19 vaccines must be kept at low temperatures. It has been reported that “…barriers include too few fridges, inadequate ice packs and vaccine carriers, and unreliable power supply… [as well as] a shortage of trained biomedical engineers” (Taghoe et al. 2021). In order to invest in solutions for overcoming these challenges, low-income countries need to have the economic ability to do so. Economic relief efforts and sustainable debt restructuring will likely be integral to allowing for such investments to be made, so as to see the success of any widespread vaccination efforts.

              One notable logistic concern of vaccine production and accessibility that bears consideration is the unwillingness of manufacturers to share patents and allow for states to develop domestic in-house vaccine production. While increased ability to produce jabs has the potential to mitigate vaccine scarcity, a lack of information sharing has resulted in limited production capabilities. It has been argued that quarrels over vaccine patents in the face of a global pandemic are inherently unethical, and that succinctly speaking “the human race doesn’t have time for this nonsense” (Salzberg 2021). The prioritization of intellectual property and accrual of wealth over the lives of millions of human beings, while perhaps unsurprising in a world dominated by late-stage capitalism, is unconscionable. A vaccine waiver, which would allow countries to circumvent patents in developing COVID-19 vaccines, has gained a modicum of support from countries including the U.S. It remains, however, that a number of wealthy countries are blocking such a waiver, leading to a multi-organization complaint to the UN that by doing so “are prolonging the pandemic and perpetuating structural racial discrimination[.]”

              The realist approach to managing the pandemic, with a focus on individual state security, has resulted in tentative recovery for high income countries. With large percentages of populations fully vaccinated, many might believe that the end of COVID times draws near. However, full recovery seems unlikely to be obtained when low-income countries are left behind. Inequitable vaccine access results in an inability to meet the population immunity threshold (herd immunity), which has been estimated at approximately 94% (Mayo Clinic 2021). The longer COVID continues to thrive in lower-income countries, the more opportunity arises for mutations to develop and spread, as has been seen with the Alpha, Delta, and now Omicron variants of the original strain of SARS-CoV-2. Each variant carries with it new challenges and unknown factors relating to virality and mortality (McNeill 2021), thus extending the campaign against the virus.

              The pandemic is not yet over. And it won’t be over until the wealthy countries of the world stage make the active choice to invest in recovery for those states that need the assistance. Displays of nationalist self interest and the prioritization of relative gains need to end in favour of global cooperation and a focus on ensuring equitable recovery for all states, regardless of capital. Only then will we be able to realize a total recovery from the COVID-19 crisis.              

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Gleeson, Deborah. 2021. “The Best Hope for Fairly Distributing COVID-19 Vaccines Globally is at Risk of

Failing. Here’s How to Save It.” The Conversation, 12 April, 2021. https://theconversation.com/the-best-hope-for-fairly-distributing-covid-19-vaccines-globally-is-at-risk-of-failing-heres-how-to-save-it-158779

Khamsi, Roxanne. 2020. “If Coronavirus Vaccine Arrives, Can the World Make Enough?” Nature, 9 April,

2020. https://www.nature.com/articles/d41586-020-01063-8

Maxmen, Amy. 2021. “The Fight to Manufacture COVID Vaccines in Lower-Income Countries.” Nature,

September 15, 2021. https://www.nature.com/articles/d41586-021-02383-z

Mayo Clinic. 2021. “Herd Immunity and COVID-19 (Coronavirus): What You Need to Know.” Accessed 8

December, 2021. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunity-and-coronavirus/art-20486808

McNeil, Taylor. 2021. “How Viruses Mutate and Create New Variants.” TuftsNow, June 9, 2021.

https://now.tufts.edu/articles/how-viruses-mutate-and-create-new-variants

Mesa-Vieira, Cristina, Felipe Botero-Rodriguez, Andrea Padilla-Munoz, Oscar H. Franco, and Carlos

Gomez-Restrepo. 2021. “The Dark Side of the Moon: Global Challenges in the Distribution of Vaccines and Implementation of Vaccination Plans Against COVID-19.” Maturitas 149 (July 2021): 37-39. https://doi.org/10.1016/j.maturitas.2021.05.003

Nhamo, Godwell, David Chikodzi, Hlengiwe Precious Kunene, and Nthivhiseni Mashula. 2020. “COVID-19

Vaccines and Treatments Nationalism: Challenges for Low-Income Countries and the Attainment of the SDGs.” Global Public Health 16 (3): 319-339. https://doi.org/10.1080/17441692.2020.1860249.

Our World in Data. 2021. “Coronavirus (COVID-19) Vaccinations.” Accessed 8 December, 2021.

https://ourworldindata.org/covid-vaccinations

Salzberg, Steven. 2021. “Patenting the Covid-19 Vaccine is Unethical.” Forbes, 23 May 2021.

https://www.forbes.com/sites/stevensalzberg/2021/05/23/patenting-the-covid-19-vaccine-is-wrong/?sh=db27dcf32f55

Singh, Bhagteshwar, Hannah Ryan, Tamara Kredo, Marty Chaplin, and Tom Fletcher. 2021. “Chloroquine

or Hydroxychloroquine for Prevention and Treatment of COVID-19.” Cochrane Database of Systematic Reviews 2021 (2). https://doi.org/10.1002/14651858.CD013587.pub2

Singh, Jerome Amir. 2021. “Why the Global South is Integral to the Development of Next-Generation

COVID-19 Vaccines and Antibody Therapeutics.” University of Toronto Medical Journal 98, no. 3 (June): 12-16. https://utmj.org/index.php/UTMJ/article/view/1508/1322

Stein, Felix. 2021. “Risky Business: COVID and the Financialization of Global Vaccine Equity.”

Globalization & Health 17 (1): 1-11. https://doi.org/10.1186/s12992-021-00763-8

Tagoe, Eunice Twumwaa, Nurnabi Sheikh, Alec Morton, Justice Nonvignon, Abdur Razzaque Sarker, Lynn

Williams, and Itamar Megiddo. 2021. “COVID-19 Vaccination in Lower-Middle Income Countries: National Stakeholder Views on Challenges, Barriers, and Potential Solutions.” Frontiers in Public Health 6 August 2021. https://doi.org/10.3389/fpubh.2021.709127.

World Health Organization. 2021. “Covax.” Accessed October 27, 2021.

https://www.who.int/initiatives/act-accelerator/covax

 

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