How Covid’s Vaccine Apartheid Exposes Global Inequality

While Western nations plan to introduce booster vaccines, millions in the Global South are still awaiting their first shot – under capitalism, global inequality must be maintained even at the expense of public health.

Credit: skaman306 / Getty Images

Last Tuesday, Health Secretary Sajid Javid announced that Covid-19 ‘booster’ vaccines would be offered to people over the age of fifty, frontline health and care workers, and younger adults with weaker immune systems from this week. While the usefulness of administering booster shots to healthy people at present has been questioned by some studies, the move comes as the UK’s Joint Committee on Vaccination and Immunisation recommended boosters as a precautionary move based on national data suggesting that vaccine protection against severe Covid-19 waned over time in older adults.

The UK now joins a host of other rich northern nations—including the United States, Hungary, and Austria—that have vowed to add the jabs. Even Latvia, still undecided as of August as to whether it would offer additional doses, had begun purchasing more stock just in case.

It is, however, telling that the conversation around boosters is taking place in a world where the UK alone has vaccinated almost as many people as the entire continent of Africa. Eight out of ten of the more than five billion Covid-19 vaccines administered so far have gone to rich countries that bought up the bulk of doses early, leaving millions of others still awaiting their first dose eighteen months into the pandemic.

This situation is in large part due to the fact that wealthier countries, including the UK, have spent much of those eighteen months blocking patent waivers that could potentially allow more firms to produce Covid-19 vaccines and lower costs. With a limited supply worldwide, this means the distribution of jabs is still, as Canadian infectious disease experts Zain Chagla and Madhukar Pai wrote recently, a zero-sum game.

In light of this, the World Health Organisation has called for a moratorium on boosters until the end of the year. The global body’s chief of emergencies Mike Ryan has put it bluntly: ‘It’s like we’re planning to hand out extra life jackets to people who already have life jackets, while we’re leaving other people to drown without a single life jacket.’

The dash for boosters is partly driven by fear of the northern hemisphere’s approaching ‘Delta winter’ – the first season in which the highly infectious Covid-19 Delta variant will circulate alongside influenza. UK officials, wary of a ‘twindemic’ in which cases of the two overwhelm healthcare systems, have hinted at a ‘bumpy winter’. Fears of a global twindemic in 2020 did not materialise largely because the ingoing imposition of Covid-19 control measures curtailed flu cases.

South Africa and many other African countries, meanwhile, weathered their Delta winters largely unvaccinated. With late access to vaccines, South Africa has remained on some form of a Covid-19 lockdown since March 2020, which may have curbed flu cases this winter even as Covid-19 deaths soared to what may be as many as 250,000 – almost twice the UK’s reported death toll. Crematoriums surrounding the City of Cape Town continue to run around the clock, say operators who have resorted to trucking bodies to a neighbouring province to cope with the surge in deaths.

Attempts to alleviate this inequity have so far fallen flat. Life sciences firm Airfinity presented research at a recent pharmaceutical industry press conference that showed rich countries could provide boosters to their populations while leaving 1.2 billion doses this year for redistribution, but that would still cover just twenty percent of adults and children in the world’s poorest countries. The world’s best shot at equitable vaccine distribution, the WHO’s COVAX initiative, will only be able to cover roughly an equal proportion this year with free jabs without urgent action by pharmaceutical companies or rich countries.

Because pharmaceutical companies do not publicly share production information, and because their rich clients, in turn, do not make known purchasing and delivery arrangements, a question mark continues to hang over whether Global South countries are being given an equal chance to buy the limited vaccines available in the first place. In the Netherlands, contracts for Covid-19 vaccines were classified as matters of national security as of late last year. Even COVAX has now begun demanding that the public join it in calling for Covid-19 vaccine supply schedules to be made transparent so that it can ascertain whether poor countries are being given a fair shot at doses first.

‘[Covid-19 vaccine] manufacturers know very well that they never gave us proper access,’ said Strive Masiyiwa this week. Masiyiwa leads an African Union task force charged with buying vaccines for the continent and the Caribbean. ‘They had a moral responsibility to ensure that [poorer countries] also had access. This could have been done very differently, and we find this very sad.’

As I wrote in Tribune back in April, disparities in vaccine distribution are a threat to everyone, giving the virus space to mutate and increasing the risk of new, smarter variants. Ongoing vaccine inequity proves the shortcomings of an atomised approach to a huge, collective problem – only real international cooperation, with equal access for all, will bring us any closer to a post-Covid world.