It is hard to overstate the massive impact of the coronavirus pandemic. Everyone around the world has been profoundly affected. Hundreds of thousands of people have lost their lives, and countless more have been left with life-long, debilitating physical and psychological consequences.
The economic toll of the pandemic has been equally tragic with the potential to push 71 million people into extreme poverty, according to the World Bank. The global economy has been brought to its knees, and the impact of COVID-19 in terms of jobs lost and poverty created will likely be felt for years to come.
Against this backdrop, the attention that is going toward vaccine research and development is understandable. Equally understandable is the instinct of governments to push themselves to the front of the queue and ensure that they can obtain as many doses as possible for their own citizens. After all: The responsibility of a government is toward its own people.
This instinct is understandable, but it is also profoundly short-sighted.
The reality is that to end the acute phase of the pandemic, the vaccine must be available everywhere it is needed — not only where it can be afforded.
If wealthy nations insist on a “vaccine nationalism” approach, then many other countries — maybe even most other countries — will not be able to access them, both because of exclusive deals between wealthy countries and pharmaceutical companies and the inevitable lag in manufacturing enough doses. This means that people in the countries with the weakest health systems, where COVID-19 is already exacting a devastating toll, will not be vaccinated, and the pandemic will endure.
However, the inherent inequity of this approach is not the only problem. Such an approach also simply will not work. With each country acting completely on its own, the tendency is to bid up the price of promising vaccines and to take a massive gamble in choosing among the many possible candidates.
Even if they are lucky enough to choose a candidate that works, countries that have initial access will not be able to vaccinate their whole populations — in particular those who are immunocompromised — and they will later be at risk for subsequent waves of the disease as it rages unchecked in other parts of the world.
In such a scenario, many of the crippling economic and travel restrictions that we all desperately want to see lifted would have to remain in place. Global trade, tourism, and many other industries would continue to suffer, with many countries keeping their borders closed or remaining unsafe to visit.
The answer, we believe, is to work together. That is why the International Federation of Red Cross and Red Crescent Societies is adding its voice to calls for all governments to support the COVAX Facility, an initiative co-led by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and World Health Organization.
This facility seeks to aggregate the purchase and equitable distribution of an eventual COVID-19 vaccine. By pooling resources, it will spread the portfolio of candidate vaccines for all countries that sign up and consolidate contracting for manufacturing and distribution, avoiding a bidding war.
It would guarantee all members the ability to purchase doses for at least 20% of their population on an equal basis and will also make it easy for wealthier countries to support those nations that would otherwise be left out.
It represents a win-win for all countries, including those with the most resources. It will save them money, increase the likelihood that they back a viable vaccine, and ensure that their vaccination campaigns are not undermined by unvaccinated neighbors.
This call for equitable access goes beyond equity between countries. It is also about equity within countries. We hope that, once available, vaccines are given first to those who need them the most. This means that frontline and community health workers should be prioritized, as should highly vulnerable groups, such as the elderly and people with chronic and severe health issues. Once again: The vaccine must go to where it is needed, not just to where it can be afforded.
I realize that this plea for multilateralism is perhaps inconsistent with the direction that global politics seems to be taking. But the message that I hope governments take away is that working in solidarity is not only our moral imperative, but it also makes the most sense from a public health perspective.
The reality is that none of us are safe, until all of us are safe.