The Coronavirus that causes COVID-19 may be indiscriminate but vaccine distribution is not. As more people are being vaccinated against COVID-19, the issue of vaccine inequity becomes more prevalent. According to The New York Times, the vaccination rates in North America and Europe are 77 and 76 doses administered per 100 people respectively, while the rate in Africa is just 4.2 doses administered per 100 people. Not only is vaccine inequity an issue that divides the global north from the global south, it is an issue that presents itself across the lines of social class. In South Africa, the head office for Discovery Ltd. in Sandton was vaccinating 2,500 people daily, while outside Chris Hani Baragwanath Hospital in Soweto only 650 doses were being administered, according to a report by Bloomberg on 8 July 2021. The jarring difference in vaccine access among the rich and the poor has several causes—from vaccine nationality and the politics of healthcare, to the context behind vaccine hesitancy.
Countries in the global north are hoarding vaccines. “We don’t want donations… we want our place in the queue”, said Tian Johnson, head of the Africa Alliance, and a member of the South African ministerial advisory committee for COVID-19 vaccines, at a co-creative workshop on vaccine equity hosted by Women Leaders for Planetary Health. Only 0.8% of COVID-19 vaccines distributed worldwide have gone to countries in the global south, according to The New York Times, with most of 1.65 billion doses of vaccines administered having been in rich countries. In fact, a few countries led by the USA spent months blocking negotiations for an emergency waiver of World Trade Organisation intellectual property rules on COVID-19 vaccines in the interests of corporate profits and at the expense of rapid production of the vaccine. The solution is not for rich countries to give poorer countries their leftover vaccines, because the problem is not poorer countries being unable to afford vaccines. Rather, the problem is the ability of poor countries to access them. In other words, the problem is vaccine nationalism.
Vaccine nationalism occurs when governments enter into agreements with pharmaceutical manufacturers whereby their own populations are supplied with vaccines ahead of those vaccines becoming available to other countries. This has not only negatively affected developing countries, but, according to the Organisation for Economic Cooperation and Development, the global economy could lose $9.2 trillion if developing countries are excluded from the vaccine roll-out. Moreover, global cooperation is required to end a pandemic. If certain regions remain unvaccinated, the virus will continue to mutate and eventually an “escape” variant will emerge, which, according to Aljazeera, will allow the virus to evade the immune response occurring from vaccines. This variant is likely to become the dominant strain and set off a new wave of infections. It is in the best interest of everyone to take a more egalitarian approach to vaccine acquisition and distribution.
is the ability of
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Even where countries acquire doses, parts of the population are still not vaccinated, either due to people’s inability to access vaccines, or because of the systemic racism behind vaccine hesitancy. The process to register for a vaccine can only be done online or via mobile phone,
is conducted in English, and favours those with medical aid. This is a problem considering 5% of the population do not own mobile phones and a further 8% share them.
Additionally, the process being in English further excludes people, and favouring those with medical aid means favouring higher earners. In a presentation dated 21 July, the proportion of insured population that was vaccinated was 48% while the proportion of uninsured population was 26%. This is especially worrying considering that only about 17% of the population is insured. Moreover, it is not only the registration process that is problematic with regard to access. The Electronic Vaccination Data System shows that 50% of senior citizens are registered to vote, however, only 30% have been vaccinated. Strategies need to be put into place so that race, disability and class do not stand in the way of vaccination roll-outs. It is imperative that vaccines are taken to the people because not everyone can access the services. There are moves towards mobile vaccination teams which are set up in places such as churches and schools within communities in order to achieve greater vaccine equity.
Where there is vaccine hesitancy, it is a result of misinformation or uncertainty with regard to the origin and effectiveness of the vaccine. Minority communities and developing country populations tend to approach the healthcare sector with caution—rightly so, considering the history of inhumanity in that regard. Racism in health-care is not yet a thing of the past. In the US, racial minorities are more likely to die from COVID-19. According to the Centres for Disease Control and Prevention (CDC), non-Hispanic blacks make up 12% of the US population, but 34% of coronavirus deaths. This is an indicator of the barriers that racial and ethnic minorities face in their access to healthcare, as well as inequities with regards to other factors affecting health, such as wealth, working conditions, housing and education. It is these same factors that pose a barrier to vaccine access, and which pose as vaccine hesitancy. The situation is similar in African countries.
Moreover, the vaccines that many African countries possess are those that wealthier countries have not approved for their own populations—so how are Africans supposed to believe in their efficiency? Vaccine inequity is everybody’s problem. We cannot use a myopic view to address a pandemic. We need global cooperation, and we need the accountability of our leaders. We need to meet communities where they are, make vaccines accessible to all, regardless of race, age, disability or class, and we need to ensure that our citizens are well-informed about the vaccines.
Image: Masehle Mailula