- What is Vaccine nationalism?
- Vaccine nationalism during COVID-19
- Is Vaccine nationalism new?
- The problems posed by nationalism
- What needs to be done?
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Hundreds of COVID-19 vaccine candidates are currently being developed. The way emerging vaccines will be distributed to those who need them is not yet clear. The United States has now twice indicated that it would like to secure priority access to doses of COVID-19 vaccine. Countries including India and Russia, have taken similar stances. This prioritization of domestic markets has become known as vaccine nationalism.
What is Vaccine nationalism?
- Vaccine nationalism occurs when a country manages to secure doses of vaccine for its own citizens or residents before they are made available in other countries.
- This is done through pre-purchase agreements between a government and a vaccine manufacturer.
Vaccine nationalism during COVID-19:
- In March, the White House met with representatives from CureVac, a German biotech company developing a COVID-19 vaccine. The US government is reported to have inquired about the possibility of securing exclusive rights over the vaccine.
- This prompted criticism from German government and an official statement that a vaccine developed in Germany had to be made available in Germany and the world.
- On June 15, the German government announced it would be investing 300 million euros (nearly $340 million) in CureVac for a 23 per cent stake in the company.
- In India, the privately held Serum Institute is developing one of the leading COVID-19 vaccine candidates. The Serum Institute signaled that, if development of the vaccine succeeds, most of the initial batches of vaccine will be distributed within India.
- At the same time, India, alongside the US and Russia, chose not to join the Access to COVID-19 Tools Accelerator, which was launched by the World Health Organization to promote collaboration among countries in the development and distribution of COVID-19 vaccines and treatments.
Is Vaccine nationalism new?
- Vaccine nationalism is not new. During the early stages of the 2009 H1N1 flu pandemic, some of the wealthiest countries entered into pre-purchase agreements with several pharmaceutical companies working on H1N1 vaccines.
- At that time, it was estimated that, in the best-case scenario, the maximum number of vaccine doses that could be produced globally was two billion.
- The US alone negotiated and obtained the right to buy 600,000 doses. All the countries that negotiated pre-purchase orders were developed economies.
- Only when the 2009 pandemic began to unwind and demand for a vaccine dropped did developed countries offer to donate vaccine doses to poorer economies.
The problems posed by nationalism:
1. Unethical practice:
- Vaccine nationalism also runs against the fundamental principles of vaccine development and global public health.
2. Rise in prices:
- It will lead to hike in the price of drugs.
- Does any government deserve to obtain exclusive rights for a vaccine that may be priced too high?
- Such a price may mean that fewer citizens and residents especially those who are uninsured or underinsured would have access to the vaccine.
- This phenomenon is a form of what economists call deadweight loss, as populations in need of a welfare-enhancing product are priced out which will cost lives.
3. Deprives Poor countries:
- The most immediate effect of vaccine nationalism is that it further disadvantages countries with fewer resources and bargaining power.
- It deprives populations in the Global South from timely access to vital public health goods.
- Taken to its extreme, it allocates vaccines to moderately at-risk populations in wealthy countries over populations at higher risk in developing economies.
- COVID-19 has already taken a higher toll on black and Latino populations.
- These populations will likely continue to suffer more than others, leading to unnecessary disease burden, continued economic problems and potential loss of life.
4. Hamper Vaccine Development:
- The private sector is willing to invest in vaccine development and manufacturing, but if the US sets prices, companies may not make that investment because the vaccines won’t be profitable.
What needs to be done?
- Vaccine nationalism is at odds with global public health principles. Yet, there are no provisions in international laws that prevent pre-purchase agreements like the ones described above.
- There is nothing inherently wrong with pre-purchase agreements of pharmaceutical products. If used correctly, pre-purchase agreements can even be an incentive for companies to manufacture vaccines that otherwise would not be commercialised.
- Institutions like Gavi, an international nonprofit based in Geneva, use similar mechanisms to guarantee vaccines for developing countries.
- But largely vaccine nationalism is a misuse of these agreements.
- The developed countries should pledge to refrain from reserving vaccines for their populations during public health crises.
- International institutions including the WHO should coordinate negotiations ahead of the next pandemic to produce a framework for equitable access to vaccines during public health crises.
- Equity entails both, affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
Vaccine nationalism is harmful for equitable access to vaccines. With modern vaccines, there are very few instances in which a single country can claim to be the sole developer of a vaccine. And even if that were possible, global public health is borderless as pathogens can travel the globe. Public health responses to outbreaks, which include the deployment of vaccines, have to acknowledge the reality and be responsible in their actions. If COVID-19 vaccines are not made available affordably to those who need them, the consequences will likely be severe for poorer or vulnerable and marginalised populations.