‘Grotesque’. A ‘catastrophic moral failure’. ‘Hope for equality and solidarity is imploding’.
These are but some of the criticisms levelled by actors including the WHO and the UN at the ‘vaccine nationalism’ which blights the global vaccine rollout. Some Western nations are hoarding huge numbers of vaccines; in the UK and US, stores hold numbers of vaccines up to six times the size of their population. As short-term supplies are restricted in some regions by production capacity and raw materials, we are seeing a sharp move away from international solidarity with regards to the equitable distribution of the vaccines. And yet, with a long-term production capacity of more than 12bn doses by the end of this year, there should in theory be enough to go around quite comfortably if states share what they have now and allow the rollout to be truly global. So, what’s going wrong?
In short, nationalism, democratic imperatives and inequality.
More than 90% of vaccinations globally have been in High Income Countries (HICs), creating a huge supply and distribution chasm between rich and poor nations and risking an entrenchment of global inequality in both economics and healthcare. Let’s take the US as an example. They’ve ordered more than 800m shots of jabs from AstraZeneca, Johnson & Johnson, Moderna and Pfizer with the option to buy more than 1bn more; clearly more than they could ever realistically need for their own populations. Measures were taken early on to grab as much supply as they physically could, particularly given that many of the early vaccines were researched and developed in the US. In capitalising on this advantage, the US along with many others has taken the decision to prioritise domestic vaccinations over the global good. The West has helped to perpetrate an artificial scarcity. They are prioritising domestic herd immunity over the global good, risking more variants and a continued shutdown of international travel but reassuring domestic voters and allowing a sense of normalcy to return locally.
This makes innate sense in a democracy. Biden, Johnson and every other democratically elected leader are inherently beholden to public opinion and thus their imperative is to take steps to put their citizens first – think ‘America First’. This is, however, at odds with the messages of international solidarity and cooperation often championed by bodies and states such as the EU, the UK’s ‘Global Britain’ campaign, and the US under Biden who has greeted international institutions with the slogan ‘America is back’. Their decisions to hoard vaccines and largely eschew the donations and vaccine diplomacy being championed by others thus is at odds with what seemed to be major policy aims, and it’s having a wider global impact.
The main problem with this cognitive dissonance in policy is the gap in vaccinations and even shots ordered by HICs compared with total vaccination doses available for those in LICs. This difference between HICs and LICs globally is enormous and will act to entrench pre-existing socioeconomic divides both within and between states. It is not clear if policies taken by the West will in fact serve to prolong the pandemic and international restrictions; in pursuing self-interested domestic vaccination programs there is a very real risk that global trade and travel will suffer for considerably longer than if equitably distributed programmes were given priority. The OECD estimated that the global economy will be $9.2trn poorer if developing countries are not given equitable access to vaccines in line with the rate of vaccination which we are currently seeing across the US, UK and EU.
However, vaccine nationalism is multi-faceted and considerably more complex than the typical ‘west vs rest’ perspective sometimes considered the norm on matters concerning international relations and economics. In this case, producers and developers of vaccines are spread globally, with the US, UK, Sweden, India, Russia, and China amongst the nations who have pioneered their own vaccines and a greater number being used as manufacturing bases for vaccines worldwide. Some traditionally friendly states are seemingly at each other’s throats, engaging in behind-closed-door deals to secure supply from wherever they can whilst trying to maintain a public image of benevolence. Even individual EU member states, such as Hungary, have negotiated conflicting deals with Russia and China for vaccines which were arriving too slowly from the EU’s vaccine procurement scheme. For those with domestic production, we see a very different story. What these nations have done with this power, both as producers and as financiers, has varied greatly.
To understand the differing opinions, we must first discuss the varied approaches and perspectives of states globally.
Vaccine nationalism and diplomacy has played out in very different ways in different parts of the world, with very public spats between nations across the world over the production and distribution of vaccines and yet there are notable donations of vaccines occurring when politically advantageous. Whilst some state actors (mainly the EU and India) have recently resorted to explicit export bans or seizures of outbound vaccine shipments, we simultaneously see a deliberate benevolence vis-à-vis certain states by China, India, Russia and others in attempts to assert regional influence and fulfil other policy objectives. More often, policy approaches by western states are prioritising domestic vaccination programs whilst maintaining a generous and cooperative façade through token donations to developing states. It emerged that the UK secretly exported more than 700,000 vaccines to Australia to fill the gap left by EU export bans; India has donated more than 6.5m vaccines to south Asian neighbours to counter Chinese influence; and the US has made more than 4m vaccines available for shipment to Mexico and Canada, along with millions of AstaZeneca doses which are not yet approved by their Food and Drugs Agency. These shows of goodwill are playing an important part in a new arena of vaccine diplomacy which is, for the time being, dominating international relations. States are jockeying for soft-power gains, and COVID-19 vaccines are a crucial form of diplomatic currency.
Perhaps the most striking demonstrator of how vaccine donations are being used for political clout is in South America – Paraguay, one of only 15 nations which still recognises the democratic government in Taiwan, accessed Chinese Sinovac vaccines only through a donation from neighbouring Chile who had received the same vaccines direct from China. The Chinese government has been incredibly effective at rolling vaccine deals into both existing Belt and Road Initiative framework and into new deals for both trialling and production within traditional US spheres of influence. Having tied vaccine access to investment in transport infrastructure, 5G networks and renewable energy, China is advancing its traditional revisionist agenda through the new tools available to them whilst the US and western liberal bastions are increasingly aiming for domestic herd immunity with only facades of international cooperation. Thus, the Chinese state manages to look friendly, reduce challenges and investigations into the origins of the virus, and advance geostrategic aims. With disputes both globally and between Western states escalating, and with damaging rhetoric and retaliatory restrictions threatened, it is clear that previously touted liberal cooperation and coordination has largely fallen by the wayside.
So, where to next?
As detailed above, western states are slowly catching up to the game of vaccine diplomacy and may well overtake China and India in distribution as they release their stockpiles following widescale domestic vaccination. The issue is the timescale around which this will happen – whilst western states could theoretically be the largest net contributors to international vaccination programs, the immediate damage has wider implications to the Eurocentric international order as other nations gain prominence and generate goodwill.
The US, UK and EU may well end up donating more doses than any other nation in the world; but the narrative now tells a story of hoarding and self-interested policy. That’ll be a difficult label to shake off.
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