Vaccine Inequality


Mwandida Nkhoma, Nurse Lead and Research Manager (Palliative Care Support Trust, Malawi) writes about vaccine inequality and its threat to a global coronavirus recovery.

“The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”

This was the stark analysis of Dr Tedros Adhanom Ghebreyesus, WHO Director-General, earlier this year. Some progress is being made to overcome vaccine inequality but much more needs to be done if this pandemic is to end globally.


EMMS International’s mission follows the example of Jesus Christ to bring health and hope through compassionate healthcare. Our Christian identity compels us to call for a more equitable distribution of the global vaccine resource.


At present, on a global scale, vaccine strategies do not prioritise the most vulnerable and do not adequately protect the world’s frontline healthcare workers.

We need an approach that sees beyond borders and shows that we truly love our neighbours.

“But when you give a banquet, invite the poor, the crippled the lame, the blind and you will be blessed. Although they cannot repay you...” Luke 14:13-14.

If ever there was a ‘banquet’ that we should share more fairly, this is it.


The present COVID-19 vaccine challenge

The race to produce a viable COVID-19 vaccination has been an example of global cooperation. Funding, knowledge and manufacturing advances have been shared across borders. The world has found a global solution to a global problem. But if that cooperation does not continue in the vaccine distribution then we have surely still fallen short.


Reaching the current rate of vaccine production hasn’t been without its challenges. We have seen the knock-on effects of production delays. But the impact for most of us is inconsequential; our vaccinations are delayed by days or weeks, no more.


However, estimates suggest that 85 countries (including Malawi and Nepal) won’t have wide vaccination availability until 2023. This is a result of limited vaccine supplies, but also local healthcare infrastructure and population sizes.

Global cooperation is already making an impact on distribution. India has shared some of its own home-produced vaccines with Nepal and Malawi, among others.


The UK and other governments have contributed to the COVAX programme, to ensure all countries have access to vaccines.


However, while the UK aims to vaccinate its adult population by July, countries which have signed up for assistance from COVAX, including Malawi, anticipate reaching only 3% of populations in the same time frame. So far, COVAX can only guarantee vaccines for 20% of enrolled countries’ populations by the end of the year, with countries relying on ad hoc donations and meeting high purchase costs if they are to attain widespread coverage.


Beyond the moral argument

The moral case for vaccine equity should be strong enough. However, even if it weren’t, there are growing warnings from the scientific community that vaccine hoarding could prolong the pandemic and deepen its financial impact on wealthy and resource-poor countries alike.


While the virus continues to spread unchecked in under-vaccinated populations, new variants are a continued risk. New variants which might be resistant to existing vaccinations could stall the global response to the virus - not just in under-vaccinated populations.


There is also an economic cost to vaccine inequality. Even if wealthy countries are fully vaccinated

this year, the supply chains that fuel their economies extend into countries which are being shut out of the vaccine roll-out.


Economists estimate a hit to the global economy of between $1.8 and $3.8 billion even if half the populations of resource-poor countries are vaccinated. The majority of this bill would be footed by wealthy countries, while at the same time the burden of poverty mounts upon resource-poor countries.


The way forward for vaccine sharing

So what do we do now? It might seem that these decisions and their impact are outside our influence but they are not. Together, we can:

  • Engage our political leaders and encourage them to take an equitable approach to sharing vaccinations.

  • Continue to support frontline healthcare workers responding to the pandemic by prioritising them for vaccination.

  • Support vital work to address other ongoing healthcare challenges in resource-poor countries.

  • Pray for those responding to the pandemic around the world, from frontline healthcare workers to political decision-makers.