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The Global Cost of Vaccine Inequity


Commentary16th November 2021

If you’re reading this in the UK, chances are you’ve been vaccinated against Covid-19 twice. You might even have a date for a booster. If you’re reading it in Africa, or one of the other parts of the world where vaccines are scarce and the capacity to get them into arms is low, you’re almost certainly unvaccinated.

High- and upper-middle-income countries account for 75 per cent of the more than 6.9 billion doses administered worldwide, whereas low-income countries make up just 0.4 per cent of this total. Europe, with just over half the population of Africa, has administered nearly five times as many vaccines. Many high-income countries claim enough supply for more than three times their population.

This disparity has generated accusations of “vaccine apartheid” among some African leaders and calls for richer countries to release their surpluses. But as wealthy nations increasingly opt for booster shots, expand eligibility to children over four and worry about variants, they continue to stockpile well above population or uptake levels.

The World Health Organisation’s targets of fully vaccinating 40 per cent of each country’s population by year-end and 70 per cent by mid-2022 are vital to preventing new variants and ending the pandemic for all. Yet Africa is alarmingly behind schedule in achieving these goals. Just 5.6 per cent of the continent is fully vaccinated, the lowest regional coverage in the world. Africa is on track to be left behind.

The Economist Intelligence Unit predicts that countries without at least 60 per cent vaccination coverage by mid-2022 will suffer $2.3 trillion in output losses by 2025. As a share of GDP, sub-Saharan Africa will have the highest losses of any region. Many African countries will be forced to cut back on critical development expenditures to continue responding to the pandemic while avoiding defaulting on loans. There is a real possibility that Africa could fall into a cycle of declining productivity and slow growth, resulting in a lost decade or more of progress and a rise in extreme poverty.

This is in addition to the health impact. Recurring outbreaks of Covid-19 in Africa will continue to strain health systems. Ongoing disruptions to essential health services, such as routine childhood immunisations and HIV treatment, could lead to a resurgence of diseases the world has invested decades into trying to eradicate.

High- and middle-income countries with ample access to vaccines and significant fiscal buffers are expected to recover relatively quickly and return to pre-pandemic normalcy in 2022. However, without widespread vaccination coverage, Africa faces a protracted pandemic and sluggish growth.

But this widening of the global wealth gap isn’t just a problem for poorer parts of the world, like Africa, who are on the wrong side of what threatens to become a “Great Divide” between the vaccine “haves” and “have-nots”. It’s also a problem for vaccine-rich countries like the UK and the US.

The global health implications are clear – the longer Africa remains unvaccinated, the more opportunity the virus has to spread and mutate. Delta’s impact on vaccine efficacy represents the risk that variants pose to global vaccination efforts. Every new Covid-19 infection is a potential threat to global recovery.

But the security implications are equally alarming. In countries where there is already a complicated security environment, rising poverty and food insecurity elevate the risk of instability. The global community should prepare to deal with new or worsened humanitarian crises in Africa and the political complexities surrounding intervention.

A study by the UN Counter-Terrorism Committee finds that pandemic-related economic and social hardships, such as rising unemployment and children being out of school, are potential drivers for an increased terrorist threat. Some terrorist networks in Africa are already exploiting the crisis to expand recruitment and radicalisation. This exacerbates local governance challenges as well as global security issues.

Declining living standards, limited government support and intensifying security concerns could trigger internal and transnational population movements. Migration, including from Africa, is a divisive topic in UK and European politics, and has contributed to the rise in popularity of nationalist political narratives.

These ripple effects will impact the global economy, as uncertainty diminishes confidence and holds back investment. It is possible that the Great Divide reduces the world’s capacity to address other existential issues, such as climate change and the next pandemic. The Great Divide will have dangerous global repercussions.

But it’s not too late to change course. That starts with equitable vaccine access. Countries must urgently fulfil their commitment to sharing excess doses and step aside in the supply queue so that poorer countries relying on COVAX – the global mechanism meant to ensure equitable vaccine distribution – can be prioritised. Travel restrictions not based on sound science need to be lifted. Leaders will always want to do what they can to protect their own people in the short term, but they must have regard for the longer-term costs of global vaccine inequity, including for their populations.

The G7 and the G20 should endorse a comprehensive financial assistance package for Africa and allow governments to decide how this money is best deployed. This includes funding for rollout campaigns to ensure vaccines make it into arms.

High-income countries must support efforts to develop local vaccine manufacturing, which will improve Africa’s long-term health system resilience. Waiving temporary intellectual-property rights on vaccines will accelerate the scaling-up of local production.  

In the short term, the Great Divide is Africa’s problem, but it will have long-term global consequences. It is in the interest of the global community to prevent a Great Divide.

Lead Image: Getty Images

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