Hundreds of COVID-19 vaccine candidates are currently being developed. Many countries are securing priority access to doses of COVID-19 vaccine.

Practice question for Mains:

Q. What is Vaccine Nationalism? Discuss various ethical issues involved and its impact on vulnerable populations across the globe.

Vaccine nationalism during COVID-19

• 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 is harmful to equitable access to vaccines.

US begins to secure

• In India, the privately held Serum Institute is developing one of the leading COVID-19 vaccine candidates.
• The Serum Institute signalled that, if the development of the vaccine succeeds, most of the initial batches of the 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.
• This was a WHO moves to promote collaboration among countries in the development and distribution of COVID-19 vaccines and treatments.

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.

Issues with such nationalism

• 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.
• Vaccine nationalism also runs against the fundamental principles of vaccine development and global public health.

Why it is unethical?

• Most vaccine development projects involve several parties from multiple countries.
• 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 COVID-19 is illustrating, viruses can travel the globe.

Its impacts

• If COVID-19 vaccines are not made available affordably to those who need them, the consequences will likely be disproportionately severe for poorer or otherwise vulnerable and marginalised populations.
• Without broad access to a vaccine, these populations will likely continue to suffer more than others, leading to unnecessary disease burden, continued economic problems and potential loss of life.

Conclusion

• 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.
• Vaccines typically do not generate as much in sales as other medical products.
• If used correctly, pre-purchase agreements can even be an incentive for companies to manufacture vaccines that otherwise would not be commercialized.

Way forward

• Equity entails both, affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
• Contracts should not trump equitable access to global public health goods.
• Developed countries should pledge to refrain from reserving vaccines for their populations during public health crises.
• The WHO’s Access to COVID-19 Tools Accelerator is a starting point for countries to test collaborative approaches during the current pandemic.
• 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.

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