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Vaccine access explained in a pandemic environment

This article has been written by Darci Horne is a negotiation consultant at The Gap Partnership.

We live in a new world, with new ways of working and living. Change has been the one constant these past eighteen months. And it continues. Both in our personal lives, as well as around us in the natural world. Change is happening there too, frighteningly fast, which the recent IPCC report on climate change made abundantly clear.

The devastating impact of the Covid-19 pandemic on the economic, social, and health status of the global population is undisputed. Experts generally agree the severity and timeline of the lingering impacts will neither directly nor imminently be mitigated unless there is a coordinated global approach to address vaccine inequity in developing economies and in the lowest income countries of the world. Without such, apart from the ongoing risk of new variants of the virus, the global economic losses will increase by trillions of dollars and the economic recovery in even the world’s wealthiest countries and largest economies will be further delayed.

How then do we agree as a global community on a coordinated approach when we represent such diverse populations, cultural norms, government structures, and vastly disparate economic circumstances?

The answer may be more complicated than it seems on the surface.

We are reminded often in daily life that the world is not fair. Individually we experience “fair” and “unfair” in unique and myriad ways. Lest we forget, fairness is subjective. The definition of “fair” or “unfair” is influenced by and built upon one’s personal perspectives, experiences, biases, beliefs, and values. Therefore, what I consider fair likely differs from what someone else considers fair when each of us looks at the same situation through our distinct lenses.

So then, whose definition of fair do we use when considering access to Covid-19 vaccines – who gets it, when do they get it, and at what price? Do we apply principles where fair means equal? Do we define fair relative to economic or value contribution? Or is fair based on need?

It depends on the context and perspective of the one answering the question.

Wealthy countries felt the devastating effects of the pandemic first, with high rates of infection and death, and broad-reaching economic impacts of lockdowns and quarantine. These countries jumped into action without regard to cost to fund the scientific and medical research innovation to quickly develop novel vaccines. Pharmaceutical companies and drug manufacturers assumed inordinate financial risk as they pushed to expedite development, testing, clinical trials, and preparation of facilities able to mass-produce vaccines.

As health and socioeconomic impacts of the pandemic spread across the world, the race to develop effective vaccines led to unexpected challenges, setbacks, and delays – limited availability of raw materials, vaccine transport and storage logistics, and insufficient global production capacity to name a few. The countries largely responsible for the promising vaccine development initiatives felt increasing pressure to secure access to sufficient doses to inoculate their full population as soon as possible, and they were able to do just that.

Restricted by tight healthcare budgets, lower income countries and developing nations are unable to respond to the pressures on the economy and healthcare system in the same way. Their annual per capita budget for healthcare will struggle to absorb the added cost of Covid-19 vaccines. Given they are almost solely dependent on imports for vaccines and have little to no production capacity locally or regionally, trade restrictions further exacerbate inaccessibility to vaccines. For these countries, their options are limited even as the societal and economic implications loom large.

The global community will continue to bear the burden of Covid-19 and its impacts for years to come. But the burdens will be different, their weight will be different, and the approach to managing them will be different. Some will decide whether to reallocate funds for standard clinical services or established immunization programs to bring Covid-19 vaccines to vulnerable populations. Some will donate millions of vaccine doses to protect vulnerable populations. Some will make massive investments to boost vaccine production and accelerate availability in areas with low immunization rates. Some will continue to adjust to the personal and professional changes the pandemic brought while awaiting vaccine booster shots.

And the question of whether access to Covid-19 vaccines has been “fair” or “unfair” will be answered in countless different ways as it is filtered through the unique lens of personal experiences, perspectives, beliefs, and values.

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