Vaccine nationalism was always going to win

How many complete strangers getting vaccinated would it take for you to give up your own dose? A tweet to that effect (which I cannot for the life of me find again) forced me to do the math on my empathy. We’d all give up our chance at a Covid-19 vaccine for our own mother. Most of us can rationalize waiting in line behind more vulnerable people in our community. But would you pass your turn for an octogenarian you’ve never met in a country you’ve never seen? A couple nurses? A whole retirement home?

For national leaders, the math is easy. Their duty is with their own population, and their interest with their voters. Vaccine nationalism is winning. If we’re honest, it never had to put up much of a fight.

Half the Covid-19 vaccine doses administered so far have been so in high-income countries. Four out of five are purchased outside COVAX, the UN-backed attempt at an equitable global procurement system. Richer nations flexed their wallet and access to secure in bilateral deals more jabs than they could ever need. COVAX has distributed 45 million doses between 120 countries – as many as the UK alone has already given its population. At last count, nineteen countries, mostly in Africa, hadn’t yet seen a single dose.

The US have been perhaps the most brazen. America First policies bear Donald Trump’s signature, but Joe Biden has been in no rush to reverse them. The US has only this weekend, after global outrage, agreed to lift an export ban on vaccine raw materials. The Serum Institute of India, the world’s largest manufacturer, had been raising the alarm for weeks. The US is also slowly loosening its grip on a stockpile of tens of millions of AstraZeneca doses, which have not been approved for use in the country and likely won’t be needed by the time they are. I don’t think it’s morals or peer pressure swaying the White House. Rather, enough Americans have now been immunized and it can afford to appear magnanimous. (Note: the podcast was recorded before these announcements.)

The UK has been similarly protectionist, ensuring it would be supplied first through clever contracts. For Boris Johnson, rapid vaccination was the only way to politically survive his lethal incompetence in 2020. Britain has chased suppliers in India to ensure its program continues, but refuses to say how many vaccines it has agreed to export. None, most likely.  The European Union has, perhaps naively, put more faith in the free market. Its battle with AstraZeneca and Westminster though has made me squirm in my seat at the tone-deafness of it all. EU nations have some of the world’s highest vaccination rates. That’s not enough. To Europeans, good healthcare – or at least better healthcare than these other guys – is a matter of pride. It’s why we pay high taxes and look down on Americans. Vaccination campaigns are scrutinized like an Olympic medal leaderboard.

So the same politicians who told us not to hoard toilet paper are stockpiling the world’s most valuable good. We their citizens outwardly deplore it while being secretly grateful to be at least one step removed from that selfish choice. We still get our jab.

The moral argument never stood a chance. We’re left with the utilitarian one. None of us is safe until we’re all safe. While SARS-CoV2 replicates uncontrolled in India or Brazil, new variants will emerge that might prove more contagious, deadlier or worse, vaccine-resistant. Trade and travel will remain hampered and economic recovery slowed. Persistent anxiety will carry an incalculable mental health cost. Vaccine inequity will stoke resentment in the global South, feed conflicts and displace populations. A pandemic that stretches out for years will eclipse other urgent concerns, such as global warming.

We have every reason to address vaccine nationalism quickly, and every reason to believe we won’t. The climate emergency taught us that. I’m left hoping rich countries  finish their vaccination drive quickly and put the same energy into helping the rest of the world with theirs. I know: I’m an optimist.

On the pod

This week on the podcast, I interviewed Tania Cernuschi, team lead for global access in the vaccine department at the World Health Organization. We talked about vaccine equity and how to not screw it up next time. Have a listen or read the full transcript.

Listen to the episode

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