An equitable vaccine rollout must prioritize the most vulnerable around the world

Turkish health workers and officials have complained that Sinovac has been slow to deliver promised doses, hampering Turkey's response to the pandemic. (Kareem Fahim/The Washington Post)
Turkish health workers and officials have complained that Sinovac has been slow to deliver promised doses, hampering Turkey's response to the pandemic. (Kareem Fahim/The Washington Post)

Many Americans are breathing a sigh of relief. Across the United States, the vaccine rollout is gaining speed. By May 1, every U.S. adult will be eligible for inoculation.

But eligibility is far from equity — and around the world, the pandemic is far from over. Already, vast disparities are emerging in vaccine access — both within countries and between them — especially for Afro-descendant and Indigenous communities.

Within countries, the gaps are stark. In the United States, for example, White people remained nearly two times more likely to be vaccinated than their neighbors of color at the end of March. In Brazil, Indigenous populations are 10 times more likely to die of covid-19 than the general population, even as wealthy Brazilians travel abroad to secure shots. And in India, many members of poor Muslim and Dalit communities are denied access to the limited vaccine supply that is available.

These blatant inequities also are apparent in the disparities between countries. Wealthy nations such as Canada and the United Kingdom have preordered enough supply to vaccinate their entire populations six and four times over, respectively. In fact, the world’s richest countries controlled more than 80 percent of the world’s covid-19 vaccines as of last week. Meanwhile, low-income countries can access only one-tenth of 1 percent.

All told, nearly 600 million doses have been administered thus far — which is good, but not good enough. With only 4 percent of the world’s 7.8 billion people vaccinated, we still have a long way to go.

The reasons for the gap are clear: Rich nations are hoarding the vaccines. Whether it’s the European Union blockading international vaccine exports entirely, or the United States stockpiling 30 million AstraZeneca doses, a wave of vaccine nationalism is depriving the world of much-needed supply.

Vaccine nationalism is not without consequences. It delays our global recovery even further. Indeed, until we are all vaccinated, we are all vulnerable.

And many people — especially those working on the front lines of the fight for equity around the globe, including many NGO partners of the Ford Foundation — are needlessly dying. At last count, at least a dozen of our courageous grantee colleagues have succumbed to the virus. This is a heartbreaking loss of life and an incalculable loss of leadership.

In other words, our vaccination regimen has become the latest harrowing outcome, and potential accelerator, of vast, underlying global inequalities.

To address these disparities, three immediate steps come to mind:

First, the United States could dip into its vast reserves and vaccinate the world — mobilizing the resources of the U.S. military and other agencies to manufacture, ship and distribute doses around the world, perhaps in the style of former president George W. Bush’s Emergency Plan for AIDS Relief. To paraphrase the Rev. Martin Luther King Jr., vaccine inequality anywhere is a threat to global health everywhere.

At the same time, the European Union, United Kingdom and United States could waive patent protections and allow more countries to manufacture and distribute vaccines themselves. Officials from India and South Africa already have drafted a World Trade Organization proposal temporarily lifting patent protections on covid-19 vaccines — and 57 member states have joined them as co-sponsors. A temporary patent moratorium would reset and realign the tattered relationship between democratic values and capitalism.

Finally, we must strengthen multilateral initiatives and create more robust, resilient health systems, for this pandemic and the next. Here, concerned philanthropists can follow the lead of pioneers such as Bill and Melinda Gates. Their foundation’s support and advocacy for Covax — a vaccination partnership among nonprofits, governments and the World Health Organization — has pushed global institutions away from vaccine nationalism and toward vaccine equity. Covax already has played a crucial role in allocating a projected 2 billion doses to low-income countries.

We must center the peoples and communities that continue to suffer the highest death tolls around the world. An equitable vaccine rollout must prioritize and protect the most vulnerable in our societies — from the Dalit community in India, to Indigenous populations in Brazil, to essential farm workers and grocery store clerks throughout the United States.

Vaccine inequality is not only a crisis to solve, but an opportunity for individuals, institutions and industries to build back our health systems, economies, and democracies better than before.

Darren Walker is president of the Ford Foundation.

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