Vaccine Nationalism

Recently, the World Health Organization (WHO) has warned against “vaccine nationalism”, cautioning richer countries that if they keep treatments to themselves they cannot expect to remain safe if poor nations remain exposed.
It is being feared that such advance agreements will make the initial few vaccines unaffordable and inaccessible to everyone apart from the rich countries in a world of roughly 8 billion people.

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.
For example, the United States, the United Kingdom, Japan, and the European Union have spent tens of billions of dollars on deals with vaccine frontrunners such as Pfizer Inc, Johnson & Johnson and AstraZeneca Plc even before their effectiveness is proven.
If seen country wise, the US has already agreed to buy some 800 million doses from six drug makers, and the UK 280 million from five.

H1N1 Flu Pandemic

The present race to hoard Covid-19 vaccines harks back to a similar situation that happened in 2009 during the H1N1 flu pandemic.
Australia, the first country to come up with a vaccine, blocked exports while some of the wealthiest countries entered into pre-purchase agreements with several pharmaceutical companies. The US alone obtained the right to buy 600,000 doses.
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.

Laws to prevent Vaccine Nationalism

Interestingly, even though vaccine nationalism runs against global public health principles, there are no provisions in international laws that prevent pre-purchase agreements.

Problems Posed by Vaccine Nationalism

Poor Countries are Hard Hit:The most immediate effect of vaccine nationalism is that it further disadvantages countries with fewer resources and bargaining power.
Non-access to Health Goods:It deprives populations from timely access to vital public health goods.
Prioritizing Wealthy Countries: Taken to its extreme, it allocates vaccines to moderately at-risk populations in wealthy countries over populations at higher risk in developing economies.
Disrupting Global Supply Chains: Thus, if countries with a large number of cases lag in obtaining the vaccine, the disease will continue to disrupt global supply chains and, as a result, economies around the world.
Against Fundamental Principle of Vaccine Development:Vaccine nationalism also runs against the fundamental principles of vaccine development and global public health.Most vaccine development projects involve several parties from multiple countries.

The alternative to arrest vaccine nationalism is global collaboration.
In order to bring about equitable and broad access, WHO, the Coalition for Epidemic Preparedness Innovations, and Gavi, the Vaccine Alliance, have come up with an initiative known as “Covax Facility”.
The facility aims to procure at least two billion doses of Covid-19 vaccines by the end of next year for deployment and distribution mainly in the low- and middle-income countries.
The countries that join the initiative are assured supply of vaccines whenever they become successful.
Moreover, the countries will get assured supplies to protect at least 20 percent of their populations.

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.
Further, 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 commercialised.
But more needs to be done. 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.
Equity entails both, affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
The world needs to prevent vaccine nationalism by sharing finite supplies strategically and globally, in order to have upper hand in fight against the COVId-19 pandemic.