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. 2022 Mar 7:10:821117.
doi: 10.3389/fpubh.2022.821117. eCollection 2022.

Global COVID-19 Vaccine Inequity: Failures in the First Year of Distribution and Potential Solutions for the Future

Victoria Pilkington  1   2 , Sarai Mirjam Keestra  3 , Andrew Hill  2   4
Affiliations

Global COVID-19 Vaccine Inequity: Failures in the First Year of Distribution and Potential Solutions for the Future

Victoria Pilkington et al. Front Public Health. .

Abstract

Within the first year of distribution of vaccines against COVID-19, high-income countries (HICs) have achieved vaccination rates of 75-80%, whilst low-income countries (LICs) vaccinated <10%. This disparity in access has been one of the greatest failures of international cooperation during the SARS-CoV-2 pandemic. Global COVID-19 vaccine inequity affects us all, with ongoing risk of new variants emerging until global herd immunity is strengthened. The current model of global vaccine distribution is based on financial competition for limited vaccine supplies, resulting in HICs getting first access to vaccines, with LICs being forced to rely on voluntary donations through schemes like COVAX. Pharmaceutical companies own the intellectual property (IP) rights for COVID-19 vaccines, allowing them to control manufacturing, distribution, and pricing. However, the pharmaceutical industry did not develop these vaccines alone, with billions of dollars of public funding being instrumental in their discovery and development. Solutions to enable global equitable access already exist. The next step in scale up of manufacture and distribution worldwide is equitable knowledge sharing and technology transfer. The World Health Organization centralized technology transfer hub would facilitate international cooperation. Investments made into developing this infrastructure benefit the COVID-19 response whilst promoting future pandemic preparedness. Whilst globally there is majority support for waivers of IP to facilitate this next step, key opponents blocking this move include the UK and other European countries which host large domestic pharmaceutical industries. A nationalistic approach is not effective during a global pandemic. International cooperation is essential to achieve global goals against COVID-19.

Keywords: COVID-19; inequality; manufacturing—R&D interface; pricing; vaccines.

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Conflict of interest statement

VP has previously worked with Universities Allied for Essential Medicines Europe on voluntary basis, but has no other competitions of interest to declare. SK is an active voluntary member of Universities Allied for Essential Medicines Europe. However, views expressed in this paper are her own and are not necessarily shared with the organizations the authors are affiliated with. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Bar graph displaying the proportions of the overall population who had received part (1st vaccine) or completed (2nd vaccine) a COVID-19 vaccination course by the end of 2021, stratified into World Trade Organization income categories. Dark green, completed course; Light green, partially vaccinated. Total proportion who have received any vaccine is stated at top of each bar. Data from Our World in Data—timepoint 31/12/21 (1).
Figure 2
Figure 2
Bar graph displaying the range of prices reported to be paid in different countries or areas of the world for the Pfizer mRNA COVID-19 vaccine (Comirnaty) during 2021, including reported higher prices being charged for booster doses and including estimate on the cost of production. Data Oxfam Coronavirus Dashboard (32). Cost price estimate from (33).
Figure 3
Figure 3
Diagram illustrating the flow of knowledge and technology transfer through a centralized technology transfer hub, to disseminate information and scale up manufacturing efforts.
See this image and copyright information in PMC

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