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The COVID pandemic has exposed huge inequities in access to health care in most countries. But there is also a global divide in access to COVID vaccines which is also heartbreaking. The Johns Hopkins Coronavirus Resource Center currently estimates that there have been over 110 million cases and almost 2.5 million deaths from the virus, estimates that most likely understate the true spread of the disease. The development of vaccines against the virus was an impressive scientific and technological feat, but the United Nations estimates that 75% of all current vaccines are being distributed in 10 countries and that there are about 130 states where no vaccines available at all. It should come as no surprise that the 10 countries are highly developed and that the states without vaccines are largely poor.

This outcome was easily predictable and to address the problem the World Health Organization (WHO) initiated what is known as the COVAX Program:

“At an early stage during this pandemic, it quickly became apparent that to end this global crisis we don’t just need COVID-19 vaccines, we also need to ensure that everyone in the world has access to them. This triggered global leaders to call for a solution that would accelerate the development and manufacture of COVID-19 vaccines, as well as diagnostics and treatments, and guarantee rapid, fair and equitable access to them for people in all countries. Today we have that solution – COVAX. The result of an extraordinary and unique global collaboration, with more than two-thirds of the world engaged – COVAX has the world’s largest and most diverse portfolio of COVID-19 vaccines, and as such represents the world’s best hope of bringing the acute phase of this pandemic to a swift end.

COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched in April by the World Health Organization (WHO), the European Commission and France in response to this pandemic. Bringing together governments, global health organisations, manufacturers, scientists, private sector, civil society and philanthropy, with the aim of providing innovative and equitable access to COVID-19 diagnostics, treatments and vaccines. The COVAX pillar is focussed on the latter. It is the only truly global solution to this pandemic because it is the only effort to ensure that people in all corners of the world will get access to COVID-19 vaccines once they are available, regardless of their wealth.

Unfortunately, COVAX has not met its objectives and many blame the lack of success on what has been termed “vaccine nationalism”. The pressures to reserve short supplies of vaccines to one’s own citizens are intense, but ultimately short-sighted. We have witnessed how transmissible the COVID virus is and are currently facing the prospect of variants for which the vaccines are less effective. In other words, it is a serious mistake to believe that vaccinating an entire national population would be effective over the long run. That same dynamic is true for the dangers of climate change as well–there is no national solution. Only a global response is capable of avoiding a catastrophe.

The International Chamber of Commerce commissioned a study to analyze the economic costs of a failed global response to the COVID pandemic. It concluded:

Key findings:

• The economic costs borne by wealthy countries in the absence of multilateral coordination guaranteeing vaccine access and distribution range between US$ 203 billion and US$ 5 trillion, depending on the strength of trade and international production network relations. The ACT Accelerator is fully costed at US$ 38 billion.
• These costs are an order of magnitude larger than those estimated by earlier studies, which calculated the costs of inaction at between US$ 119 – US$ 153 billion in 2021 and up to US$ 466 billion by 2025 (Duke Health, Eurasia Group, RAND). This is because the new study is calibrated to a large set of countries and sectors, fully incorporating international trade and production network.
• The study shows a clear positive relationship between the economic cost of uneven vaccine distribution and trade linkages – the more open an economy is, the stronger the economic incentive it should have in ensuring trading partners have access to vaccines.
• If advanced economies continue to prioritize vaccination of their susceptible populations without ensuring equitable vaccination for developing economies, the total cost to the world varies between US$ 1.5–9.2 trillion.
  • The expected economic cost to the United States is US$ 45 billion to US$ 1.38 trillion. The expected economic cost to the United Kingdom is US$ 8.5–146 billion. The expected cost to Germany is US$ 14–248 billion.
• Key advanced economies most impacted include many European countries (including Belgium, France, Germany, the Netherlands) Norway, Switzerland, the United Kingdom and the US, who might lose up to 3.9 percent of their GDPs relative to a world where all countries are vaccinated.

The political will to treat the pandemic for what it truly is will be difficult to summon. Most populations look to their own national governments for security and persuading those populations that substantial commitments to non-citizens will be hard to realize. But there is no necessary distinction between a national and an international response. Both require substantial financial commitments. The obstacle is to understand fully how interdependent the human population is. But we already knew that. We have much historical evidence: global plagues have rattled humanity ever since the Plague of Athens in 430 BCE. Why the lesson is so difficult to learn is the true challenge.