COVID-19 vaccine inequity

In ten contributions, mathematical modellers, public health officials, intellectual property experts and activists explain how vaccine inequities continue to fuel the pandemic, and how multilateral cooperation can help.

COVAX emerged as a key mechanism to advance COVID-19 vaccine equity. To fully succeed, it needs support that extends beyond vaccine donations, argues Anuradha Gupta.

Breaking pharmaceutical monopolies helped to address the HIV crisis. The same could be done to end the COVID-19 pandemic, but we must act decisively, writes Winnie Byanyima.

Global vaccine inequity reflects deeper issues within our market-driven global health system that fixates on innovation, intellectual property and the individual good as the solution, argues Tahir Amin. To end COVID-19 and achieve real progress, we need to incentivize the collective good instead of clinging to the current system, which only fuels divisions.

Although the Global North is grappling with whether COVID-19 will turn endemic, in Mali and other resource-poor countries ‘living with COVID-19’ would be devastating, warns Samba Sow.

Global crises require tight international cooperation. Unilateral measures such as travel bans are often not rooted in science; instead of fostering cooperation, they impede communication, discourage transparency and hinder evidence-based decision-making, writes Philani Mthembu.

Ethical principles dictate that limited, life-saving resources should be allocated fairly. Keymanthri Moodley affirms that achieving global distributive justice is one of the greatest challenges of the COVID-19 pandemic, and current distribution strategies are ethically indefensible.

Global inequities in access to COVID-19 vaccines stem from pre-existing disparities. The Global South and Global North must cooperate to address them, argues Ayoade Alakija.

It is seemingly in the interest of high-income countries to prioritize vaccinating their own population against COVID-19, despite it being immoral. However, mathematical modelling by Ye et al.¹ shows that this approach offers only limited, short-term benefits, whereas equitable vaccine distribution would substantially curb the emergence and spread of new variants.

Using data-driven mathematical modelling that combines viral evolution with epidemiological dynamics, Ye et al. show that COVID-19 vaccine inequity leads to the emergence of new variants and new waves of the pandemic, while equitable allocation of vaccine doses reduces case counts and fatalities in all countries.