The inequitable distribution of COVID-19 vaccines

An analysis of vaccine orders shows that 82% of the COVID-19 vaccines produced are for high income and upper-middle-income countries.

Scientists across the globe have been working diligently in the development of vaccines to fight the COVID-19 pandemic. 212 vaccines are currently under development, of which 48 vaccines are in Phase 3 of testing, some of which have been approved for emergency use.  

As countries rush to procure vaccines from manufacturers, data shows that the race is tipped in favour of high-income countries. Of the 6.4 billion vaccine orders placed across manufacturers, 82% are from high income and middle-income countries with a per-capita income exceeding $4046. Consequently, these countries record greater vaccine coverage for their populace. 

137 of the 195 countries in the world have placed orders for COVID-19 vaccines. 

24% of the orders will serve the 27 member states of the European Union, while 10% will cater to 55 member states of the African Union which has a population that is over twice the population of all the European Union countries combined. This disparity in vaccine orders will mean that some high-income countries will have enough to vaccine their entire population five times over, while some low-income countries will barely cover half of their population. 

Middle-income countries, albeit with their economic constraints, have pushed for domestic vaccine development, and are moreover, better equipped to manage vaccine distribution that requires clinical testing facilities, cold storage, and electricity which many low-income countries lack.

Making vaccine distribution equitable

The World Health Organization along with other health organizations is taking measures to support low-income countries.  COVID-19 Vaccines Global Access (COVAX) has been launched by the Global Alliance for Vaccines and Immunization, the World Health Organization, and the Coalition for Epidemic Preparedness to help low-income countries achieve equitable access to COVID-19 vaccines. 

The initiative has currently placed 300 million doses of the Oxford-AstraZeneca vaccine for distribution in low-income countries. It seeks to raise $5 billion by the end of 2021 to cover 2 billion doses of vaccines. The European Union, Bill and Melinda Gates Foundation, World Bank, and UNICEF have similarly pledged funds for equitable access to COVID-19 vaccines. UNICEF has collaborated with the Pan American Health Organization (PAHO) and the International Air Transport Association (IATA) to speed up the delivery process for countries such as Burundi, Afghanistan, and Yemen.

“This invaluable collaboration will go a long way to ensure that enough transport capacity is in place for this historic and mammoth operation,” said Etleva Kadili, director of UNICEF’s supply division, in a statement.

These measures are expected to expedite access for low-income countries, however, given the numerous logistical bottlenecks, a study by the Duke Global Health Institute estimates that most low-income countries will have to wait until 2023 or 2024 to achieve greater vaccine coverage.