Why much of the world is facing a Covid-19 vaccine famine
- The Covax Facility and richer countries unfortunately conflate fundraising with distribution, and the countries that provide the funds are not subject to the same distributive system
- There must be a stronger focus on ensuring vaccines are manufactured in countries beyond rich nations, so each can practise vaccine nationalism
Characterising a lack of vaccine access as a famine is important because it illuminates a key point that Amartya Sen, the Nobel-Prize-winning development economist, explained in his seminal 1981 book Poverty and Famines: famines imply starvation, but starvation does not imply famine. When people are hungry, it is not necessarily because of food shortages. It could be because the distribution of the food or the money to buy food is not working.
This is important when it comes to vaccines. The fact is, there is not – yet – a global vaccine shortage. The World Health Organization has suggested that 11 billion vaccine doses would be sufficient for the world to achieve herd immunity, while current projections suggest 12 billion doses can be produced by the end of 2021.
Indeed, G7 countries are enjoying a relative feast – on average they have fully vaccinated 33 per cent of their population and there are internal debates about when children, the least vulnerable to Covid-19, should receive jabs.
So why are other countries facing a vaccine famine? As mentioned above, Sen’s argument is that famine arises from poor distribution. This has two key implications for the handling of pandemics, and other global problems.
The first is that there must be a stronger focus on ensuring the manufacturing of vaccines in countries beyond the G7 and other rich nations, so that, in some way, every country or region can practise vaccine nationalism, or – in Sen’s analogy – has more autonomy to avoid local famines.
This is welcome progress, but the second implication of Sen’s analysis is more fundamental. It implies a reordering of the multilateral system.
In the case of the actual toilet paper crisis, this kind of hoarding was addressed through regulation in some neighbourhoods. Supermarkets set purchase quotas, while allowing health workers to come in earlier than other patrons. Toilet roll famines ended.
The reason is that Covax and richer countries in particular conflate fundraising with distribution. Those who provide funds are never subjected to their distributive systems because international organisations like the WHO are expected to just focus on the poorest countries.
Yet, being able to finance the multilateral system should not mean a country is exempt from the implications. It’s hypocritical, and in an emergency like a pandemic both circumvents and disrupts the system.
It should never have been up to the G7 to decide how many vaccine doses to donate. The role of plurilateral groups like the G7 or international tools like Covax is not to enable charity, solidarity or self-interest. This not only embeds in our imaginations an indefinite “rich world versus poor world” concept, but Sen’s analysis also shows it will lead to famine – the vaccine famine we are experiencing now.
It’s time to recast the international system and, as Sen suggested 40 years ago, to distribute entitlements to health, environment and other global public goods equally.
Hannah Wanjie Ryder is CEO of Development Reimagined, an African-owned international development consultancy with headquarters in China, and offices in Kenya and the UK. She was formerly head of policy and partnerships for UNDP in China