Amidst reports of crumbling EU vaccine solidarity, 6th Sense staff writer Niklas Illenseer interrogates how far this already tenuous solidarity extends beyond Europe. He argues that global COVID-19 vaccine inequality underlines that profit margins, rather than health concerns, govern the international inoculation rollout.
Even before the first COVID-19 vaccines were rolled out, news broke that a few countries were already securing doses for themselves. Unsurprisingly, richer nations of the Global North were able to capture a grand share of vaccines, concentrating much of the supply in the hands of governments representing a fraction of the global population. If this calculation does not seem skewed already, now, on top of belated and restricted access to vaccines, low-income nations also seem to be facing higher prices: Politico reported that poorer countries such as Bangladesh, South Africa, and Uganda are hit with a higher price tag for the Oxford/AstraZeneca jab than their richer counterparts.
Facts and figures are blurred, numbers were published and retracted, the pricing intransparency of companies and the opacity of government deals do not help with keeping a clear view. According to reports, while the EU comes in cheapest at $3.50 per dose, India is due to pay $4 or $5 per dose, South Africa $5.25. A first report that Uganda would pay $7 has made the rounds but has not been confirmed. Price differences are explained by differing costs of manufacturing and the volume purchased by countries, among other factors.
Global vaccine (in)equality: Socialist dream, capitalist reality
$7, $6, or $5 – ultimately, the specific number does not matter. While AstraZeneca still claimed a “commitment to broad and equitable global access” in a press statement from June 2020, any such price discrimination tells a different story. And although it makes economic sense that price differences exist as a consequence of varying supply and distribution chains, it begs the question if an economic axiom should be the guiding principle when it comes to vaccination access. This alludes to the larger dilemma that those most in need are the ones with the least bargaining power. An intriguing juxtaposition of socialist ideals and capitalist realities is playing out on the global stage. After all, while resolute cooperation and economic planning have produced vaccinations at rapid speed, their distribution puts the global inequities of our capitalist world on full display.
The speed at which research was conducted and vaccines developed was astonishing and showed what cooperation can achieve if resources are pooled, sometimes even across borders. To say that companies producing the vaccinations heavily relied on public funding is an understatement. Much financial backing was flooded their way by affluent governments. Usually, vaccinations are far from being the best business model as they are intertwined with massive financial risks. This risk-return trade-off is one of the reasons we have seen pharmaceutical giants shy away from developing vaccinations without public pressure. Now, governments effectively took on the financial risks and guaranteed that vaccines would be bought.
Given the currently high demand, one could argue that vaccines would have been developed either way. But it would be short-sighted to think market forces alone would have led to a development as rapid as we have seen. Besides the acute funding of the last months, the pharmaceutical industry experienced years and even decades of extensive public backing. On top of that, many governments have prepared the grounds to ensure a smooth and rapid vaccination rollout even before trials were finished. If it were not for this support of the public sector, we would not be seeing this rollout of vaccines today. The innovation clearly has been a product of the state, not the market.
The economic fable of zero-sum
At the same time, absurdly, it is also the pharmaceutical giants setting discriminatory prices for the sake of profit. While patent laws are complex and time has been no asset these last months, medical patent issues and their entanglement in global public health are by far not novel. It might make for a reductionist account of the global supply network, but in essence, it is profit-driven business interests constraining vaccine distribution. They are the reason production is not ramped up, supply is not maximized, and doses are not delivered where they are most urgently needed. Put simply, leaving vaccination rollouts to the market is prone to failure. We see this most notably in the oligopoly on vaccines. Such market-based accounts pretend vaccine allocation is a zero-sum game, in which only those that get them are the winners and all other losers. While that might make for an enticing economic fable, it is far from the truth: nobody will be safe until everybody is safe. Ultimately, the longer the virus rages uncontrollably in any part of the world, the higher the risk of mutations for everyone. This sort of vaccine nationalism is shortsighted and helps no one but the virus.
Leaving vaccination rollouts to the market is prone to failure.
The pandemic has done its job in uncovering how seriously we truly take global solidarity and equity when push comes to shove. It is unrealistic that large corporations would give out patents for free, however much one could make the ethical argument. We are left to ponder what it would look like if pharmaceutical companies were to share their know-how and enable more doses of vaccines to be produced, more people supplied. Even then, Pfizer, Moderna, and AstraZeneca would still be able to reap profits from royalties.
The COVID-19 vaccine crisis reveals character
Hopes for Europe to put global equity front and centre have also long perished. The butchered rollout within the EU casts serious doubts on Europe’s ability to effectively support a global and equitable vaccination plan. In fact, while rolling the dice on its continental vaccine strategy, not much coverage has been given to the slow efforts to support other countries, particularly those in the Southern hemisphere. ‘Global solidarity’ might still crop up in speeches of Ursula von der Leyen and several of her colleagues; a comprehensive, effective strategy is yet to be seen.
The near monopolistic vaccination bottleneck is ineffective at best, immoral at worst. The much-needed public intervention has laid bare the inefficacies of the market and underlines that the vaccination rollout simply should not be left to profit-driven entities. Rather than a political oversight, it alludes to a deliberate lack of leadership and political intervention: not only has the EU gambled when it came to its own supply, it has also failed in its commitment to global equity. Instead, it sends the clear signal that global solidarity, though sometimes preached, is far from being practiced.