From the beginning of the Covid-19 pandemic, there have been irrefutable reasons for designing a global vaccination programme that put need ahead of geography. The strongest argument was of course a moral one. A truly equitable system would put the most vulnerable groups, including healthcare workers and the over-70s, at the top of the queue irrespective of the country in which they live. There is no good reason for vaccinating a healthy 25-year-old in Europe ahead of an intensive-care nurse in Africa. But the argument for equity is also a practical one. With a disease as deadly and as transmissible as Covid-19, nobody is protected until everybody is protected.
At an intellectual level, this is widely understood. Admirable efforts have been made to mitigate the effect of vaccine nationalism, notably through Covax – a global public/private effort to incentivise more rational distribution. However, almost two months after the first vaccines were approved for use, the evidence so far suggests we are sleepwalking into what the head of the World Health Organisation warned would be a "catastrophic moral failure".
By late January, 39 million doses of vaccine had been administered in at least 49 wealthy countries. Across the lowest-income states, the figure was 25. Not 25 million; not 25,000; a mere 25. That figure has risen in recent weeks, but not by much. Covax is short of $2 billion it needs to pay for doses due this year alone. Even if it meets its target of delivering 2.3 billion doses this year, that will only cover a fifth of the target group, meaning most will have to wait until 2022 or 2023. Across the west, meanwhile, governments have ordered far more vaccines than they will need to immunise their entire populations, but without making any plans for distributing the surplus. And where governments have shared their allocations with neighbours, it has often been part of a soft power-play in which vaccines are used as diplomatic tools to advance broader geopolitical goals. India and China have been giving away millions of doses to strategically-located states they wish to bring closer to their respective spheres of influence, such as Nepal and Sri Lanka. The United Arab Emirates has been buying vaccines for its neighbours.
The world is getting this very wrong, in other words. And the cost of that error is becoming clearer with every passing day. With the rapid spread of the disease, significant mutations are occurring that could render vaccines less effective. Already South Africa has flagged concerns about a local variant's ability to resist the AstraZeneca vaccine. By hoarding supplies and leaving the poorest countries frantically trying to source their own, the world's wealthiest countries are not only acting immorally. They are actively prolonging the pandemic.