Western ‘Rich First’ Vaccination Strategy Will Increase Global COVID-19 Death Toll

Pfizer-BioNTech COVID-19 vaccine
Pfizer-BioNTech COVID-19 vaccine. Credit: U.S. Secretary of Defense, CC BY 2.0, via Wikimedia Commons

“If you took [the] two billion doses we have agreed to procure, and distributed them among the 50 highest-income countries, you would reduce deaths around 31 per cent; if you distributed across countries equitably, you get to a little over 60 per cent of death reduction”, Dr Seth Berkley, head of Gavi, the Global Vaccine Alliance, told the BBC HARDtalk programme.

Here we have it, plain and simple: two billion doses could save 60 out of every 100 people that would die as a result of the COVID-19 pandemic. This will not happen, however, and it is so because – we quote from Professor Anthony So’s report published by the BMJ – “several countries have made premarket purchase commitments totalling 7.48 billion doses, or 3.76 billion courses of Covid-19 vaccines from 13 vaccine manufacturers. Just over half (51%) of these doses will go to high income countries, which represent 14% of the world’s population.”

We do not yet know what the future holds, but it is clear that we are headed towards the first of the scenarios outlined by Dr Berkley – the one whereby 2 billion doses save 30 per cent in the richest parts of the world, instead of 60 per cent world-wide. That difference of 30 out of every 100 deaths is the true price tag on the ‘our people first’ vaccination strategy adopted by high-income countries which have employed all means at their disposal to secure the vaccines for their people.

Let us add the third line of data. According to official WHO figures, Covid-19 has so far killed 2.5 million people, although this figure is certainly very severely understated, as it derives from official reports shared by member countries of the WHO. For the sake of intellectual experiment let us assume that this figure would only double over the next year. Two and a half million deaths and a 30 per cent difference in vaccine effect on mortality rate between the two vaccine-distribution regimes means arriving at a mind-blowing conclusion: we are able to save 1.5 million people around the world, but we seem to have decided to save 750,000 in the richest parts of the world while allowing 750,000 elsewhere to die.

The above will probably not surprise those who follow how the West has perfected externalization of costs of its own wellbeing. Examples vary — one of the most recent being the EU-Turkey deal under which the EU pays Turkey for arresting subsequent waves of Syrian and Middle-Eastern refugees and asylum-seekers. On the other end of the spectrum are centuries-long post-colonial practices, which for the last couple of decades mostly take the shape of externalization of environmental costs to the developing countries, a practice which permits large parts of the affluent West to consume while being (relatively, and for the time being) shielded from the toll production of consumed goods takes on the environment.

When it comes to the Covid-19 vaccination effort, however, there is something strikingly new. Not in the way the highest-income countries have quietly decided to pay for their safety with the lives and livelihoods of people living in poorer parts of the world, but in the fact that the moral dimension of this deed cannot be neutralised by any of the numerous narrative strategies that are traditionally employed to ease the conscience of the West.

The first among those is undoubtedly the argument that there are two sides to every coin. It is true that industrialization of South East Asia, for example, brings not only pollution and exploitation of workers, but also results in gradual development. In the case of vaccines against coronavirus, however, this argument does not apply: the snatching of vaccines by the developed countries will bring nothing but death and misery to the rest of the world. There is no flip side to that coin.

Second comes the argument of tradition, understood here as pointing towards historical inequalities between parts of the world to justify that they still exist today. These countries, it is so often argued, were poor for centuries and although we do as much as we can, it may take years, decades or centuries before some will eventually make it to the high income threshold.

Covid-19 vaccination falsifies this explanation entirely — as both the virus and inoculations which protect against it were unheard of only slightly over a year ago, the global response could have been structured in a just and reasonable way, that is to curb deaths in the most effective way possible (most Western countries for that matter, stress the importance of minimizing the discrimination against underserved communities). In effect, the fact that vaccines are taken by the rich states at the expense of the poor proves that global inequalities cannot be explained as historical. In fact, they are not only structural but also functional from the point of view of the affluent countries, allowing them to capture the positive and externalize the negative effects on any given subject, be that industrial production or vaccinations.

Third on that list of narratives would be the inability to foresee the consequences. Much has been written about how decolonization processes (particularly in Africa) were apparently underlined with an intention to create inherently unstable countries — a feature that would render them open to influence and exploitation. Similarly, discussion around populism stressed the issue of how the introduction of neoliberal economic policies in the West resulted in a global production shift to Asia, which left behind millions with no means by which to fulfil their aspirations. Case after case, we hear that at the time no one could have foreseen the long-term side effects of decisions which were well-intended but effectively turned out to be disastrous.

In the case of Covid-19 vaccination, however, we already know at the very beginning that the way these doses are being currently distributed across the world will result in millions of otherwise avoidable deaths. Furthermore, modelling allows the head of the Global Vaccine Alliance to give exact figures behind the two scenarios — and, as it is already known how many vaccines are being delivered and to which countries they go, when this pandemic is over it will not be at all difficult to calculate the number of deaths resulting from the inequitable distribution of vaccines.

Finally, the fourth narrative worth mentioning is aimed at containing problems arising in different parts of the interconnected world by branding them as ‘regional.’ The leaders of the United States for decades now do their absolute best to regionalize the problems of Latin America as having nothing to do with the US. Their European counterparts have recently refreshed this narrative to describe Syria as a Middle Eastern problem which should be contained in the Middle East. In this way the affluent countries get to cherry-pick issues that do or do not concern them; the latter are branded as regional, and therefore perfunctorily neglected.

Notably, by employing regionalization, the West has also downplayed the growing possibility of a world-wide pandemic. MERS — the illness arising from infection with the previous coronavirus that caused an outbreak, and which has so far cost nearly 1,000 lives — is an abbreviation of Middle Eastern Respiratory Syndrome. The very name reflects on the regionalization of the problem which, as the current pandemic proves, should not be contained in this way.

The wave of unnecessary deaths in poorer parts of the world will not only result from the ‘rich first’ strategy which boiled down to its essence, is the effect of the high income countries leaders’ decision to employ the entire power at their command to push their constituents towards the front of the vaccination queue.

I-MAK’s Tahir Amin in an excellent piece for the Foreign Affairs has documented how the West has also managed to severely curb the supply. The UK, the US and the EU, supported by major Western pharmaceutical companies, have blocked an initiative to waive the WTO treaty on intellectual rights protection for the duration of the coronavirus pandemic.

The motion was supported by more than 100 middle and low-income states, as suspension of the treaty would allow vaccine manufacturers in the developing countries to produce much needed jabs. Dozens of vaccine plants, capable of manufacturing billions of doses a year will remain idle. Johnson & Johnson has licensed one manufacturer in South Africa, and India’s Serum Institute has received a production licence from both AstraZeneca and Novavax. Pfizer and Moderna have both licensed no one and top the income charts with $15 billion and $18 billion in expected Covid-19 vaccine revenue in 2021, respectively.

Curbing the supply of the vaccine in order to boost Western companies’ revenues, and hoarding most of what is produced – both these phenomena spring from an attempt to take part in politics in the globalized world of the 21st century by means of a 19th-century invention, that is the nation state, whose aim was to take advantage of each and every opportunity to make itself and its people better off by internalizing rewards and externalizing costs. The Covid-19 crisis is yet another reminder that egoism of nation states is by no means an answer to the challenges humanity faces in the 21st century, especially the most significant one, that is the global climate crisis.

If it would not be allowed to be forgotten, the consequences of allowing hundreds of thousands to die of COVID-19 would be severe.

Geopolitically, this policy permitted China and Russia to step into the vacuum created by the West. Both have signed contracts to have their vaccines delivered to countries on all continents, while the Western COVAX scheme remains largely inoperative and will remain so for as long as the Western countries have not yet inoculated their people.

Secondly, the West places a dangerous bet by denying vaccines to poorer countries. We know that the virus mutates, and numerous new strains are being identified across the world. As autumn begins on the southern hemisphere, a spike in number of cases should be expected in populous countries of the global south. From a deeply disillusioned point of view it would be an appropriate punishment of the Western greed, if one – or more than one – new strain would over time proved to be vaccine-resistant and restarted the pandemic.

The West, finally, risks something extremely precious by letting the world down during the pandemic. The damage is not dispersed, it is all taken by the narrative that is absolutely central to Western soft power, that is the self-evident proof that the Western peace, affluence and wellbeing results from the Western democracy, hard work and the ideals of human rights. After the West has shielded its own population with an untimely end for thousands in the developing world, this narrative will be once and for all compromised.

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Stanislaw Skarzynski is a UK-based journalist, currently serving as Gazeta Wyborcza (Poland) international affairs correspondent. Hannah Barta is an intern journalist. The views and opinion expressed in this article are those of the authors.