Vaccine Inequality: A Damning Lens on Today's Society?
According to the World Health Organisation (WHO), the vast majority of vaccines are administered in high-and-upper-middle-income countries, and 56 countries were not able to vaccinate even 10% of their population by the end of September 2021, most of these being in Africa.
The worst part about this is that it isn’t due to a lack of vaccines; there are 1.5 billion doses created per month. They just aren’t being distributed equitably. If they were, then this would increase global population immunity and reduce risk of new variants.
Most vaccines go to rich countries, while just 7% of people in Africa have had two doses. For every 100 people in the US there are 100 vaccines. For every 100 people in low income countries there are just 1.5 vaccines. This means many people in low income countries may have to wait until 2023 to be fully vaccinated.
This isn’t just a healthcare crisis, but an economic one. £1.6 trillion is estimated to be lost in global economy output due to the pandemic, affecting the poorest the most (Newey, 2021). This is while shipments of vaccines are prioritised to wealthy countries, and donations of vaccines from Britain were nearly expired, leaving not enough time for them to be distributed.
This is bad for everyone. New strains emerge, such as Omicron, which can affect people even if they’ve been vaccinated. Strains emerging in countries with a significant proportion of unvaccinated people traverse borders and make ending the pandemic less likely, so it’s not ideal that the UK only delivered 11% of the vaccines they promised to.
For every first dose in the poorest countries, there are six times as many third and booster doses in the richest parts of the world. 89% of vaccines have been given to rich countries, and 79% of future shipments will be going to them. This feels similar to giving extra life vests to people on lifeboats while others are still in the water.
Healthcare inequality isn’t new. Around 5 million patients with HIV/AIDS have no access to treatment, with treatment coverage being 28% in Sub-Saharan Africa, 19% in Asia and only 14% in low and middle-income countries of Eastern Europe and Central Asia (Russo et al., 2017). This is compared to Western and Central Europe and North America, where 4 in 5 people living with HIV are on treatment.
This leaves around 80% of individuals with HIV/AIDS in the poorest places being unable to access treatment, while 81% in the richest regions have access. This is even starker when you realise 20.7 million people in Eastern and Southern Africa are living with HIV, compared to 2.2 million in Western and Central Europe and North America.
What worse is that two-thirds of children living with HIV are found in Eastern and Southern Africa. For example, in 2020 there were 98,000 children aged 0-14 living with HIV in Uganda.
Most people who take daily HIV treatment can reach an undetectable viral load within six months, according to the NHS. Furthermore, Zidovudine treatment during pregnancy, labour and the first weeks of a baby’s life can reduce the risk of HIV transmission from mother to child by two-thirds.
In 2017, WHO revealed that 800 million people spent 10% of their household budgets on healthcare, and for 100 million people this was enough to push them into extreme poverty, living on $1.90 or less a day.
There are gaps in availability of services in Sub-Saharan Africa and Southern Asia. Only 17% of mothers and children in the poorest fifth of households in low-and-lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74% for the wealthiest fifth of households (WHO, 2017).
So it’s clear that, even before the COVID-19 pandemic, the poorest communities lacked access to healthcare. It is estimated that 5.7 million people in low and middle-income countries die each year from poor quality healthcare, and 2.9 million die from being unable to access care (Moore, 2021).
COVID-19 has highlighted and exacerbated already existing inequalities, and perhaps has created a cycle of immunodeficiency and infection. For example, in an article by Freer and Mudaly (2022), they point out that poverty and stigma, as well as poor access to treatment, means individuals with HIV in South Africa are often not in continuous care.
The coronavirus pandemic has further reduced access to care, testing and treatment. This leaves more immunocompromised people who are very vulnerable to covid-19. This leads to a ‘synergistic pandemic’ where individuals with already compromised immune systems due to HIV/AIDS may host mutations of coronavirus, leading to new variants.
There is hope though. South Africa’s HIV activism, such as the Treatment Action Campaign, provides a model now used by the Movement for Change and Social Justice (Freer & Mudaly, 2022). This movement has been part of local health responses to COVID-19 in South Africa and has also worked to advocate for communities and reduce stigma.
Groups working so hard on the ground to help impoverished communities can only achieve their goals if wealthy countries stop ‘vaccine nationalism’; stockpiling vaccines “at the expense of international distribution” (Freer & Mudaly, 2022).
Resources used in this article:
Freer, J. and Mudaly, V. (2022) 'HIV and covid-19 in South Africa'. BMJ, p.e069807.
Hiv Rates by Country 2021. (2022) Worldpopulationreview.com. [Online] [Accessed on 30 January 2022] https://worldpopulationreview.com/country-rankings/hiv-rates-by-country.
HIV/AIDS. (2022) Who.int. [Online] [Accessed on 30 January 2022] https://www.who.int/news-room/fact-sheets/detail/hiv-aids?fbclid=IwAR3WI09HQt8Rrxijj9FBCaBneQWPtpQWjxqY6Hd6_YP8BWS2UGxu6p5ijdY.
HIV and AIDS - Treatment. (2022) nhs.uk. [Online] [Accessed on 30 January 2022] https://www.nhs.uk/conditions/hiv-and-aids/treatment/?fbclid=IwAR32qdyUmCVgXyQP175llgtk7kr47dShytnytxeLDuPOVepBapc4QpZjL7A.
Moore, S. (2022) How Can We Achieve Equal Global Health Access?. News-Medical.net. [Online] [Accessed on 30 January 2022] https://www.news-medical.net/health/How-Can-We-Achieve-Equal-Global-Health-Access.aspx.
Newey, S. (2022) ‘Glacial’ pace of global Covid vaccine rollout will cost $2.3 trillion in lost GDP, report warns. The Telegraph. [Online] [Accessed on 30 January 2022] https://www.telegraph.co.uk/global-health/science-and-disease/glacial-pace-global-covid-vaccine-rollout-will-cost-23-trillion/.
Russo, G., Bloom, G. and McCoy, D. (2017) Universal health coverage, economic slowdown and system resilience: Africa’s policy dilemma.