Rich Countries Are Using Vaccines as a Power Play — and Everyone Could Suffer

Over the past few weeks, the world has gotten a glimpse of just how ugly international relations could become if the COVID crisis doesn’t ease up in the coming months.

While a handful of countries — the U.S., the U.K. and Israel in particular — have vaccinated large percentages of their populations, for most of the world, getting vaccinations into arms on a scale capable of blunting the spread of the virus remains a distant aspiration.

In Brazil, as the virus rampaged and Jair Bolsonaro’s government hemmed and hawed in the face of calamity, by the weekend, close to 4,000 people a day were dying of the disease. In much of Eastern Europe, deaths were higher in late March than at any point to date in the pandemic. Although a frightening COVID spike is ongoing in the United States as well, hopes are still high as vaccinations continue apace, with 28 percent of Americans having received at least one dose of the vaccine.

As that divide grows between countries with robust vaccination programs and countries with less access, some governments may slide further into what might be called vaccine nationalism: blocking the export of vaccines, even if they have already been paid for by other countries; insisting that people hoping to enter the country have received a vaccine manufactured by that country; and using selective vaccine exports as ways to shore up overseas influence — in a similar way to, say, arms sales or development grants.

This past month, it was the European Union (EU), which has prided itself historically on its openness and its sense of international spirit, that wielded raw power in a particularly crude way to start blockading the export of vaccines.

France called it the end of “naivety”; Italy said it was an imperative to halt exports while its own population was under-vaccinated; and Germany — even while using more moderate language — cited the imperatives of protecting one’s own population first and foremost. However it was packaged, the result was the same: The EU, which has massively bungled the rollout and distribution of vaccines within its borders and is being overwhelmed by the spread of the U.K. variant, is now severely restricting exports of vaccines made on European soil to Canada, the U.K., Australia, and other countries whose governments have already paid for certain numbers of doses of Pfizer and AstraZeneca vaccines.

The European Commission rejected the language of a “blockade,” saying it was just protecting its own in the same way as the U.S. has done, but it’s hard to see how else to interpret the shifting EU priorities. It’s also hard to see how such a policy will be successful in speeding up the EU’s vaccination program, given that many of the bottlenecks have far more to do with an inadequate distribution infrastructure for vaccines than with actual shortages on the continent. In other words, the EU’s aggressive stance is political posturing to deflect attention from a stunning public health failure vis-a-vis vaccine distribution. Tragically, this posturing could cost many lives.

In the U.K.’s case, the situation could end up being particularly dangerous, as the government has embarked on a strategy of distributing as many first doses as possible, and stretching out the second doses to 12 weeks out — far longer than is permitted in the U.S. That strategy was premised on the assumption that doses contractually signed for would actually be delivered promptly, and the second doses would arrive when expected. Now, however, the steady supply of vaccines is at risk, since the Pfizer doses that the U.K. relies on are manufactured in Belgium, meaning those second doses might be postponed even further. This risks a breakdown in immunity for those who are only partially vaccinated, and could conceivably lead to a new wave of infections in the late spring and summer. Should that happen, the already frayed relations between Brexit Britain and the EU will likely worsen still more.

Vaccine nationalism is, however, by no means only a European issue. Under Trump, the U.S. withdrew from the World Health Organization (WHO) and refused to participate in the international COVAX program, designed to deliver vaccines promptly to poor countries that were being frozen out of the marketplace.

While Biden has rejoined WHO and announced that the U.S. will, indeed, participate in international vaccine-aid efforts, and while the administration recently announced it would send millions of vaccine doses to Mexico and to Canada, the vast majority of U.S.-made vaccines are still being held for use only in the U.S., and poorer countries in the hemisphere are being largely denied access to the Pfizer and Moderna vaccines. Meanwhile, even with renewed U.S. participation, the COVAX program is currently only able to guarantee enough vaccines for Africa over the coming months to ensure that 20 percent of the continent’s population is vaccinated; and, as of now, the entire continent, with well over a billion people, has received only 20 million doses.

In addition to the U.S., other countries are also wielding vaccines as a form of power, a new tool in a peculiarly 21st-century Great Power game. China, which has some of the most restrictive requirements in the world for anyone hoping to enter the country, is only willing to relax those restrictions for those who have proof that they were inoculated with a Chinese vaccine. It is doing so despite the fact that at least Pfizer and Moderna have produced vaccines that seem to have a far higher efficacy rate than do the Chinese vaccines.

Meanwhile, Russia is surging exports of its Sputnik V vaccine to many poor countries around the world, particularly in Latin America and in Asia, possibly as a way to re-establish a global footprint in areas from which it was largely ousted in the post-Cold War decades.

In Israel, which has the highest per capita vaccination rate on Earth — and has begun implementing a vaccine passport system allowing inoculated individuals to go into public spaces barred to the non-vaccinated — the government has implemented what amounts to a vaccine blockade against Palestinians in Gaza and the West Bank, distributing only a few thousand vaccines to local authorities in those regions. Doctors Without Borders has calculated that an Israeli is 60 times more likely to have vaccine access than is a Palestinian living in one of the occupied territories. Meanwhile, settlers in the West Bank have received vaccine access even while Palestinian residents have not. This amounts, in some ways, to a racial or religious litmus test for vaccine access.

The COVID crisis represents the biggest global public health challenge in more than a century. While the development of vaccines in under a year represents one of the greatest acts of scientific cooperation in human history, now much of that cooperative spirit is being lost in the swirl of nationalist politics and the language of exclusion that surround distribution of the vaccines.

In the long run, vaccine nationalism, and the protectionism of rich countries against poor countries, helps no one. If new, more contagious variants emerge over the coming months and years in poorer countries that can’t compete for vaccines with the U.S., the U.K., the EU and other powerhouses in the global marketplace, there’s a real risk that some of those variants will end up evading vaccines. Such a development could bring everyone, rich and poor alike, back to square one, and that’s a scenario that would be catastrophic in its global implications.