Global vaccine equity is within reach if we act now

As the U.S. convenes a global COVID-19 summit at the UN, discussions about COVID-19 vaccines are bringing new voices to an old conversation. How — and when — should essential medical technologies, such as COVID-19 vaccines, be equitably distributed around the world?

The arguments in support of rapidly scaling up equitable global access to COVID-19 vaccines are self-evident. The world’s poorest 52 countries, home to more than 20% of the global population, have access to less than 5% of vaccines. Health care systems in low- and middle-income countries have been overwhelmed by waves of COVID-19 outbreaks. These outbreaks lead to widespread human suffering and profound economic and social disruption. They also imperil global progress against the pandemic through the rise of novel variants, which may in the future evade existing vaccines. A recent letter from IDSA and HIVMA, co-written by one of the authors of this post, warned of this danger and urged the Biden Administration to take action.

The primary motivation for equitable global access to COVID-19 vaccines is the same one that compels us to improve access to life-saving technologies and essential medicines for other diseases: to alleviate avoidable suffering. Access to vaccines and medicines is not a privilege, but a universal right — and is within our power.

Immediate Action Is Needed

The U.S. and other countries have made considerable contributions to the global fight against COVID-19, donating nearly 150 million doses at the time of this writing. However, the global community is far short of the 1 billion doses needed by the end of this month, according to the Independent Panel for Pandemic Preparedness and Response. Donating and distributing vaccine doses in late 2022 and beyond will be too late: We must act now to increase global vaccine access within the next 3-6 months. Three broad measures should be simultaneously and urgently pursued to change current realities:

1. Stockpiled vaccine supplies in high-income countries should be donated and distributed to countries most at need, starting now.
2. High-income countries need to support marked increases in vaccine manufacturing without delay. We have seen that it is insufficient to solely rely on production by existing manufacturers. We can address this in two ways. First, by harnessing and building manufacturing capacity in the U.S. and other high-income countries for COVID-19 vaccines and their components, for example through public production in the U.S. in collaboration with industry. Second, by helping low- and middle-income countries build their capacity to manufacture themselves. Capacity-building must involve following through with intellectual property waivers and committing to a coordinated system of technology transfer.
3. Finally, high-income countries need to help strengthen health systems in lower-income countries so that they can rapidly deliver COVID-19 vaccines. We should support expansion and deployment of the health care infrastructure and workforce necessary to meet the many challenges of mass vaccine distribution. These structural investments will also help us respond to future global health crises.

This week’s UN summit is an important opportunity to commit to these measures. While other actions, such as improving access to PPE, oxygen supplies and testing, are urgently needed, global vaccine equity must be accelerated. Future generations will judge us by our actions — or lack thereof — in this moment.