Redressing COVID-19 vaccine inequity amidst booster doses: charting a bold path for global health solidarity, together

Abstract

Background With large swathes of the world’s population—majority clustered in low- and middle-income countries—still yet to receive the minimum of two doses of the COVID-19 vaccine; The need to address the failures of international solidarity to equitably distribute COVID-19 vaccines is now more urgent than ever to help curb the pandemic and prevent future variants. However, many high-income countries have adopted a “me first” approach, proceeding to offer COVID-19 booster doses to their entire populations, including those at least risk of severe illness, whilst the rest of the world is left unvaccinated or partially vaccinated with one dose for even their most vulnerable communities. Main body COVID-19 vaccine inequity places the health of the global population at risk and exacerbates socio-economic repercussions, especially in low- and middle-income countries. Initiatives launched to combat vaccine inequity such as the Fair Allocation Framework for the COVID-19 Vaccines (COVAX) have been unsuccessful as several governments, primarily from high-income countries, have scaled down their contributions to the initiative. Furthermore, COVAX has not seriously engaged with the Access to COVID-19 Tools (ACT) Health Systems Connector, as was originally intended, leading to crucial health systems components critical to vaccine delivery to be overlooked. Several strategies can be employed to help achieve the desired global immunization goals, such as Intellectual Property waivers, increased donations, and activation of new COVID-19 vaccine manufacturing hubs. In addition, continued advocacy for vaccine equity by all involved and affected stakeholders, as well as critical amendments to existing or upcoming legislation and funding mechanisms will help address the shortcomings of current inequitable vaccine distribution. Conclusions Global solidarity and collective action through pandemic governance mechanisms are urgently needed to ensure vaccine equity. These interventions are vital to rapidly mitigate ongoing health and humanitarian crises and ultimately curb the pandemic, sooner rather than later.

Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture

“…58 , 59 , 60 With ongoing vaccine inequity, the emergence of new SARS-CoV-2 variants, and travel restrictions that disproportionately affect low-income and middle-income countries, international organisations and high-income countries have a special obligation to prevent and mitigate direct, indirect, and discriminatory exclusion of stakeholders from low-income countries in pandemic preparedness and response negotiations. 61 …”

The Impact of COVID-19 Vaccine Coverage on Deaths Outcome in Africa, Subregional Differences and the need for a Renewed Multi-level Effort

“…Many African countries have been unable to procure vaccines in a timely fashion. The failures of COVAX, and vaccine procurement arrangements by high-income countries, which gobbled up existing supply, are the main reasons [14,15]. There are also significant country-specific variations in terms of government interest in acquiring vaccines, and in terms of fiscal capacity to do so [16].…”

Challenging the Illusion: Health Equity Amidst New Variants

“…LMICs had to heavily rely on COVAX and other bilateral donation programs, which have resulted in fewer doses of the vaccines. To compound this, the price of vaccine doses is also not feasible for LMICs to afford, with some reports of vaccine manufacturers even increasing the costs of doses for LMICs—a move that is ultimately self-defeating for global public health [ 13 ].…”