As COVID-19 vaccines are developed and approved, national leaders face a dilemma: which to prioritize – country or planet?

Both, most people would answer. Nonetheless, ‘‘vaccine nationalism,” where countries prioritize their own vaccine needs, is forecast to handicap not just the global health recovery but the economic one, too, with one report estimating its impact at more than $1 trillion per year.

That’s because although progress has been made through initiatives like COVAX (the global effort to ensure access to COVID-19 vaccines for all countries), the majority of the world’s poor are still unlikely to be immunized in 2021 – prolonging disruption.

The world’s richest nations have pre-ordered billions of doses of vaccines – enough to protect some populations several times over. However, in doing so they have left less for others and may push up treatment prices, too.

With this year’s Davos Agenda focusing on themes of interdependence and cooperation, leaders’ vaccination priorities look set for renewed scrutiny.


a chart showing immunizations promised to different income countries by the major vaccine/pharmaceutical developers

Wealthier nations have an advantage in the race for immunity.
Image: New York Times

Is vaccine nationalism new?

In a word, no. A similar pattern was seen during the 2009 H1N1 influenza pandemic. Before that, vaccines for HIV/AIDS, smallpox and polio were only available in developing nations after developed countries had secured enough stocks for domestic needs.

Indeed, historic limitations in international cooperation may have spurred the development of home-grown immunological capabilities among countries such as China and India.

But while there may be a certain inevitability to nations’ desires to protect themselves first, such decisions have consequences for all.

No real winners

“New research outlines that global competition for vaccine doses could lead to prices spiking exponentially in comparison to a collaborative effort such as the COVAX Facility,” World Health Organization chief Tedros Adhanom Ghebreyesus said this year.

“It would also lead to a prolonged pandemic as only a small number of countries would get most of the supply. Vaccine nationalism only helps the virus,” he added.

And it’s not only the poorest who will suffer. As long as COVID-19 is not under control everywhere, the cost of the global pandemic will continue to be as high as $1.2 trillion per year, according to research nonprofit RAND Europe. Continued disruption to the world economy, through battered supply chains and weaker demand will continue to weigh on all nations.

High-income countries and regions, including the US, the UK and the EU, are forecast to lose around $119 billion per year, until a global recovery is secured.


The best medicine

The securing of 2 billion doses of candidate vaccines by COVAX could not have been achieved without considerable global cooperation.

At least 1.3 billion doses are expected to be made available to 92 economies eligible for the COVAX scheme, targeting up to 20% of populations by the end of 2021.

The coming year may also bring increased multilateralism. US President-elect Joe Biden has not yet committed to joining the COVAX facility, but his transition team has reportedly met with GAVI vaccine alliance leaders. Biden has also pledged to rejoin the WHO, which could lead to a renewed focus on global solutions.

The global vaccine alliance, Gavi, says further COVAX pledges offer the clearest pathway to ending the acute phase of the pandemic. More lives and livelihoods could be at stake.