The Tragedy of "My Country First" — The Fletcher Forum of World Affairs

Apr 29

Apr 29 The Tragedy of "My Country First"

by Yug Sinha and Dikshi Arora

The outbreak of the COVID-19 pandemic and previous experience from the 2009 H1N1 pandemic has demonstrated that national governments tend to prioritize their own interests rather than pursue a globally coordinated approach. While international institutions such as the United Nations, the World Health Organization (WHO), and the Global Alliance for Vaccines and Immunization (GAVI) are working together to coordinate global COVID-19 vaccine efforts, several governments have already arranged deals with vaccine manufacturers to access the vaccine as soon as one is ready.

How well the global pandemic is controlled and contained depends on global coordination and cooperation. However, according to Duke University’s Global Health Institute, a group of rich countries comprising just 16% of the world’s population has reserved 60% of the global vaccine supply for themselves. The United States has been reluctant to invest in these coordinated efforts and Canada has enough vaccine to inoculate its population six times over.

There are several economic implications that result from pursuing this nationalistic behavior regarding the manufacturing and distribution of COVID-19 vaccines. Three essential elements of vaccine nationalism are:

· Prioritizing vaccine development and positioning it under the ambit of national security issues. This is where domestic supremacy comes into play and could affect global medical supplies.

· Huge deals with pharmaceutical companies who are the suppliers of vaccines are quotidian during the race to access vaccines.

· Changes in export and import policies provide an advantage to frontrunners in the vaccine race. This led to the hoarding of supplies and an increase in demand (observed during H1N1 Influenza crisis and H3N2 virus).

So far, the frontrunners in this vaccine race have adopted a self-centered approach rather than a collaborative, synergistic, global one.

There have been international efforts to synchronize a global response. COVAX, a public-private partnership between the WHO and GAVI, seeks to supply 1.3 billion vaccine doses to middle and poor-income countries, but it has had a slow rollout.

Vaccine nationalism is closely tied to the current diplomatic relations between global superpowers. In the race of becoming a frontrunner, several countries planned to bypass domestic regulatory health approvals to display superiority. Typically the development of a vaccine takes several years of extensive testing and improvisation of efficacy. Russia and China, for instance, have approved certain vaccines even before the completion of Phase III trials. This could erode public trust and hinder the genuine efforts of the countries to protect their citizens from COVID-19 via herd immunity. Public trust and accountability are a sine qua non for achieving this goal.

There is a limited global vaccine supply chain but unlimited demand. According to Toby Peters, technology expert, “This is the biggest logistical challenge the world has ever faced”.

The supply chains for vaccine production are global. It is unlikely that a country possesses all essential inputs to manufacture and sustain the production of vaccines as components are gathered from multiple geographical locations. Such global supply could allow countries that are not manufacturing vaccines themselves but have control over a supply of input, to ensure access to the finished products. However, frontrunner countries are choosing to hoard certain inputs resulting in interrupted supply chains. This could mean extreme pressure on the domestic health systems of the poor countries, propelling towards an eventual collapse.

COVID-19vaccine distribution, therefore, is akin to the Prisoner’s Dilemma, which illustrates how two agents acting in their own self-interest end up with a worse outcome than if they had coordinated their behavior. The world can achieve an optimal outcome and defeat the pandemic if all countries cooperate. However, the dilemma is such that each country also has an incentive to cheat i.e., expecting others to share their vaccine supply while keeping their vaccines to themselves.

A global crisis needs a globally coordinated response and hence the need to treat COVID-19 vaccines as global public goods arises. International competition for vaccine production and supplies could negatively affect global accessibility and affordability. A coordinated response would ensure equitable availability of vaccines in all countries, and not only with those who bid the highest for these vaccines.

The World Trade Organization received a never-before-seen emergency Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver request by India and South Africa. This emergency waiver, if approved, promotes the exchange of critical technological and medical infrastructure and would promote the principle of vaccine equity. However, there are also countries who oppose the emergency waiver. Critics of them say that they are protecting pharmaceutical companies from potential losses and that pharmaceutical companies should not be allowed to promote vaccine apartheid.

While a mild form of nationalism is desirable, an effective form of vaccine nationalism prioritizes one's own without refusing or dismissing duties towards other countries. This is in consonance with the ‘Principle of Equal Value’, which establishes that all individuals, regardless of citizenship or identity, deserve vaccine-induced protection against COVID-19.

There is an urgent need for an ethical and equitable solution to vaccine delivery. The 'principle of equal value’, as an alternative approach must be followed by the vaccine superpowers. COVID-19 deaths will continue to rise, and the clock is ticking. Overall, the global distribution of vaccines has mirrored the domestic distribution mechanism: unjust, unequal, and incompetent. To fight this pandemic together, we must shed our thick skin and cooperate on a multi-dimensional level.

It is high time that countries decide the disastrous implications of their vaccine nationalism.

Dikshi Arora is a second-year law student at Rajiv Gandhi National University of Law, CPL 2021-22 Public Policy Fellow and Columnist for Centre for New Economics Studies, O.P. Jindal Global University.