The need for global cooperaton on vaccine allocation

Trump administration officials have compared the global allocation of vaccines against the coronavirus that causes COVID-19 to oxygen masks dropping inside a depressurizing airplane. “You put on your own first, and then we want to help others as quickly as possible,” Peter Marks, a senior official at the U.S. Food and Drug Administration who oversaw the initial phases of vaccine development for the U.S. government, said during a panel discussion in June. The major difference, of course, is that airplane oxygen masks do not drop only in first class—which is the equivalent of what will happen when vaccines eventually become available if governments delay providing access to them to people in other countries.

By early July, there were 160 candidate vaccines against the new coronavirus in development, with 21 in clinical trials. Although it will be months, at least, before one or more of those candidates has been proved to be safe and effective and is ready to be delivered, countries that manufacture vaccines (and wealthy ones that do not) are already competing to lock in early access. And to judge from the way governments have acted during the current pandemic and past outbreaks, it seems highly likely that such behavior will persist. Absent an international, enforceable commitment to distribute vaccines globally in an equitable and rational way, leaders will instead prioritize taking care of their own populations over slowing the spread of COVID-19 elsewhere or helping protect essential health-care workers and highly vulnerable populations in other countries.

That sort of “vaccine nationalism,” or a “my country first” approach to allocation, will have profound and far-reaching consequences. Without global coordination, countries may bid against one another, driving up the price of vaccines and related materials. Supplies of proven vaccines will be limited initially even in some rich countries, but the greatest suffering will be in low- and middle-income countries. Such places will be forced to watch as their wealthier counterparts deplete supplies and will have to wait months (or longer) for their replenishment. In the interim, health-care workers and billions of elderly and other high-risk inhabitants in poorer countries will go unprotected, which will extend the pandemic, increase its death toll, and imperil already fragile health-care systems and economies. ...

It is not too late for global cooperation to prevail over global dysfunction, but it will require states and their political leaders to change course.

What the world needs is an enforceable COVID-19 vaccine trade and investment agreement that would alleviate the fears of leaders in vaccine-producing countries, who worry that sharing their output would make it harder to look after their own populations. Such an agreement could be forged and fostered by existing institutions and systems. And it would not require any novel enforcement mechanisms: the dynamics of vaccine manufacturing and global trade generally create layers of interdependence, which would encourage participants to live up to their commitments. What it would require, however, is leadership on the part of a majority of vaccine-manufacturing countries—including, ideally, the United States....