ANALYSIS - Consequences of global COVID vaccine inequality

Many vaccine products have shown limited signs of being globally available

Jonathan Fenton-Harvey   | 02.02.2021
ANALYSIS - Consequences of global COVID vaccine inequality

The writer is a researcher and journalist focusing on conflict and geopolitics in the Middle East and North Africa, primarily related to the Gulf region.


Global COVID vaccinations are seeing positive results, as Novavax, Johnson & Johnson have recently approved successful products and join other companies such as Moderna, Pfizer-BioNTech, Oxford-AstraZeneca, along with their Russian and Chinese rivals Sputnik V, Sinopharm, and Sinovac.

While this raises hopes that life could eventually see a return to “normal”, the coronavirus pandemic has evidently worsened many global inequalities, and this could increase as more vulnerable parts of societies across the world face less access to a vaccine.

BAME (Black, Asian, and Minority Ethnic) groups, for example, have already been found to be more at risk of catching COVID-19 than others. A study by the UK’s Office for National Statistics showed that BAME individuals were less likely to receive government stimulus support or worked in low-income jobs where they could not practice social distancing.

Now, many vaccine products have shown limited signs of being able to reach most of the world’s population. Low-income countries are more vulnerable due to supplies remaining in the hands of wealthier governments.

According to, as of January 22, 52 countries had begun to vaccinate their citizens while 142 others had not yet started mass vaccination programs.

Of the 53 million doses of coronavirus vaccines administered so far, over 22 million doses have been administered in Asia, 17 million in North America, 13 million in Europe, 330,000 in Central and South American countries, and 7,000 in Africa.

Countries such as the United Kingdom, United States, and European Union countries have already acquired high levels of vaccines and plan to roll them out to most of the population within 2021, with priority groups such as the elderly, frontline workers, and those with health conditions expected to be immunized before the summer.

The issue of inequality is largely clear within the European Union (EU). On January 8, the bloc procured a deal with Pfizer-BioNTech to acquire 300 million doses of its vaccine, which was then half of its current supplies. That the EU can acquire so many doses from a company that has taken the lead in providing the vaccine globally amounts to “vaccine hoarding”.

Many Western countries have ordered enough doses of vaccine to cover their populations many times over. For instance, the UK has acquired around 367 million doses from different companies, which is more than five times its population of 67 million. Canada, New Zealand, and Australia meanwhile have acquired enough supplies to give their populations around four doses each.

The current data suggests a high degree of vaccine hoarding, while many countries in South Asia, Africa, and South America have less access to these supplies. A study by the Economic Intelligence Unit revealed that 84 poorer countries may not have widespread access to vaccination until 2024. Meanwhile, a number of rights groups, including Amnesty International, Frontline AIDS, Global Justice Now, and Oxfam warned that a total of 67 low-income countries will have no access to the vaccination in 2021, having made no purchases of any of the leading products.

There are concerns over how this could impact Africa in particular, due to a very limited rollout rate. According to World Health Organization (WHO) officials, Guinea is the only African country to have begun vaccinations, after it began the rollout of the Russian Sputnik V vaccine in January. Many other countries face challenges, such as securing vaccine ingredients, production quotas, delays in delivery, weak medical infrastructure, and a shortage of qualified health workers to administer injections.

Low-income countries are often more reliant on COVAX from Gavi the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO, rather than big pharmaceutical companies like Pfizer, Moderna, and Oxford-AstraZeneca. This could lead to a delayed roll-out of the vaccine since COVAX’s supplies could potentially be slower to arrive. COVAX announced that it would be able to vaccinate over 20 percent of Africa by the end of 2021.

The Middle East is another region where many of these inequalities are laid bare. For example, while the oil-rich Gulf countries have rapidly acquired vaccines and begun immunizing their citizens, countries such as Yemen, Syria, and Libya face limitations due to instability and conflict conditions. Meanwhile, Lebanon, which is in the midst of an economic crisis, has yet to announce any vaccine rollout, despite its recent procurement of a million doses of the Pfizer vaccine.

Even within wealthier countries, there may be less access for ethnic minorities in question. African Americans are less likely to access vaccination than their white and Hispanic fellow countrymen. In North Carolina, for instance, black people have so far accounted for just 11% of the vaccine recipients despite making up 22% of the population in that state.

Experts believe that several factors could be behind this, such as deep distrust among African American communities towards the medical establishment due to the discriminatory treatment they have historically been subjected to, and a lack of access to the vaccine. This indicates a prevailing risk of widening racial health inequalities in the US and other Western countries, which existed well before the pandemic.

Not only could these global inequalities disproportionately harm most individuals around the world, but they could also undermine international efforts to counter the pandemic and help return to normal life. Bill Gates and his wife Melinda warned of the risks of “immunity inequality” in the distribution of the COVID vaccines.

As Melinda Gates wrote in their annual letter: “Already, wealthy nations have spent months pre-purchasing doses of vaccine to start immunizing their people the moment those vaccines are approved… But as things stand now, low and middle-income countries will only be able to cover about one out of five people who live there over the next year.”

Warning of the need to ensure global immunity, Gates added that new clusters will emerge and spread globally, perpetuating the cycle of worldwide lockdowns.

Should this global inequality over vaccinations continue, this could also extend the opportunities of China and Russia to utilize “vaccine diplomacy” for the purpose of boosting their geopolitical clout. China for instance has secured deals with various African and Asian countries to roll out its Sinopharm and Sinovac products.

And due to the limitations that Western countries face in helping to counter the virus in poorer countries, Beijing has now taken the lead in supplying protective equipment and medical supplies to many African and Asian countries. This has helped to extend its geopolitical reach, as per its so-called Belt and Road Initiative (BRI), showing how its aid could fill a vacuum and help increase its economic control in more vulnerable regions.

*Opinions expressed in this article are the author’s own and do not necessarily reflect the editorial policy of Anadolu Agency.

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