While rich countries are already working on booster shots, poor countries have not even vaccinated all vulnerable elderly people against corona. But a solution seems near.

While the coronavirus is still spreading around the world, rich countries in particular seem to be gaining the upper hand. The most prosperous countries managed to claim the first stocks of vaccines and have already been able to jab the majority of their citizens. In the meantime, there is already talk about booster shots and vaccinating children. And that while some poor countries have only just started poking vulnerable citizens. It seems that a fair distribution of the highly sought-after corona vaccine is far from feasible. Or is it?

Moral failure

At the beginning of this year, World Health Organization Director-General Tedros Adhanom Ghebreyesus already highlighted the “outrageously unbalanced” distribution of vaccines. Wealthy countries claimed the bulk of all available vaccines, while representing only 14 percent of the world’s population. Thus, according to Adhanom Ghebreyesus, we would be ‘on the brink of catastrophic moral failure’. But his words made little noise. Because as things stand, rich countries are currently vaccinating children, while many frail elderly in poor countries haven’t even had their first shot. The patience of the poorest in the world is therefore being severely tested.

Poor countries

There are several reasons why it has not yet been possible to distribute the vaccines fairly. First of all, there are relatively few vaccines available. And as a result, poor countries often miss out. “When vaccines are scarce, it becomes expensive to obtain them,” explains Danish expert Andreas Albertsen in an interview with Scientias.nl from. “Low-income countries with fewer resources are currently unable to afford the price of vaccines. Even as the scarcity of vaccines becomes less acute, the problem remains that low-income countries do not have the resources to obtain them. This puts vulnerable people in poor regions at great risk.”

Fair share

Still, since the start of the pandemic, experts have insisted on the need to distribute vaccines fairly around the world. It is questionable whether residents of wealthy countries can ever really feel safe as long as the virus is still circulating in other parts of the world. After all, there is a real chance that in countries where the virus still makes many victims, new virus variants will arise against which current vaccines do not work. But if rich countries buy up all current vaccines, there will be little left for poorer countries, with less thick wallets. “When vaccines are distributed through the known mechanisms of supply and demand, vaccine distribution does not necessarily reflect who wants or needs a vaccine most, but to a large extent also their ability to pay,” explains Albertsen. “This means rich countries can buy large quantities of vaccines at a price that low-income countries can hardly match.”

COVAX

To give poor countries a chance, the COVID-19 Vaccines Global Access (COVAX for short) was created. A wonderful initiative on paper to which countries, philanthropists and the private sector can pledge money, in order to make COVID-19 vaccines available to everyone. But in practice, little comes of it. “One obstacle to COVAX is that you can only distribute vaccines if you have them,” says Albertsen. “When COVAX does not receive enough donations, it becomes difficult for them to obtain vaccines.”

Vaccine Tax

In an opinion piece however, the Danish expert shares an effective solution to the unfair distribution of vaccines. This is due to an introduced vaccine tax. “The vaccine tax is intended to make extra money available for COVAX,” says Albertsen. It means rich countries pay taxes on their vaccine purchases to help the rollout of vaccines in less fortunate countries.

“The vaccine tax is intended to make extra money available for COVAX”

How does it work?

That’s how the idea works. “For every vaccine purchased, a fraction of the price paid for the vaccine is set aside,” explains Albertsen. “The selling company then transfers this money to COVAX.” So the basic idea is that the tax ensures that those who buy vaccines for their own population also help fund international efforts to make vaccines available to the poorest. “An introduction of the tax would rigorously increase COVAX’s ability to purchase large quantities of vaccines,” Albertsen said. “This will improve the current situation, where many vulnerable people have not been vaccinated in low-income countries. At the same time, this ensures that donations to COVAX are not only made out of charity. So far, that has contributed to some countries failing to fulfill their moral obligations to the world’s most vulnerable.”

fairer

In that sense, taxation would therefore be a lot fairer than the current donation model. While market forces drive vaccine development, it inevitably means rich countries are always first in line. And if these prosperous countries subsequently don’t give anything to COVAX, the unfair distribution of vaccines around the world will persist. Taxing one’s own vaccine purchases could therefore help to tackle ‘Western egoism’.

How high?

Another advantage of the vaccine tax is that the contribution is proportional to the amount of vaccines each country purchases for its own population. “For example, if the purchase price increase was set at 1 percent, for every 1,000 vaccines purchased, 10 vaccines would be redistributed among low-income countries,” Albertsen said. “The fairest version of the vaccine tax is arguably a progressive one, with the size of the tax depending on how wealthy a country is. So high-income countries pay more tax than middle-income countries. It would also be reasonable if low-income countries did not have to pay taxes.”

Improved system

In practice, this means that countries pay a tax to vaccine manufacturers, which is then passed on by the selling party to organizations such as COVAX. To encourage vaccine makers to get involved, COVAX could then decide to buy vaccines only from companies that comply with the tax. And in this way, the less fortunate in the world will also have the opportunity to be vaccinated against the devastating coronavirus. “It can improve a bit on the current system that is flawed in many ways,” Albertsen says. “Unfortunately, however, it cannot remedy all defects.”

“It can slightly improve the current system that is flawed in many ways”

scarcity

For example, the vaccine tax will not be able to solve all the problems surrounding the production of the vaccines. “The unequal distribution of vaccines is one of the problems we face in the current situation,” Albertsen noted. “The other is (or was, at least for long periods in the pandemic) that there were far too few vaccines available. The introduction of the vaccine tax is intended to reduce the unequal distribution. However, it is unlikely that this will also solve the problem of vaccine scarcity. In short, it will not solve the vaccine shortage, but it will mitigate the unfairness.”

All in all, Albertsen’s proposal shows how we can distribute corona vaccines more fairly in an effective way. “My goal is to make my idea known, because I think it can significantly improve the current state of affairs,” he says. “In my article I also mention several ways in which it can be implemented.” However, the coming period will have to show whether his proposal will be implemented or whether vaccine nationalism will eventually prevail.