Opinion: Vaccine Apartheid in Context

YOUNG AMBASSADORS PROGRAM

Opinion: Vaccine Apartheid in Context Contributors: Kimberly Rolle, Alexi Santiago, and Alonna Williams September 21 is designated as International Peace Day by the United Nations National Assembly. The day calls for a 24-hour ceasefire. Even with an absence of violence, there is still turmoil and inequity globally. Covid-19 and its residual effects make inequities more transparent. Global vaccine inequalities lead to worsening human development and socio-economic outcomes.

The pandemic’s impact on health inequalities and political unrest became extremely translucent during quarantine. When the world’s economy shut down, people were required to isolate themselves in their homes. As individuals isolated, the world’s leading democracies also entered a period of medical isolationism. The United States of America (U.S.) pulled out of the World Health Organization (WHO) and placed restrictions on domestic vaccine distributors. These measures created greater apparent inequity in vaccine distribution.

According to the World Health Organization (WHO), over 4 million people have died of Covid- 19 globally. There are over 220 million confirmed cases in the world. Many donor and developed nations administered the Covid-19 vaccine to at least 30% of its population. However, over 100 developing and periphery nations have not administered a single dose of the Covid 19 vaccine. The largest consequence of Covid-19 is tremendous death, but there are several collateral consequences to the pandemic.

Covid-19 is highlighting global economic inequality. The constraints on many countries' economies are a contributing factor to global social unrest. This pandemic has ushered in a period of greater global turmoil. From the United States, Cuba, Berlin, and Australia, Covid-19 and its effects are a major factor in political and social unrest.

Global turmoil is not unfamiliar to the world with respect to disease outbreaks. The first outbreak of the Ebola virus in South Sudan in 1976 spread similarly to Covid-19. A close contact viral infection, the Ebola virus started in a cotton factory and was contracted by others in hospital areas. Ebola virus collapsed the healthcare system during the 2000s in West Africa largely due to mistrust in the government, inadequate disease surveillance, poor testing capacities, and incomplete information. There was a heavy

YOUNG AMBASSADORS PROGRAM reliance on international organizations and efforts by the Center for Disease Control, U.S. Borders and Customs Protections, Department of Homeland Security, and the World Health Organization to provide support to the countries affected by the epidemic.

The involvement of international organizations and wealthy countries like the U.S. in the fight to stop the spread of Ebola illustrates how the international community can help lead a region out of an epidemic.

As seen with the Ebola epidemic, policies in donor countries have a cascading effect in recipient countries. Increased social unrest and health isolationist policies within these countries can negatively affect the funding and distribution of medications, vaccines, and personal protection equipment to lower income countries in need, which leads to issues like global vaccination inequalities. Last summer, the Trump administration chose to withhold the United States’ $62M contribution to the World Health Organization. With China, the U.S. decided to decline efforts to work together with 172 other countries to develop and manufacture a Covid-19 vaccine. This decision illustrated the administration’s lack of commitment to equitable vaccine access to other countries. This is further exemplified by the words of the Director of Global Affairs in the Department of Health and Human Services, Garrett Grigsby, whose words echoed a sense of ‘vaccine nationalism’.

"Once the American people, their needs with respect to the vaccine, are met ... we certainly will be looking to do our fair share in terms of supporting the global need for vaccinations," This point of view from a Director of Global Affairs from the U.S. Department of Health is especially alarming amid a global pandemic. Former Secretary of State, Mike Pompeo, recognized that the U.S. is a leader in vaccine distribution. He also stated that the country's commitment to vaccine distribution would be “unmatched'' by other countries, yet the words and actions of the U.S. suggested otherwise.

During the Trump Administration, the U.S. adopted the attitude of “America First” which changed the U.S. posture toward the world. This is indicative in the trade wars with China, pulling out of the Paris accords and most relatable, and pulling out of the WHO. While the current president, Joseph Biden, has reversed many of these actions, the attitude is still amiss among the general population.

YOUNG AMBASSADORS PROGRAM The lack of attention paid to social and economic inequalities in the U.S. drove people to vote for an administration they felt would finally listen to them. As many Americans found themselves out of work because of what they believed to be due to globalization, they felt threatened by candidates aligning themselves with it. They wanted the America of their youth back; they wanted the United States to be “great again.” This attitude among much of the population led to the election of a congress and president that focused on the U.S. The U.S. is a hegemonic power and leading donor to most intergovernmental organizations. Therefore, the country’s domestic policies greatly affect the rest of the world. If the U.S. decides to pull funding from global health organizations like the WHO and COVAX, then there is significantly less funding to help lower income countries.

As Covid-19 continues to mutate and spread uninhibited, the effects on long-term peace and security in conflict zones and fragile states will become increasingly dire. Already, we are seeing governments and armed groups exploiting the pandemic to consolidate power and repress citizens. In Myanmar, where the de facto ruling party is desperately clinging to authority, civilians deemed threats to the regime are continually denied access to lifesaving care and scarce vaccines are reserved for loyalists. In parts of Colombia, armed groups are imposing strict measures to contain the spread of Covid-19, using violence or threats of violence to enforce restrictions and control social order.

Elsewhere, the pandemic has interfered with critical peacebuilding efforts. Take South Sudan, where disarmament, demobilization and reintegration (DDR) activities have been halted and humanitarian relief disrupted. Places like Libya and Venezuela have also seen significant delays in diplomatic efforts due to pandemic-related travel restrictions and de-prioritization on behalf of international leaders. Equally concerning is the challenge that a prolonged pandemic poses to local peacebuilders who must find alternative ways to build community amidst strict social distancing measures as well as fight for attention and funding from international donors hyper-focused on pandemic-relief efforts.

This is all to say that for many in the global south, the consequences of vaccine apartheid extend far beyond a protracted public health crises and imminent recession.

Experts project that at the current rate of vaccination “poorer economies'' will not achieve widespread vaccination coverage until 2023, if at all. It is impossible to know

YOUNG AMBASSADORS PROGRAM precisely how this will impact global conflict, but it is likely something we cannot afford to find out.

It goes without saying that wealthy countries and big-pharma must begin to realize that slowing the spread of Covid-19 is about more than ending the pandemic. The choices they make regarding vaccine distribution impact everything from global peace and security to poverty and climate change. At the same time, as peacemakers, we too must remember that our expertise, as unrelated to epidemiology as it may seem, is just as critical to getting vaccines into conflict zones, educating communities on immunity, curbing vaccine hesitancy, and facilitating collaboration between governments, armed non-state actors, and citizens on Covid-19 relief.