MultiHub Forum

The COVID19 pandemic should have been a wakeup call about vaccine equity global, but I'm not sure we learned the right lessons. While wealthy countries hoarded vaccines and boosters, many lowincome countries struggled to vaccinate even their healthcare workers.

The statistics on vaccine equity global are stark: highincome countries vaccinated about 75% of their populations, while lowincome countries reached only around 25%. This isn't just about COVID19 it reflects broader patterns in vaccine equity global.

I've worked in immunization programs for diseases like measles, polio, and HPV, and the same patterns emerge. Vaccines are developed based on markets that can pay, not necessarily where disease burden is highest. Delivery systems are weakest where they're needed most.

What frustrates me about the vaccine equity global discussion is the focus on charity rather than rights. The COVAX initiative depended on donations from wealthy countries rather than establishing a system where vaccines are treated as global public goods.

We have the technology to produce enough vaccines for everyone. We have delivery systems that work in challenging environments (polio eradication shows this). What we lack is the political will and economic models to ensure vaccine equity global.

How do we build systems that ensure vaccine equity global not just for the next pandemic, but for all vaccinepreventable diseases?

The COVID19 vaccine equity global failure should be a lesson for all vaccinepreventable diseases. We have the same patterns with vaccines for pneumonia, rotavirus, HPV, and others: wealthy countries have access while poorer countries wait years or never get access at affordable prices.

I've worked on immunization programs where we couldn't introduce new vaccines because the cost was prohibitive, even though the disease burden was high. This is a fundamental failure of vaccine equity global.

We need to change how vaccines are developed and distributed. This could include publicly funded R&D with open licensing, technology transfer to manufacturers in developing countries, and pooled procurement mechanisms that guarantee markets while lowering prices.

The economic argument for vaccine equity global is strong but underutilized. Vaccinepreventable diseases impose enormous economic costs through healthcare expenditures, lost productivity, and longterm disability. Ensuring vaccine equity global would reduce these costs globally.

I've calculated that the economic benefits of achieving vaccine equity global for just a few diseases would far outweigh the costs. But the benefits are diffuse (accruing to many countries and over many years) while the costs are concentrated (falling on pharmaceutical companies and wealthy country governments in the short term).

We need economic mechanisms that align incentives with vaccine equity global. This could include advance market commitments that guarantee purchase of vaccines for global distribution, or tiered pricing based on countries' ability to pay.

Climate change may affect vaccine equity global in unexpected ways. Some vaccines require cold chain storage, which becomes more challenging in areas with increasing temperatures or more frequent power outages due to extreme weather.

I've worked in regions where maintaining vaccine cold chains is already difficult, and climate change is making it harder. This undermines vaccine equity global even when vaccines are available, because they may lose potency before reaching communities.

Addressing vaccine equity global requires climate resilient health systems. This means reliable power for cold chain equipment, transportation that can function during extreme weather, and healthcare facilities that can maintain services during climate disruptions.