Vaccine equity

Source: Wikipedia, the free encyclopedia.

Vaccine equity is giving everyone equal access to vaccines.[1] Vaccine equity can decrease the risk of vaccine resistance.[1]

Vaccine inequity has multiple causes, but wealth is a major factor.

Inequity damages the global economy; supply chains cross borders, and even areas with very high vaccination rates depend on areas with lower vaccination rates for goods and services.[2]

Factors

The wealthy generally have better access to vaccines than the poor.[3] Within countries, there may be lower rates of vaccination in racial and ethnic minority groups, in rural areas, in older adults, and among those living with disabilities or chronic conditions, in rural communities. Some countries have programs to redress this inequality.[4] Political, economic, social, and diplomatic factors can limit vaccine availability in some countries.[3]

Logistical difficulties are an obstacle. Hot climates, remote regions, and low-resource settings need cheap, easy-to-use vaccines.[5][6] Vaccines are often not tested to see if they can survive outside a fridge or be administered in a single shot, as it is not in the financial interests of the manufacturer.[6] Cheap vaccines are often not administered due to a lack of infrastructure funding.[7]

Doctors Without Borders (MSF) lists five major obstacles to vaccine equity:[5]

  • Vaccine prices; new vaccines are on-patent and expensive
  • Getting vaccines to children; this is expensive and gets even more difficult in conflict zones and natural disasters
  • Five clinic visits in the first year of life is often too many; for people in remote areas with many children, it can be much more costly and difficult to get to a clinic.
  • Keeping vaccines cold; see cold chain.
  • Age-out; children who don't get vaccinated on-schedule often have to pay for their shots. Disruption from natural disasters or conflict can mean that entire generations go unprotected.

Intellectual property

Intellectual property law causes problems with the economics of vaccines. IP currently operates by granting pharmaceutical monopolies lasting decades. The economics of monopoly power give the monopolist a strong financial incentive to use value-based pricing and set prices that many, often most, potential customers can't afford (a pricing strategy that charges what the market will bear, unlike traditional cost-plus pricing charges the cost of production plus a markup). Price discrimination attempts to charge each person the maximum they would be willing to pay, and charges every purchaser more than they would be charged in a fully-competitive market. A vaccine monopolist has no incentive to let the rich actually subsidize the poor. Medical-product monopolists may claim that the high prices charged to the rich subsidize the lower prices charged to the poor when in fact both are being charged well over independent estimates of the cost of production (see, for instance, GeneXpert cartridges and pneumococcal vaccine).

Amnesty International, Oxfam International, and Médecins Sans Frontières (MSF; Doctors without Borders) have criticized government support of some vaccine monopolies, on the grounds that the monopolies dramatically increases prices and harm vaccine equity.[8][9][10] During the COVID-19 pandemic, there were calls for COVID-related IP to be suspended, using the TRIPS Waiver. The waiver had support from most countries, but opposition from within the EU (especially Germany), UK, Norway, and Switzerland, among others.[11][10][12]

COVID-19

Vaccine inequality has been a major concern in the COVID-19 pandemic, with most vaccines being reserved by wealthy countries,[1] including vaccines manufactured in developing countries.[13] Globally, the problem has been distribution; supply is adequate.[14] Not all countries have the ability to produce the vaccine.[15] In low-income countries, vaccination rates long remained almost zero.[16] This has caused sickness and death.[quantify][1]

In September 2021, it was estimated that the world would have manufactured enough vacine to vaccinate everyone on the planet by January 2022. Vaccine hoarding, booster shots, a lack of funding for vaccination infrastructure, and other forms of inequality mean that it is expected that many countries will still have inadequate vaccination.[17]

On August 4, 2021, the UN called for a moratorium on booster doses in high-income countries, so that low-income countries can be vaccinated.[2] The World Health Organization repeated these criticisms of booster shots on the 18th, saying "we're planning to hand out extra life-jackets to people who already have life-jackets while we're leaving other people to drown without a single life jacket".[13] UNICEF supported a "Donate doses now" campaign.[18]

See also

References

  1. ^ a b c d "COVID vaccines: Widening inequality and millions vulnerable". UN News. United Nations. 19 September 2021. Retrieved 30 October 2021.
  2. ^ a b The Lancet Infectious Diseases (September 2021). "COVID-19 vaccine equity and booster doses". The Lancet. Infectious Diseases. 21 (9): 1193. doi:10.1016/S1473-3099(21)00486-2. ISSN 1473-3099. PMC 8360703. PMID 34391506.
  3. ^ a b "Global Dashboard for Vaccine Equity". UNDP Covid-19 Data Futures Platform. UN Development Program.
  4. ^ "Partnering for Vaccine Equity | CDC". www.cdc.gov. CDC. 28 October 2021.
  5. ^ a b "Vaccination". Doctors Without Borders - USA. Retrieved 30 October 2021.
  6. ^ a b "Global vaccine plan draws criticism". Nature News Blog.
  7. ^ Paulson, Tom (15 May 2012). "Doctors Without Borders criticizes Gates-backed global vaccine strategy". Humanosphere.
  8. ^ "G7 support for pharma monopolies is putting millions of lives at risk" (Press release). Amnesty International. 10 June 2021. Retrieved 20 August 2021.
  9. ^ "Vaccine monopolies make cost of vaccinating the world against COVID at least 5 times more expensive than it could be" (Press release). Oxfam International. 29 July 2021. Retrieved 20 August 2021.
  10. ^ a b "MSF calls for no patents or profiteering on COVID-19 drugs and vaccines / No profiteering on COVID-19 drugs and vaccines, says MSF". Médecins Sans Frontières (MSF) International.
  11. ^ "Countries must not let another opportunity slip by to advance the global waiver on overcoming COVID-19 medical-tool monopolies". Médecins Sans Frontières (MSF)/Doctors Without Borders. 13 September 2021. Retrieved 23 September 2021.
  12. ^ "Governments must act fast on consensus supporting historic move to suspend monopolies during pandemic / COVID-19: Governments must build consensus around waiver". Médecins Sans Frontières (MSF) International.
  13. ^ a b "COVID-19 Virtual Press conference transcript - 18 August 2021". www.who.int. Retrieved 30 October 2021.
  14. ^ "Vaccine equity". www.who.int. Archived from the original on 1 November 2021. Retrieved 1 November 2021.
  15. ^ Brosig, Malte (2021). "6. COVID and global order". Africa in a Changing Global Order: Marginal But Meaningful?. Switzerland: Palgrave Macmillan. p. 194. ISBN 978-3-030-75408-2.
  16. ^ "Impact of vaccine inequity on economic recovery". UNDP Covid-19 Data Futures Platform. UN Development program.
  17. ^ Bokat-Lindell, Spencer (14 September 2021). "Opinion | The Global Vaccine Drive Is Failing. Can It Be Saved?". The New York Times.
  18. ^ "Dear G20 leaders: Vaccine equity is a must for Africa". www.unicef.org.
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