Prioritizing Equity: Who's Being Left Behind In The Global COVID-19 Vaccine Rollout?

Man getting a COVID-19 vaccine that is administered by a medical professional.

This time last year, I remember telling my mom that I didn’t think vaccines against COVID-19 would be a reality before 2022, if at all. I’m familiar with how long it usually takes to develop, approve, manufacture and distribute vaccines—the fastest timeframe from development to approval was previously four years, for mumps—and I just didn’t see this being any different. Luckily, I was proven wrong.

It took less than 12 months between the first confirmed case of COVID-19 and the administration of the first vaccine. As of today, more than 310 million doses of COVID-19 vaccines have been given around the world. I’m in awe at what the world has been able to accomplish with the right mix of scientific prowess, political will and financial resources.

But behind these achievements hides a reality that too few people want to talk about—the wildly inequitable ways in which these vaccines are being distributed around the world. While some countries have already vaccinated more than 20, 30 or even 50 percent of their populations, dozens of countries have yet to receive a single dose.

Unfortunately, this divide is following predictable patterns, with high-income countries leading the race and low-income countries falling to the back of the pack. Out of the 8.2 billion confirmed doses of the COVID-19 vaccine purchased worldwide, only 670 million have been purchased directly by low-income countries (or just over 8%).

In the past few weeks, we’ve seen some encouraging signs as low- and middle-income countries—including Kenya, where I’m based—are starting to vaccinate their most vulnerable populations. They’re doing this with support from COVAX, a global effort to help ensure people everywhere will get access to COVID-19 vaccines, regardless of their wealth. But even with COVAX, it’s estimated that more than 85 poor countries will not have widespread access to coronavirus vaccines before 2023. Meanwhile, countries like the United Kingdom, the United States and Canada are on track to vaccinate their entire adult populations in the next two to six months.

Graph Source: Duke Global Health Innovation Center

Vaccine equity is not just a concern at global levels. In the United States, for example, many older people are struggling to get vaccinated while Latino and Black Americans are being vaccinated at a lower rate than white or Asian Americans. At the same time, around the world, unscrupulous individuals are finding ways to get vaccinated before it’s their turn.

Something’s not right with this picture.

Crisis and emergencies often bring out the best in people, and COVID-19 is no exception. Frontline healthcare workers, for example, have been putting their own lives on the line since day one, treating as many people as possible, often under grueling circumstances. The darker side of the story is that crisis and emergencies can also bring out our most selfish nature. Sadly, it feels to me like this is what’s happening with the rollout of COVID-19 vaccines.  

Understandably, we all want to be vaccinated as soon as possible, so that we—and our loved ones—can be protected, and so that some semblance of normalcy can return to our lives. But the problem is that right now there’s a finite number of vaccines available on the planet, and what’s being given somewhere is not being given somewhere else. There’s a strong case to be made for sharing supplies, and some researchers are putting forward ways to do so.

In January 2021, the World Health Organization (WHO) called on all countries to work together in solidarity to ensure that within the first 100 days of the year, vaccination of health workers and older people was underway in all countries. As that deadline approaches, now is the time for all of us to do our part and call on our leaders to do what’s right—not only for other countries, but also for our own, because ultimately this pandemic won’t truly be over until it’s over everywhere.

There’s something very simple we can all do to be part of the solution. I’ve signed the WHO’s COVID-19 Vaccine Equity Declaration—will you join me?