Vaccine inequity in infographics

By (1) Chris Shin, (2) Julia Shuurmans, Stephanie Erhart, (3) Romy Labranche, (4) Nicole Giroux, (5) MariaLuisa Vigano, Delaney Barth

This post is part of a series of opinion pieces in diverse mediums focusing on the theme “What makes you mad about global health?” These submissions are by McGill students who were part of the course PPHS 511 Fundamentals of Global Health in Fall 2021.

Explanation

Equitable access to COVID-19 vaccine is critical to global health because inadequate global vaccine coverage is resulting in both direct and indirect consequences throughout the world. In countries with low vaccination rates, waves of COVID-19 infections continue to cause excess illnesses and deaths. The continued vulnerability to increase in cases is also aggravating the burden of already struggling healthcare systems and significantly limiting their ability to provide care for other health conditions. For instance, the continuous postponement of vaccination campaigns has steeply decreased childhood vaccination rates last year, as immunizations to at least 13.5 million people were delayed in some of the most vulnerable countries in the world. Furthermore, the overwhelmed healthcare and surveillance systems are less likely to be able to detect and respond to new and existing endemic infectious diseases. In 2020, about 1 million people were left undiagnosed and untreated for tuberculosis, reversing over a decade of investment and global efforts to fight this disease.

The continued diversion of resources to COVID-19 response also leads to consequences beyond direct health impacts. Due to the economic recession from responding to COVID-19 outbreaks, 95 million more people around the world have been pushed to extreme poverty and another 200 million are predicted to be at risk between now and 2030. Additionally, the pandemic also undercut advances in global childhood education and women’s empowerment; combined with increased poverty, these factors would lead to increased global health concerns. The economic impact of vaccine inequities also extends to the global market. As it has been estimated that the world would lose $153 billion per year in GDP if the poorest countries are not able to access the vaccines, addressing vaccine inequities could be helpful for recovering from the global economic recession (which is threatening global health). Finally, the continued transmission of COVID-19 increases the risk of variants. As already occurred in low and middle income countries like Brazil, India, and South Africa, the viral variants with selective advantage in transmission or immune evasion can cause rapid surges in cases, worsening the already precarious situation in those countries. These variants also pose threat to vaccinated individuals and individuals in higher income countries, reminding us that the pandemic will not end without global vaccine coverage and highlighting the importance of addressing vaccine inequities.

Explanation: 

In the light of the new vaccines against SARS-CoV-2 (Coronavirus), which has killed millions worldwide, high income countries are hoarding resources, while low-income countries continue to fight the worse of the pandemic. It is completely selfish to not have a global perspective in the fight against this pandemic. The pandemic is not over until everyone worldwide has access to vaccines. Not only is it not fair that high income countries in the Global North can continue with their lives safely while others are dying, but this inconsideration puts these countries at risk as well, as more contagious variants are arising from non-vaccinated countries. This will continue to extend the pandemic for everyone and create even more long-lasting repercussions on the economy and global health infrastructures, as depicted in the American journal of public health, ‘‘These nationalist policies have transgressed international law, with cascading effects on international trade, health determinants, and human rights.’’ (1). The selfish behaviours that rose during the peaks of the pandemic reflect a worrisome future for global health. Gostin continued to explain that ‘‘Rather than working together to fight a common threat, nationalist strategies pit nations against nations, subvert global action to curb the pandemic, and grind the world to a standstill.’’ (1). This is a topic that is very upsetting to me considering how prevalent it is. It is shocking that politicians and government officials are not coming together to end this for all. The priority should be every human’s safety, rather than nationalistic ideologies to ‘‘get ahead’’. In sum, I can’t say it better then Dr. Pai in a Forbes interview, ‘‘Covid-19 is a sharp reminder that everyone should be concerned with making vaccines available, regardless of ability to pay, the country in which you happen to be born or live, or any of the other criteria that have long been abused to deny equitable access to the fruits of modern science.’’(2) 

I hope my infographic can help students and adults better understand what is happening right now and potentially spark passion in the readers. I hope to inspire people to fight for change in this topic of global health to help those that are suffering. 

References:

  1. Gostin, L. O., Moon, S., & Meier, B. M. (2020, November). Reimagining global health governance in the age of covid-19. American journal of public health. Retrieved November 30, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542258/. 

  2. Pai, M. (2021, February 11). Ebola, covid-19 and the elusive quest for global health equity. Forbes. Retrieved November 30, 2021, from https://www.forbes.com/sites/madhukarpai/2021/02/08/ebola-covid-19-and-the-elusive-quest-for-global-health-equity/?sh=2d18535578e4. 

Explanation:

Throughout the pandemic, high income countries (HICs) have been highly nationalist in their response. Low and middle income countries (LICs & MICs) have been left behind in the race for every country to protect their populace no matter the cost, with many resources hoarded first by those that can afford them (1,2). Effective global health policy requires effective and equal partnerships and collaboration, instead of only a national focus. The existing issue of vaccine inequity is a key example of nationalist responses coming at the cost of global health, and effectively prolonging the pandemic.

Currently, despite the number of COVID-19 cases in low-income countries (LICs) exceeding those recorded in high-income countries (HICs), as of November 12th 2021, only 6.5% in LICs as compared to 65% of people in HICs have received at least 1 dose (1). Many of these HICs are hoarding vaccines and allowing them to go to waste rather than sharing doses with other countries that have less vaccine access (1,2). Countries need to be informed by reliable science instead of prioritizing politics. In the case of booster doses, the scientific evidence is not clearly in support of booster shots (especially for already vaccinated, healthy adults), but there is clear evidence that increased vaccine access for unvaccinated populations would be more beneficial for protecting people, saving more lives and ending the pandemic (3,4). Even if boosters are shown to have a beneficial effect on the immunity of already vaccinated individuals, we would still save more lives if completely unprotected/unvaccinated people were able to receive some protection through the vaccine (3,4).

Unfortunately, COVID-19 vaccine pharmaceutical companies (ex. Pfizer, Moderna, etc.) are not doing enough to make vaccines accessible to all; in fact, several reports are being published emphasizing the growing role of these companies in fuelling this unprecedented crisis (5). Their continued inaction has demonstrated their prioritization of profit at the expense of saving lives. This is particularly evident in their failure to prioritize vaccine deliveries to lower-middle income countries, refusal to waive intellectual property rights and share vaccine technology in addition to maintaining higher vaccine costs (5). Not only are countries failing to uphold their global citizenship responsibilities, but vaccine pharmaceutical companies like Pzifer, BioNTech SE, Moderna, etc. are as well (5).

Due to how connected our world is today, it is not possible for the pandemic to simply end in one country. As long as the pandemic is allowed to continue in countries with reduced access, it will continue to bleed into every country around the world. Further, unhindered spread of the COVID-19 virus provides ample opportunity for new and deadlier mutations to arise that may evade existing immunity derived from vaccines (3,6). Ultimately, nationalist vaccine policies will harm everyone, even those lucky enough to have previously benefited from increased access.

Additionally, prolonging the pandemic and perpetuation of existing inequalities makes it difficult to respond to existing global health problems that we were trying to tackle even before the pandemic (4,7). Funding and services for other global health efforts have been diverted, causing interruptions in childhood vaccinations, increases in food insecurity, and many other setbacks (7). These issues in global health become further collateral damage from COVID-19, which will only become more perpetuated the longer issues like vaccine inequity prolong the pandemic.

Overall, COVID-19 Vaccine inequality is not only a moral failure to be global citizens, but is also prolonging the pandemic, perpetuating existing inequities, and resulting in many preventable deaths. We hope to visually demonstrate some of these deeply shocking and saddening aspects in our infographic.

References:

  1. Global Dashboard for vaccine equity. UNDP Data Futures Platform. United Nations Development Programme; 2021. Available from: https://data.undp.org/vaccine-equity/

  2. Atthar Mirza ER. Here's just how unequal the global coronavirus vaccine rollout has been. The Washington Post. WP Company; 2021. Available from: https://www.washingtonpost.com/world/interactive/2021/coronavirus-vaccine-inequalityglobal/

  3. Krause PR, Fleming TR, Peto R, Longini IM, Figueroa JP, Sterne JAC, et al. Considerations in boosting COVID-19 vaccine immune responses. Lancet. 2021;398(10308):1377-80

  4. Padma TV. COVID vaccines to reach poorest countries in 2023 - despite recent pledges. Nature. 2021;595(7867):342-3

  5. Press releases: Amnesty International UK. Press Releases | Amnesty International UK. Available from: https://www.amnesty.org/en/latest/news/2021/09/new-report-shows-leading-covid-19-vaccine-pharma-companies-fuelling-unprecedented-human-rights-crisis/

  6. Gyawali N, Al-Amin HM. Living and Dying With COVID-19 in South Asian Low- and Middle-Income Countries. 2021;9(874)

  7. Branswell H. Covid-19 pandemic has caused historic setbacks in Global Health. STAT. Boston Globe Media; 2020. Available from: https://www.statnews.com/2020/09/14/new-report-says-covid-19-pandemic-has-caused-historic-setbacks-in-global-health/

Acknowledgments:

We would like to thank Professor Madhukar Pai for setting and sharing this assignment results with us and the teaching assistants Alexandra Jaye Zimmer, Lavanya Huria and Angie Sassi for their support in coordinating the results.

Ethics & EquityMcGill Perspectives on Global HealthCOVID-19, Ethics & Equity, Opinion, McGill, Infectious Disease