With around 130 million adults in the U.S. having received at least one dose of the COVID-19 vaccine, vaccine rollout in the West has increased exponentially these last few months. The U.S. currently is administering three different COVID-19 vaccines: Johnson & Johnson, Moderna and Pfizer. With these statistics, it is not surprising that the U.S. holds the title of the country with the highest number of vaccines distributed in the world. However, other Western countries also have incredibly high vaccination rates. The United Kingdom is on its way to vaccinating a majority of its population. With this in mind, it is interesting to consider that a large portion of the 181 countries who have begun vaccine rollouts are wealthy Western countries. A majority of low-income, low-resource countries have not yet received the funds for vaccines or possess the resources to carry out such a centralized system of vaccine administration. 

A fundamental root to this problem is a term called “vaccine nationalism,”which refers to the way wealthier, more powerful countries secure vaccines and other medications at the expense of low-resource countries. This is extremely harmful to these countries, and as a result, they will have to depend on the generosity of wealthier countries for aid. We have seen this exact same problem happen before the coronavirus pandemic with the HIV epidemic. Regions, such as sub-Saharan Africa, suffered the devastating impact of HIV due to the fact that antiretroviral therapy was not accessible to them. Because treatment was extremely overpriced, it essentially prohibited poorer countries from obtaining such medicine. What’s even more bizarre is that the United Nations and several Western countries had the main goal of preventing HIV/AIDS and they tried to carry out this goal by putting up advertisements within lower-resource countries and creating safe sex education courses. While there were good intentions behind these actions, these programs generally fell short of their intended impact. Many people did not take the advertisements seriously, and a lot of the social structures already in place made it difficult for people to follow these new “preventative” strategies. A more effective way to control the HIV epidemic would’ve been for these antiretroviral therapy drugs to be sold at much lower prices so these countries had equal access to them.  

We are currently seeing a repeat of the HIV epidemic. While many wealthy countries are reaping the benefits of vaccine nationalism, several countries are now going through the worst parts of the pandemic. 

At the moment, India is in its second wave of the pandemic, and they are struggling to cope with a rapid increase in cases. With a population of 1.366 billion people, they are reporting more than 380,000 cases daily. The entire country is low on medical oxygen and oxygen generators and are relying on foreign support and fundraisers to receive more oxygen generators. While the government is at fault for not handling the pandemic appropriately, by holding in-person elections and gatherings, it is hard for India to follow the same social distancing guidelines that many Western countries have been implementing for the last year. Ironically enough, India is the world’s largest vaccine exporter, exporting around 66 million doses before they succumbed to the peak of the pandemic. While there has been news of the U.S. exporting large quantities of the AstraZeneca vaccine to India, this has been a situation we have seen many times in the past where the low-resource countries suffer devastating medical consequences from vaccine nationalism and depend on the fluctuating generosity of wealthier countries. 

Vaccine nationalism, at its heart, is largely imperialist and capitalist, and patenting the COVID-19 vaccines has just contributed to this problem. Many healthcare advocates have been insisting that the vaccine concoctions and patents be shared globally so that all countries have access and the ability to manufacture the vaccines. However, big pharmaceutical companies have been pressuring the government to resist doing that, and as a result, vaccine manufacturing and distribution again lie at the hands of wealthy countries. Although, this past Wednesday, President Biden fortunately backed waiving intellectual property protections on COVID-19 patents, marking a step forward in ending the pandemic through a united effort. 

Countries have also ignored the World Health Organization’s multiple warnings to guarantee doses to lower-resource countries. However, this move may come back to hurt these same wealthy countries. Without proper vaccine doses, low-resource countries such as India will start to develop mutant variants of the coronavirus, some of which are resistant to current vaccines. Vaccine nationalism has made the U.S. largely selfish and self-serving by only agreeing to supply vaccines to other countries once their own needs have been fulfilled. 

At its core, vaccine nationalism is anti-global and is taking us further and further away from global healthcare equity. Socioeconomic health disparities across and within countries are further exacerbating this large gap, and it’ll be harder to overcome this gap if it is not fixed soon. However, vaccine nationalism and healthcare disparities cannot not be fixed overnight, especially with powerful governments—including the U.K., other European countries and the U.S. (until Wednesday)—and important institutions advocating against initiatives such as patent sharing. That said, grassroots organizing may help convince local officials of the importance of these initiatives and other means of improving healthcare accessibility; every supportive official is another chance to work up to the top of the food chain and convince government leaders. For now, though, vaccine nationalism has put the U.S. at its sweet spot for herd immunity at the expense of the rest of the world not being able to reach herd immunity anytime soon.