COVID-19 Vaccine Inequality and Global Development: A Primer

Access to COVID-19 vaccines, key to ending the pandemic and its devastating consequences, is characterized by vast inequalities. High-income countries pre-purchased most of the initial supply of vaccines licensed to big pharmaceutical companies and approved in Europe and the United States, vaccinating their own populations ahead of the global interest in vaccinating healthcare workers and vulnerable people everywhere. The proposed multilateral solution to vaccine supply, the World Health Organization- and GAVI-backed COVAX initiative, has suffered from ‘vaccine nationalism’. While India was projected as the key source of COVAX’s initial supply, its vaccine production has also been redirected to domestic distribution. China and Russia have instead emerged as alternative sources of supply with their domestically developed vaccines. Amid overall scarcity, enormous controversy has emerged over how to scale up vaccine production and increase vaccine accessibility. The chapter reveals layers of vaccine inequalities not just between the Global North and South, but also within the Global South – especially between middle- and low-income countries. The chapter concludes that the challenge of providing COVID-19 vaccines, and the inequalities involved, appears indicative of wider challenges related to 21st-century global development.