Letter to the Editor: Vaccine Diplomacy And Access

The following article was sent for publication by Partners in Health, an organization at UGA dedicated to advocating for global health investment and equity.

BAILEY HEBERMEHL & ARIANA MURRAY – Surely, 2021 could not be worse than what we’ve just seen. With COVID-19 vaccinations ramping up, many are optimistic about a new year without face masks and quarantines. And while it’s reassuringly likely that this reality may develop, it’s far too easy to forget major discrepancies between health systems across countries. A new year without face masks and quarantines for who exactly? A look back at the world’s epidemiological past and into pandemics like HIV/AIDS and tuberculosis reminds us that not everyone will be rid of the pandemic once a vaccine or other therapeutics are discovered and distributed in the West. 

The deadly human immunodeficiency virus (HIV) traveled to and emerged in the United States in the 1980s. The virus, confusing the country with a new disease that was infecting people via unknown transmission, came with no treatments. Although therapeutics are now available, AIDS is still not a completely curable disease, still infecting people today with around 38 million cases worldwide. But countries in Southern Africa, where the virus originated, are only recently controlling their epidemic and still grapple with the highest HIV/AIDS prevalence in the world. As of 2019, Southern and Eastern Africa have 20.7 million people living with HIV. Meanwhile, 2.2 million people make up the HIV population in Western and Central Europe and North America. Another disease, tuberculosis, has also hit Southern Africa hard as of late, alongside countries like India, China and Indonesia. Not to mention the six percent incidence of multidrug resistant TB in some countries, further increasing the challenge of controlling the disease. TB is an extremely serious illness that affects the lungs, and when often combined with HIV in countries like Africa, is incredibly deadly. Sub-saharan Africa holds 84% of total deaths from the double-teamed illnesses of HIV and TB. 

Why does this happen? Why these regions in particular? The answer is beyond just medicine. Centuries of abuse and neglect, economically, socially, and yes, medically, have created an international caste. Those at the bottom are put on hold, receiving therapeutics far too late, or not at all. Diseases like HIV and TB are entirely treatable, but not when you’re receiving trickles of support from up “above.” How do we prevent repeating this grim past with the latest global ailment?

Before all else, it is imperative to understand why an underdeveloped country may lack access to vaccines and other essential medical services. Here, a slew of factors resurface: Negative stereotypes regarding the ability of their citizens to fight off certain diseases, high equipment costs that make it difficult to purchase enough supplies in the right places, insufficient staffing and access to Personal Protective Equipment (PPE), and challenges with storing and transporting treatments like vaccines due to the specific conditions they require to remain efficient. To confront these complex challenges, it is necessary for the governments of countries around the world to work together and incentivize creativity through recognizing that everyone’s health is connected. As long as there are countries where Covid-19 ravages communities, the pandemic will continue to pose challenges for people everywhere.

In recognizing that our global health lies with protecting the most vulnerable, governments across the globe should collaborate to ensure that the vaccine is affordable and accessible for developing countries. The Global Alliance for Vaccines and Immunization (Gavi) has helped to vaccinate almost half of the world’s children against common illnesses and is now leading the charge to make the Covid-19 vaccine affordable for vulnerable and low-income countries by helping them cover the cost of purchasing vaccine samples and increasing the confidence of vaccine manufacturers so they can produce ample supply to vaccinate the global population. Global alliances like Gavi prove that collaborations between countries are possible and vital to ensure that all people can access the immunizations and healthcare that they require. 

It is also important for the populations of individual countries to advocate for equitable distribution of the Covid-19 vaccine. By organizing together and showing their dedication to this issue, government leaders will be more inclined to value equitable vaccine distribution as well. As of now, there simply isn’t any political advantage for a rural Congressman in central Georgia to care about jabs in the arms of people half a world away, unless his/her constituents show that they care and are willing to make lack of action a political disadvantage.  Initiatives such as freethevaccine combine artistic endeavors with advocacy in order to encourage governments around the world to put people and their health over profits. Advocacy for an equitable vaccine doesn’t have to be restricted to governments and organizations—anyone could support this effort, especially those reading this article. Consider contacting your representatives and signing petitions through Right to Health Action to demand that any Covid-19 vaccines are distributed with the vulnerable in mind. Outside of political advocacy, ask close friends and family about their confidence in the vaccine and understand the importance of reducing vaccine hesitancy.

With collaboration between governments and individuals, the Covid-19 vaccine will be accessible to communities that need it the most, contributing to a faster end to the pandemic. As interconnected as the world is today and with the knowledge gained from past pandemics, we know it won’t be over until we’ve crossed the last mountain, and the mountain beyond that.

Sources:

https://www.cdc.gov/media/releases/2017/p0724-hiv-swaziland.html

https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics

https://www.who.int/tb/publications/2009/airborne/background/info/en/

https://www.who.int/tb/areas-of-work/tb-hiv/en/

A Covid-19 Vaccine Will Need Equitable, Global Distribution (hbr.org)