The international community’s goal of widespread vaccine inoculation is now within reach. However, some states are succumbing to nationalist vaccine policies whilst paying lip service to the need for international cooperation and coordination in the global rollout. MSc student Jenifer Elmslie discusses how Vaccine Nationalism is both medically self-defeating and economically damaging, and explores possible new policy directions.

To beat it, we must act as one community’ closed Dr Tedros Ghebreyesus’ February think piece in Foreign Policy, which highlighted the importance of combatting nationalism in global health. Last week, new WTO chief Dr Ngozi Okonjo-Iweala warned against ‘protectionism’ in global rollout efforts.

Many leaders are paying lip service to strategies of global community and coordination. 190 countries and economies have signed up for the COVID-19 Vaccine Global Access (COVAX) initiative, which aims to ensure global equitable access to the vaccine supply. UK Prime Minister Boris Johnson last week appealed to G7 states to end ‘nationalist and divisive policies’ against the ‘common foe’ of the virus. Meanwhile, the UK has purchased five times as much vaccine as its population needs, while the African Union and Latin America (excluding Brazil) have purchased enough vaccine to inoculate less than half of their populations.

The alarm bells have been raised on vaccine nationalism. But despite this talk of global cooperation, current manufacturing capacity, as well as distribution patterns, meet only a fraction of global need. As of February 2021, 16% of the world’s population had access to 60% of the global supply of COVID-19 vaccine. COVAX is struggling to purchase enough vaccine to cover 20% of low- and middle-income countries (LMICs) by the end of this year. There are supply shortfalls in many states: 130 countries had received no vaccine by mid-February 2021. Many wealthy countries have turned inward, to Vaccine Nationalism, due to the pressure on governments to return ‘back to normal life’. This nationalism was reflected earlier in the pandemic with the widespread decrement of export bans of pharmaceutical equipment among the EU common market during Italy’s hour of need.

This should have been foreseen. Scholars of the Realist school of International Relations have pointed to the tendency of states to turn to nationalism, rather than cooperation, in a crisis. This is reflected in the international response to other health crises such as 2009’s H1N1 outbreak, where a small number of wealthy countries bought up the global vaccine supply. After the 2004 H5N1 outbreak, vaccine-sharing negotiations mediated by WHO broke down, to the point where Indonesia refused to share virus samples with WHO. American AIDS-related deaths fell sharply after Antiretroviral drugs hit markets in the mid-1990s, while African deaths continued to rise due to the cost of drugs combined with a lack of coordination and cooperation.

Turning inwards in crisis response has not only happened before, it has happened in strikingly similar circumstances.

This policy must be avoided in the current emergency.

The immorality of Vaccine Nationalism is self-evident, raising questions about who the global community considers ‘deserving’ of the life-saving vaccine.

Moreover, the approach could render obsolete the cause for vaccine development in primo loco. Failing to adopt a global health approach could make existing vaccines powerless against new vaccine-resistant variants, which can quickly spread across frontiers. This can be seen in the recent spread of two variants first detected in the UK and South-Africa, across the UK and USA. Indeed, there is already evidence that some vaccines are less effective against new variants first identified in South Africa and Brazil.

Additionally, a non-global rollout strategy will further entrench the global economy into crisis. WHO estimates that global inoculation will prevent the loss of US $375 billion to the global economy each month. The International Chamber of Commerce found that the global economy stands to lose as much as US $9.2 trillion in economic activity through fully vaccinating rich countries’ populations while neglecting those of poor countries. Vaccine Nationalism as a response to the COVID-19 crisis hurts everyone and widens the scope of the existing economic crisis.

A way forward?

Initiatives like COVAX rely on international cooperation norms and the pressure states feel to defend their global reputation as liberal, democratic regimes to function. But as shown in this discussion, this pressure is not enough to encourage coordination and trust between states during health crises. WTO leader Dr Okonjo-Iweala has suggested an extension of soft law, waiving WTO rules on intellectual property so that more drugs manufacturers can make already-approved vaccines, or even licensing manufacturing for use in poor countries so that adequate supplies are reached without impinging on IP rules.

But an even stronger response is needed to ensure that this repeating pattern does not continue into the future. A security approach would stress the health threat to individual countries from new variants potentially threatening to their inoculated populations, coupled with the threat of further economic damage. This is the right path to encourage international cooperation and vaccine sharing. In a crisis, states revert to their realist tendencies of self-preservation. Global health actors have to acknowledge this reality and present a strategy on their terms. The use of soft power to encourage international cooperation is not enough.

Future pandemics are not a question of if but when. It is vital that mechanisms are put in place so that states prioritize global approaches, through the guidance of WHO and other public health actors and institutions. This is crucial to ensure that in future pandemics, vaccine availability is not met with nationalism, protectionism and every-state-for-himself behaviour from the international community. International vaccine rollout strategies based on global need and preventative capacity (such as states’ capacity to contact trace and treatment capacity) could aid this.

Jenifer Elmslie is currently pursuing an MSc in Gender, Development and Globalization at the LSE. She has previously worked at United Nations OCHA and at global NGO Plan International and hopes to work with gender mainstreaming in development agendas in the future.

The views expressed in this post are those of the author and in no way reflect those of the International Development LSE blog or the London School of Economics and Political Science.