Africa’s vaccine rollout is credited to investments from richer governments and institutions – with a plan to incentivise pharmaceutical companies to produce COVID-19 vaccines for low- and middle-income countries. The initiative is referred to as COVID-19 Vaccines Global Access (COVAX), coordinated by the UN, among others. COVAX’s AstraZeneca supplies 99% of Africa's total vaccination, although there are indications that there will be additional supplies from Russia.

Preliminary analysis from the AstraZeneca vaccine rollout in Africa shows that 64 million vaccines will be distributed by the end of May – covering only 5% of the continent’s population, compared to 20% in the US, and 34% in the UK. The vaccination debacle in Africa is ambivalent. The liberal conscience of global health governance is currently indisposed. The underlying motivation for vaccine distribution is incongruent with liberal thoughts: No one should have undue privileges that put others at a disadvantage. Vaccine nationalism is rising – a buzzword used to describe a situation where a government controls the actions of in-country vaccine manufacturers in a way that favours them above others.

Loss of Control

Only a few countries are participants of the world’s vaccine supply, and these countries do not want the music to stop. Their auspicious position is strengthened by the WTO’s Trade-Related Aspects of Intellectual Property Rights (TRIPS), which gives compulsory licensing to pharmas in protection of property rights. South Africa had forced the WTO to reconsider the TRIPS’s strategy during a dispute in 2001, demanding access to cheaper AIDS drugs, and has recently written the WTO to clarify their position on a waiver (interpretive) on TRIPs as it relates to COVID-19 vaccine intellectual rights. The message is simple: Can Africa produce their own vaccines?

Controlled pricing, which is presumed to reduce costs, does not work for global drug production as pharmas estimate optimal pricing from the high-income segment of the population, and not the average. This precondition does not favour the Global South. An important consequence of vaccine dependency is the blight of time. It will take African nations more time to achieve herd immunity, without which countries will technically remain locked down despite low incidence, mortality, or morbidity rates. For countries like Seychelles and Cape Verde, two Africans countries among the top six countries in the world that depend on tourism as a proportion of their GDP, the immunity effect can be devastating.

Paying more for less

African countries have been recorded to be paying more for the vaccine. According to leaked information from a Belgian minister, the European Commission is paying $2.19 per dose for AstraZeneca compared to South Africa’s $5.25 – more than a double of the EU price. It is also known that the African Union is paying $10 for Janssen vaccine compared to Europe’s $8.50. A few others in the continent are paying a premium for speed to accelerate manufacturing of the vaccine.

An additional report shows that the rich countries of the EU, Israel, the USA, the UK, Australia, and Canada have over 200% (two per person) potential vaccine coverage, compared to Egypt with 47% (one for two persons), which has the best coverage in Africa.

Saving the best for the biggest

It is hard to imagine that the survival of an entire continent depends on the quality of the drugs it does not produce. Africans are receiving the drugs under trust, believing that the pharmas will deliver on the quality promise, despite no-fault agreements that allow for compensation. There are fears about AstraZeneca vaccine with disproportionately low cost to be of poor quality, and there is growing suspicion on its ineffectiveness. AstraZeneca committed 64% of its dosage to poor countries. Despite the disapproval of AstraZeneca vaccines for US citizens, the Biden administration is adamant on not exporting those produced locally, and have submitted to nationalistic obligation of vaccine overpreparation and oversupplies.

In this light, European powerhouses are quitting the sales of the AstraZeneca vaccines. In a paradoxical twist, they are also key investors of the COVAX project that provides the same vaccines to countries in the third world. The COVAX project intention was to raise $2 billion last August, but currently boasts of a financial commitment worth $6.3 billion as at March 2021. It is highly supported by richer countries and institutions. Why would these countries commit to something they are less likely to use? Are these the sort of agreements within global health governance creating self-sustaining dominance for countries?

Because it is implausible that a nation-state will prioritize others over itself, the current pandemic has created new layers of political and liberal controversies. Vaccine procurement and roll out, in the aftermath of the current pandemic, have returned the agony of these lingering rhetoric. While vaccine nationalism may not be defined with concerns of self-interest, it is finding expression in undue control and inordinate privileges – perhaps, the greatest test of moral irresponsibility of our time.

 

Abiola Oyebanjo is a PhD Researcher in Sociology at the Berlin Graduate School of Global and Transregional Studies, Cluster of Excellence “Contestations of the Liberal Script” (SCRIPTS). His research interests are in educational inequalities, labour market inequalities, return migration, and development sociology.