The unvarnished truth of our hope…On vaccinating the world.

We have lived through an extraordinary 18 months. In my wildest dreams I never imagined a time when our borders would be shut, our cities emptied of workers, our children shut out of schools. We have endured grief and anguish, the wilting of dreams, the pains of separation. There have been too many funerals without mourners, too many weddings without guests, too many homes without visitors.

Our lives have been held captive to a virus.

And now freedom is so close we can almost smell it, touch it, grasp it. The development of multiple vaccines in timeframes measured in months rather than decades is an astonishing feat. Very soon Australia will reach that threshold of shared vaccination that will allow the resumption of more humane ways of life.

We therefore find ourselves in the middle of a massive effort to get people vaccinated as quickly as possible. This has not been without its controversies. The disneyesque unanimity of purpose and policy that the “National Cabinet” worked so hard to project in the first months of the pandemic was always going to fracture under the weight of contested policies and interests. One of the most piercing criticisms has been that the Federal Government was too slow in securing vaccines for Australia, thus unnecessarily delaying the vaccine rollout.

Taking a step back however, I cannot help but feel a level of shame at my expectation that our government should not only secure the vaccines we need but secure them now. However slow off the mark the Morrison Government may have been, the unvarnished truth is that Australia, along with the world’s other rich nations, has bought our way to the front of the global vaccination queue and secured rights to way more doses than we need, leaving the world’s lower income countries far short of what they need.

It can be summed up in a single statistic: as at September 8, 2021, 59% of people living in high income countries had received at least one dose of a covid vaccine, but only 2.7% of people living in low income countries have received at least one dose. (Global Dashboard for Vaccine Equity)

Early in the pandemic leaders from nations across the world recognised the need to develop vaccines quickly and once available ensure that they were distributed equitably.

To facilitate this the COVAX partnership was developed. This allowed all countries to make investments in the development of vaccines and provided a mechanism for their equitable distribution. Yet 18 months into the pandemic the global distribution has been anything but equitable. Global bodies have been raising the alarm about this for some time. In June, the International Monetary Fund noted that:

“A two-track pandemic is developing, with richer countries having access [to vaccines] and poorer ones being left behind.”

IMF Blog June 1, 2021

Just yesterday the COVAX alliance spelled out very clearly why this was occurring:

“In the critical months during which COVAX was created, signed on participants, pooled demand, and raised enough money to make advance purchases of vaccines, much of the early global supply had already been bought by wealthy nations.”

COVAX Joint Statement Sept 8, 2021

The world’s poorest are missing out because the rich kids (that includes Australia) have used their wealth and power to place themselves at the head of the queue. Rich nations have formed contracts with pharmaceutical companies that ensure they are first in line to receive vaccines as they are produced.

Not only have rich nations locked in priority for themselves, they have locked in supply of vastly greater quantities than they need. Canada has contracts that will see it receive enough courses to vaccinate its entire population 4 times over. Italy, New Zealand and Australia have locked in supplies that could vaccinate their populations more than three times over. The only OECD country that has not locked in at least double the quantity required is Denmark. Meanwhile 56 nations, including almost all the world’s lowest income nations, have been unable to lock in even half of what they need to vaccinate their people once.

COVAX will accomplish something astonishing. It is highly likely that by the end of 2023 every country on earth will have vaccinated the majority of its population against a virus that emerged only 3.5 years earlier. Yet rich countries will get there much earlier than the world’s poorest nations. The world’s poorest have fewer resources to combat the virus and will endure its disruptions and devastations for much longer. That the vaccination rollout might have been done equitably has proven a forlorn hope, an unworkable idealism in an international order in which every nation pursues its own interests and in which bonds of familial affection and shared national identity have a stronger claim on our moral sensibilities than our shared humanity. It is a chastening reminder that the great vaccination gulf is not between Australia and other wealthy nations but between the world’s wealthy nations and its poorest.

“No one is safe until everyone is safe” has become the mantra of the COVID-19 pandemic, with good reason. Unmitigated transmission means rampant viral replication, which in turn means infinite opportunities for the emergence of new, more transmissible variants that could escape natural or vaccine-induced immunity. A perverse social experiment would be to allow the virus to continue ripping through low-income and lower-middle-income countries (LMICs), where people tend to live in close proximity and infection prevention strategies are difficult to implement because much of the populations rely on hand-to-mouth income (India being a case-in-point), while seeing how quickly HICs can redesign vaccines to counter yet another variant that has emerged from LMICs…

Vulnerable people in HICs have already been prioritised; vulnerable people in LMICs cannot wait until 2023 for their turn, and this wait is in the best interest of no one.

The Lancet Infectious Diseases Journal

I long for the day we can once again share meals with our friends, celebrate passages of life with our families, and revel in the atmosphere of a stadium full of die-hard fans cheering their sports teams. But when I do, I hope that I will not only be filled with gratitude for the gift of vaccination, but that there remains a twinge of shame that should be felt by those who know how we got here. And I make this promise to myself, that I will not forget those who we pushed aside in order to jump to the head of the queue, who will wait up to 2 years longer than I to access vaccines. The Nepali parent who has lost a child to the virus; the Somali small business owner who has been plunged into poverty thanks to an economy ruined deeper and longer than mine; the isolated for whom separation from those they love has not yet ended. It is an awful thing that we have pushed them to the back of the queue and hoarded oversupply of the vaccines they need. It would be unforgivable to abandon them.