Vaccine apartheid: Echoes of colonialism – global inequalities in vaccination

Michal Trčka

Michal Trčka


The World Health Organization (WHO) is once again pointing to global inequalities in vaccine redistribution. Specifically, the WHO criticized widespread third-dose booster programs, introduced at a time when the poorer part of the world is still trying to get the first-dose vaccines.  The WHO pointed out that it is the unvaccinated who are most at-risk. WHO officials warned that unequal access to vaccination could lead to further mutations of COVID-19 that would prolong the crisis.

This state has occurred in similar situations in the past.  In this context, it is worth examining the distribution of vaccines as being an echo of colonialism and the irrationality of intellectual property protection by global capitalism.

Global inequalities in population vaccination

According to analyzes of Oxford University Our World in Data platform, the crucial factor that determines how healthy, rich and educated someone is chiefly depends on: “… whether or not you were born into a productive, industrialized economy or not. The vast majority of the world is very poor: almost 4 billion people live on less than $ 6.70 a day. If you live on $ 30 a day, you’re part of the 15% richest in the world. ”

Other data paint an even gloomier picture. In several countries in sub-Saharan Africa, life expectancy is less than 60 years, compared with more than 80 years in European countries.  Low-income countries have, on average, more than ten times higher child mortality than high-income countries.

Similar data is seen with the COVID-19 pandemic and its effects. In terms of global vaccination coverage, 58.2% of the world’s population received at least one dose of COVID-19 vaccine, but only 8.5% of people in low-income countries received a single dose.

When we look at COVID-19 mortality data and how it is affected by the vaccination status, we see a noticeable disparity between vaccine and non-vaccine deaths in all countries. Moreover, mortality is rising not only in connection with the pandemic itself. In the case of the effects of a pandemic in developing countries, the pandemic has slowed down mass vaccinations against a number of other diseases in many countries, such as polio, measles or cholera, as since attention is diverted to coronavirus. If we compare the mortality rate on COVID-19 with the latest GDP data, we see that countries that have managed to protect the health of their populations during a pandemic have also generally protected their economies.

When we combine the above data, it is clear that less vaccination in poor countries leads to higher mortality and to economic decline, widening the scissors of global inequality.


Intellectual property protection – a barrier to higher global immunization

In the book One World, Peter Singer recalls the ethics of globalization and the unavailability of AIDS drugs in South Africa in 2001, when an estimated 20% of the adult population became infected with HIV. The cost of drugs to control the infection was around $ 10,000 at the time, an unattainable amount for most of Africa’s population. But local production could bring the price down to $ 350. It would still be a lot, but it represented a more realistic solution to get the drugs to as many people as possible.

The Clinton administration first turned down the proposal for local production using the threat of trade sanctions to protect intellectual property, but later withdrew the threat. But as the U.S. government withdrew from the dispute, a lawsuit by pharmaceutical corporations ensued. By way of contrast, with the threat of an anthrax attack in North America in the same year, senior US politicians put pressure on pharmaceutical companies to reduce the price of Cyprus, an anthrax antibiotic. They justified this by saying that intellectual property rights must not hinder the protection of public health. Clear evidence of a double standard.

The same double standard applies in the more than a year-long debate over the release of coronavirus vaccines. The validity of vaccine patents is administered by the World Trade Organization (WTO), whereby all members must agree if there is a rule change to take place.

The debate has two sides.  Proponents of the release would free up patents to speed up production. More companies could produce vaccines, including countries that cannot afford them now. Pharmaceutical corporations would not lose profits, since the release of patents would be temporary. Protecting global public health, breaking out of a protracted pandemic, and faster economic recovery would be the main winnings of this strategy.

According to opponents of the release of vaccine patents, this represents an infringement of intellectual property rights. It would also damage private research and put its future incentives to fund innovation at stake. According to opponents, gains would be short-lived, and such a  strategy is therefore short-sighted.

India and South Africa are the leading proponents of patent release.  In 2020 they submitted a proposal to suspend patent restriction related to COVID-19 treatment. The Biden government of the United States has supported them, as have a large number of European countries.  The International Federation of the Pharmaceutical Industry and Germany disagreed, and the proposal to lift patents was not approved.

Though the COVAX (Covid-19 Vaccines Global Access Facility) program, which seeks to obtain vaccines worldwide and target them to poorer countries, is up and running, data show that this effort is thus far insufficient despite to fulfill its goals.

Vaccine neo-colonialism and the irrationality of global capitalism

Although most of the decolonization process took place in the former colonies of the European powers in the mid-20th century, it’s clear that economic and political dependence persists in many countries. Additionally, history has shown that the establishment of commercial companies in former colonies, forerunners of today’s multinational corporations, has proved far more effective in politics and power than have military incursions.

In the 1970s, inequality between the rich North and the poor South was addressed via so-called structural adjustment programs.  For developing countries this meant borrowing from developed countries, thus deepening their reliance on them, while deregulating and heir markets.  Companies from developed countries turned their poor counterparts into factories, assembly plants, etc.  Decolonization was replaced by economic and political forms of neocolonialism, by further dependence on global superpowers, large economies and multinational corporations. The global inequalities in vaccine distribution follow the pattern.

Most African countries that have registered with COVAX have received either AstraZeneca and Oxford or Novavax vaccines in limited quantities.  The vast majority of these countries’ available vaccines today are Chinese Sinopharm vaccines, which are only marginally effective.

This shows how international assistance by countries such as China, Russia, the EU, the USA and possibly India is reflected as a power strategy of spreading influence and dependence. Chinese vaccine exports can further be linked to the construction of the Silk Road and the strengthening of its influence in the Third World.

By not lifting patents and “protecting property rights,” both the right to life and its protection and the running of the global economy are undermined.  As WHO officials have summarized in their criticisms regarding booster vaccines, if some countries don’t have any vaccines to fully vaccinate the population with the first dose, the situation is made even worse by favoring the emergence of mutations that will prolong the pandemic.  An example is the omicron variant, which emerged in South Africa, where only a quarter of the population is vaccinated.  The irrationality of refusing to lift patents is also shown in the fact that a large part of the cheap labor force of many multinational corporations is concentrated in the countries of the so-called global poor South, where losses resulting from coronavirus infection of workers would have a significant impact on production.

The term “vaccine apartheid” has become common in professional journals of the day, which note that solutions involve aid models in the form of vaccine donation, reaching a global consensus on IPR waivers, democratizing vaccine intellectual property and know-how, and supporting low- and middle-income countries in building production capacity for this and another pandemic.  A recent article in Scientific American stated that “the new approach will require sustained funding, fair cooperation with the global South and unconditional support for human rights and global public health systems.”

 Article translated from Czech, first published in Přítomnost magazine  on January 10, 2022.

published: 17. 1. 2022