Why vaccine nationalism could prolong the COVID-19 pandemic

The race to secure a vaccine against COVID-19 has pitted country against country, which could undermine efforts to control the virus worldwide.

While the World Health Organization is calling for those at highest risk of getting and spreading the virus to receive a vaccine first, rich countries are making deals to stockpile their own supplies even before safe and effective vaccines exist and that comes with risks.

This kind of vaccine nationalism meansevery country fends for itself, with wealthier nations buying up supplies of vaccines and leaving little for other nations.

Dr. Margaret Harris, a spokesperson for the World Health Organization, says vaccine nationalism is self-defeating in multiple ways: it will hinderthe revival of the global economy and extend disruptions of world trade and travel.

"You could take the view that your population might like you better if you were the one grabbing all the vaccine," Harris said. "But your population won't love you if the pandemic is going on and on and on."

Canada has made deals to secure up to 282 million doses of potential vaccines.The federal government has also signed on to WHO's COVAX program,whichaims to buy and fairly distribute shots globally.

If the vaccines wealthy countries have pre-ordered directly from manufacturers don't pan out,COVAX offers a life insurance policy of sorts. Under COVAX, theywould have access to vaccines that did succeed, but only enough for 20 per cent of their populations, to ensure global coverage.

Alyson Kelvin, a virologist evaluating made-in-Canada vaccines at the VIDOInterVac lab in Saskatoon, said she thinks it's important for Canada tosecure doses for its own people.

"I often think of this as a situation where we're all on a plane, and when the plane's going down, they ask you to make sure that you have your mask on before you help others," Kelvin said. "Keeping our own country running is going to help us help other people prepare."

Dr. Ezekiel Emanuel, a former White House policy adviser, warned that vaccine nationalism has limits.

"Canada'spre-boughtabout six or seven times its population," Emanuel said. "We need tothink throughthat. Is that a kind of hoarding?"

Emanuel and his co-authors outlined three principles for anethical framework of allocating vaccines:

• Limit harm in the world.
• Prioritize the disadvantaged.
• Show equal moral concern.

If the ethical framework isn't followed, Emanuel said, there could be consequences.

"What that really means is that people will unnecessarily die," Emanuel said.

Modeling researchers also predict that if COVID-19 vaccines are monopolized byrich countries rather than distributed equally, that could lead to twice as many deaths from the diseaseglobally.

Geopolitical influences at play

U.S. President Donald Trump won't join COVAX because he objects to WHO's leadership.

Instead, the U.S.'s Operation Warp Speed aims to produce and deliver 300 million doses of safe and effective vaccines, withthe ambitious target of havingthe initial doses available by January 2021.

So far, the U.S. has made deals forMassachusetts-based Moderna's mRNA vaccine candidate, and AstraZeneca/University of Oxford's adenovirus vector vaccine, among others.

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Meanwhile, China is still in negotiations to join COVAX. It has more than a half dozen vaccine candidates, according to WHO's list.On Tuesday, a WHO official told reporters that China is in preliminary discussions to have its vaccines included in a list for emergency use.

Russiawas the first country to give regulatory approval for a novel coronavirus vaccine, which has been met with suspicion by the West because it was approvedbeforelarge-scale clinical trials were done. It is being offered first to teachers and front-line health-care workers.

Lawrence Gostin, a law professor at Georgetown University in Washington who specializes in public health law, said geopolitics has affected the world's viewof the Russian vaccine candidate because it violated scientific and regulatory norms.

"Some countries have hoarded vaccine supplies by contracting with vaccine companies in advance," Gostin said in an email. "There is also a geopolitical competition for the vaccine, mostly between Russia, China, and the United States. This clouds the judgment of leaders and even the public."

WATCH | How vaccine nationalism could hinder pandemic fight:

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Vaccine nationalism, when rich countries buy up vaccines making them unavailable for other countries, could hinder the global fight to end the COVID-19 pandemic and a program to have vaccines available everywhere is still not fully funded.

Microsoft founder Bill Gates said Tuesday that under a best-case scenario, wealthy countries could be back to something close to normal by late 2021 if there is a COVID-19 vaccine thatis safe, effective and ready to be widely distributed to the general population.

But even then geopolitics will still come into play."Now, the capacity will take time to ramp up,"Gates, 64,told the Wall Street Journal CEO Council. "And so the allocation within the U.S., and between the U.S. and other countries, will be a very top point of contention."

The Bill and Melinda Gates Foundation has signed agreements with pharmaceutical companies to facilitate broad distribution of approved vaccines and is participating in COVAX.