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Even before the final stages of human trials or regulatory approval were completed, several wealthier countries such as Britain, France, Germany and the United States entered into early purchase agreements with manufacturers of Covid-19 vaccines, a development known as “vaccine nationalism.”

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It is feared that such early agreements will make the first vaccines unaffordable and inaccessible to everyone except rich countries in a world of around 8 billion people.
This has led the World Health Organization (WHO) to warn that countries that stockpile potential Covid-19 vaccines while excluding others would worsen the pandemic.

“We must prevent vaccine nationalism. Sharing scarce supplies strategically and globally is actually in the national interest of each country”
WHO chief Tedros Adhanom Ghebreyesus said on Tuesday.

To achieve broad and equitable access, WHO, the Coalition for Innovations in Epidemic Preparedness and Gavi have launched an initiative known as the “Covax Facility”.
The facility aims to purchase at least two billion doses of Covid-19 vaccine by the end of next year for deployment and distribution primarily in low- and middle-income countries.

What is vaccine nationalism?

When a country succeeds in securing doses of vaccine for its own citizens or residents and prioritizes its own domestic markets before they are available in other countries, it is referred to as “vaccine nationalism”. This is done through advance purchase agreements between a government and a vaccine manufacturer.
For example, the US, UK, Japan, and the European Union have spent tens of billions of dollars on deals with leading vaccine companies such as Pfizer Inc, Johnson & Johnson, and AstraZeneca Plc even before their effectiveness is proven.

Vaccine nationalism is not new

The current race to rack up Covid-19 vaccines dates back to a similar situation that occurred in 2009 during the H1N1 flu pandemic. Australia, the first country to create a vaccine, has blocked exports, while some of the wealthier countries have entered into pre-purchase deals with various pharmaceutical companies. Only the United States has obtained the right to purchase 600,000 doses.
It wasn’t until the H1N1 pandemic began to subside, that developed countries volunteered to donate doses of vaccines to poorer economies. However, it should be noted that H1N1 was a milder disease and its impact was much less than Covid-19, which has already infected more than 22 million people worldwide and killed 777,000 people.

The US and UK have already made deals worth millions

According to London-based analysis firm Airfinity, the US, UK, European Union and Japan have so far obtained around 1.3 billion doses of potential Covid-19 vaccines.
Options to purchase additional supplies or pending deals will add more than 1.5 billion doses, according to their figures.
From the country’s perspective, the United States has already agreed to buy some 800 million doses from six drug companies and the United Kingdom 280 million from five.
Last week, the European Union negotiated with AstraZeneca the purchase of 300 million doses of the candidate vaccine developed by the University of Oxford. It has also reached an agreement with the French pharmaceutical giant Sanofi for 300 million doses.
Airfinity predicted that the global supply may not reach 1 billion doses before the first quarter of 2022, Airfinity predicts.

Are there no laws to prevent vaccine nationalism?

Interestingly, although vaccine nationalism runs counter to global public health principles, there is no provision in international law that prohibits pre-purchase agreements.

What are its disadvantages? What is the alternative?

The main drawback of vaccine nationalism is that it puts countries with fewer resources and less bargaining power at a disadvantage. Therefore, if countries with large numbers of cases fall behind in obtaining the vaccine, the disease will continue to disrupt global supply chains and, consequently, economies around the world.

“If you were to try to vaccinate the whole of the United States, (and) the whole of the EU, for example, with two doses of the vaccine, that would come down to around 1.7 billion doses. And if that’s the number of doses available, there isn’t much left for the others. If a handful or even 30 or 40 countries have vaccines, but more than 150 do not, then the epidemic will spread there, ”
Reuters quoted Seth Berkley, chief executive of the GAVI alliance, as saying

The alternative to arrest vaccine nationalism is global collaboration, which is being done through the WHO-backed COVAX Facility mechanism. So far, more than 170 countries have expressed interest; about 90 low- and middle-income countries and 80 fully self-financing countries.
The countries who join the initiative are assured supply of vaccines whenever they become successful. Moreover, the countries will get assured supplies to protect at least 20 percent of their populations.