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Commentary: We need a plan for global vaccine distribution

Really fighting COVID-19 requires an equitable sharing of the vaccine

South African President Cyril Ramaphosa receives a Johnson and Johnson COVID-19 vaccine in Khayelitsha, Cape Town, South Africa, Wednesday, Feb. 17, 2021. Ramaphosa was among the first in his country to receive the vaccination to launch the inoculation drive in the country. (Gianluigi Guercia/Pool via AP)

Millions of people in the United States are turning down the COVID-19 vaccine, while countries such as Afghanistan, Pakistan and Nigeria still battle with polio. In Utah, every adult age 16 and older is now eligible to receive the vaccine. However, Utah is still ranked among the lowest of U.S. states per capita to be fully vaccinated. Should these precious doses be sent elsewhere to those who are actually willing to receive them?

Historically, low-income nations have suffered disproportionately due to the inequitable allocation and distribution of vaccines. This inequity creates vast health disparities between upper and lower-income nations. In the midst of the current pandemic, history is on track to repeat itself — prioritizing the health of the rich nations over that of the poor. This will ultimately result in more people coping with greater and longer-lasting effects of the COVID-19 pandemic.

We can learn from our efforts to eradicate polio that equitable vaccine distribution is the only way to sustainably control the spread of the virus on a global scale. In order to successfully mitigate the impact of the pandemic globally, vaccines must be distributed both equitably and proportionately throughout the world — regardless of socioeconomic status.

Data interpretation by the Duke Global Health Innovation Center indicates that historic trends of inequitable vaccine distribution will remain in place as the world fights the spread of COVID-19. Of the 5.3 billion doses purchased, fewer than 800 million have been reserved for the world’s poorest countries while their population far exceeds that of high-income countries.

Countries such as the United States and Canada have purchased enough doses to vaccinate their entire populations more than four times over, whereas most middle and low-income countries do not have enough doses for a single vaccination of their populations. This disproportionate distribution of vaccines, based on wealth rather than population size, causes significant health disparities for the larger number of people living in low-income countries who may have to wait until 2023 or 2024 for vaccination.

Some would argue that an equitable, worldwide distribution of vaccines is not necessary in all circumstances. In the case of COVID-19, where transmission is facilitated through person-to-person contact, countries with lower population densities have reported fewer cases. For example, according to Our World in Data, countries in Africa have some of the lowest COVID-related death counts in the world. However, the BBC states that Africa’s low numbers may be due to their experience handling epidemics (such as Ebola), warmer climate, younger population and underreporting due to a lack of testing and resources.

Although some might argue that countries such as the United States stand in greater need of a vaccine (given that they have the largest number of cases worldwide), those numbers can be attributed in part to a greater amount of testing and resources available.

The time to make a worldwide plan for vaccine distribution is now. COVID-19 needs to be our wake-up call. Now is the time to prepare and plan for future threats while preventing further mortalities. To do this, international collaboration led by World Health Organization needs to be prioritized.

COVID-19 will soon likely be in the rear-view mirror, and the world will be eager to forget about its hardships. However, we cannot forget how the entire world can be impacted so rapidly—or the universal consequences of not acting quickly and working together.

If we do not act now by creating a plan to allocate funds and distribute resources where they are most needed, the next pandemic could have even more devastating effects.

Chance McCutcheon


Jonny Woolstenhulme

Alan Clegg

Chance McCutcheon, Jonny Woolstenhulme and Alan Clegg are first-year medical students at the University of Utah School of Medicine. They are participating in the Global Health Pathway Curriculum and pursuing a Graduate Certificate in Global Health in addition to their medical degrees.

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