To Combat New COVID Variants, the U.S. Must Bolster Vaccine Efforts Worldwide

Meghan Fitzgerald, RN, MPH, DrPH, is an adjunct associate professor with the Columbia University Mailman School of Public Health and a private equity investor. She has decades of experience working in the healthcare field, ranging from frontline patient care to advising prominent healthcare firms. Here, she explains why vaccine inequity worldwide is a major issue for everyone.

If a virus finds a vulnerable host, it will continue to mutate and launch new variants. This is all a virus like SARS-CoV-2 lives to do. As a result, COVID-19 variant news feels incessant. With the Omicron variant stressing global markets and diverging public health responses, it is time to think about how to achieve widespread global protection against the most adverse health outcomes of COVID-19—hospitalization and death. 

To do this, public health officials must bypass inefficient bureaucracy to get the vaccines and therapeutics to those in need.

Vaccination Rates Lag in Developing Countries

We continue to see evidence that COVID-19 does not respect national borders or cultural boundaries. Brutal travel bans do not work. Yet nearly two years into this pandemic, the disparities between rich and poor countries are stark. Nearly forty-four percent of the world is fully vaccinated, but only 6.3% of people in low-income countries have received at least one dose.

There are several reasons why the developing world is so far behind and none of them are good. A slow and mismanaged rollout of vaccines to poorer nations, a lack of appreciation for logistical and infrastructure challenges, and weak demand have all complicated our efforts.

Although vaccine deliveries are accelerating in Africa, actually getting people vaccinated is the most difficult obstacle. Reports that millions of doses have been provided to poor countries or that countries like Africa have vaccine hesitancy aren’t wrong, but they don’t tell the whole story. Nor do they solve the tactical challenge of getting shots in arms.

In the United States, we strive to make health care frictionless, meaning we seek to remove inconvenience—even if it doesn’t alway seem that way. Early in the pandemic, for example, the U.S. had maximum friction when seniors were camping out all night for vaccines, so public health officials pivoted to using local pharmacies and supermarkets as a release valve for distribution. 

Thousands of miles away, most healthcare systems do not have distribution or logistic advantages to deploy. Stories out of Africa depict patients walking miles to be vaccinated or risk losing a job. In India, 65% of the population is considered rural, making it difficult for decentralized health workers to reach, especially since there’s very little funding to help them do so. Less than 1% of India’s gross domestic product (GDP) is spent on public health.

What's Being Done?

Globally, some organizations are stepping up to help with vaccine equity. The World Bank has provided grants to minimize the risk of weakening global health systems. Pharmaceutical company Merck signed a voluntary licensing agreement for its COVID treatment, molnupiravir, to be distributed in 105 countries.

Public and private partnerships can help, too. A U.S. firm called Zipline is delivering Astra-Zeneca vaccines to Ghana using self-flying drones.

Resource sharing would be infinitely easier, however, without travel bans.

The U.S. Does Not Get Out of COVID Unless the World Does

In addition to upholding and upping vaccine commitments, the U.S. also needs to fund and offer services to help with the distribution, logistics, and on-the-ground vaccine deployment in other countries. This is not only for the initial round of vaccinations, but the ongoing distribution of boosters, new antivirals, and supplies.

War zones, worker shortages, and walking miles for healthcare are not common first-world problems, but they remain our global problem to solve. Treating all citizens as our own is the best and only path out of any pandemic. Preventing the continued spread and new variants requires the sharing of our products, people, and processes that go well beyond dumping supplies at a port.

If the U.S. allows a massive imbalance between the developed and developing world on vaccination to persist, we will continue to live in a world with significant economic, health, and security risks for all.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.