To date, countries (notably Kenya, Ghana, Ethiopia, and Senegal) have relied on very aggressive policy, including stay-at-home orders, early school shutdowns, and restriction of public gatherings, to limit COVID-19’s impact, but it is unclear how long they can maintain it without increased international assistance, most notably for vaccines. Failure to address these inequities will be costly—for everyone. A RAND study puts the economic damage of unequal COVID-19 vaccine allocation at $1.2 trillion per year, with losses coming heavily from contact-intensive sectors, like tourism, travel, and transportation, compared to equitable global vaccine distribution. Conversely, according to the Eurasia Group, equitable distribution could generate an estimated $153 billion in economic benefits by the end of this year, which could triple to over $460 billion by 2025 when accounting for just 10 major economies. The transnational reality of the virus and stark costs of vaccine nationalism make greater multilateral collaboration on global vaccine deployment an imperative as gaps in distribution will allow for further spread and increase the risk of additional mutations.
International Vaccine and COVID-19-Related Aid Needed
Barring any significant change, these countries will have to rely on international financial institutions and other partners to fill gaps to keep the pandemic from worsening. Significant funding commitments will be required. A full treatment of the Pfizer or Moderna vaccine costs $40 or more, which becomes very expensive for poorer nations that need to purchase hundreds of millions of doses. In addition, indirect costs to store, transport, and administer the vaccine are substantial. As such, delivery will require refrigerated vehicles, temperature-monitoring devices, and adequate roads to transport vaccines to rural locations. Glass vials, syringes, and needles are other critical supplies for vaccines that can be costly for developing nations to acquire.
Pharmaceutical companies, among other entities, have stated that they would make low-cost doses available for poorer countries, but with high-income countries already having purchased 4.6 billion doses (out of approximately 8.5 billion purchased globally), and only a few direct deals between vaccine manufacturers and low-income countries for a limited supply of doses, the latter will have to rely entirely on the approximately 13 percent of supplies purchased through global vaccine initiatives such as the World Health Organization’s (WHO) COVAX—a collaboration among governments and manufacturers that seeks to provide equitable access to COVID-19 vaccines. Even if these are all provided at discount prices, they only amount to 1.1 billion doses, enough for just the combined populations of Indonesia, Pakistan, and Brazil, for example. While the COVAX initiative is seeking to provide equitable access to both rich and poor countries, it faces serious funding concerns: at the end of last year, COVAX estimated that it needed to raise another $6.8 billion for 2021, $6 billion of which could facilitate supply and delivery to developing countries. Additional support is being mobilized; in February, the G-7 countries committed $4.7 billion to the ACT (Access to COVID-19 Tools) Accelerator, the project that oversees COVAX. The ACT Accelerator funds development and equitable rollout of tests, treatments, and vaccines. The recent pledge brings total commitments to $10.3 billion, but the Accelerator still faces a $23 billion shortfall for 2021.
As the pandemic has reversed decades of progress in international development, targeted foreign aid represents another vital means of support. Foreign, and particularly bilateral, aid details are limited, but data gathered by Cooper-Smith indicates that COVID-19-specific foreign aid, particularly from the United States government, is flowing to countries with the highest case rates.