Reflections on the panel discussion hosted by Dr Beverley Essue, Dr Stephen John, Professor Lydia Kapiriri, Dr Wanrudee Isaranuwatchai, and Dr Iestyn Williams.
In the global response to COVID-19, the vaccine rollout has come under heavy scrutiny. With news of the first vaccines developed in the latter months of 2020, the world’s eyes were on manufacturers as well as state governments to see who would be successful first in approving and administering vaccine rollout. Now halfway through 2021, the reality of the global rollout has raised questions over inequities on both the national and global scale and was the key focus of discussion during this Forum for Global Challenges expert panel event. As all panellists agreed, the pandemic has not only demonstrated existing societal inequities but also heightened them. Reflecting on the past 6/7months, the event focused on lessons that could be learnt from the COVID-19 vaccine rollout, with an eye on response to future pandemics. In the following summary, I will reflect on points raised by panellists in the discussion, before looking to the future with regards to setting priorities when putting equity at the forefront of decisions.
Beginning on a positive note, Dr Essue noted that the response to COVID-19 has been a global effort, thus reframing perceptions of crisis response to a collective ‘we’. The fight against COVID, through the vaccine rollout, has united governments, researchers, and technology across the world, having quickly identified that working together is vital in response to pandemic scenarios. Dr John reiterated this in observing the general global population's response within societies, noting that people do care, and there is a mutual interest to ensure those within our communities remain safe.
However, this care and collaboration has been tainted, Dr John notes. Concerns over equity has been lost in vaccine rollout response, both within and across states. Within individual states, the elderly has been unanimously prioritised, yet Pr Kapiriri highlights that not all elderly are equal - there are inequalities across elderly people related to issues such as race and income that have not been identified in vaccine rollout. Furthermore, Dr Isaranuwatchai highlights that in Thailand, despite elderly people generally becoming sicker from COVID-19, it is the working class who are more at risk of contracting COVID-19 and thus must be prioritised in vaccine rollout. Interestingly, the global response must not be considered within a ‘one-size-fits-all’ framework, but instead contextualised to different localities, appreciating varying inequities.
Furthermore, the discussion centred on issues of intellectual property rights (IPs) that limit access to the vaccine ‘recipe’ to the pharmaceutical manufacturer that originally created it and making it easier for high-income states to purchase vast amounts of doses. Dr Williams noted caution here, as sharing vaccine processes risked a bottleneck in material supply. However, Pr Kapiriri argued that low and middle-income countries had proven their ability to learn and produce technology quickly in response to the pandemic and suggested removing IPs would allow greater agency for states to produce products their population can use. Observing the European Union’s collaborative vaccine rollout and the challenges it faced, as well as the challenges faced by the COVAX scheme, also raises critical arguments around controlled collaboration. Removing IPs is an interesting area of debate in regards to greater global vaccine equity, with the potential to improve equity between low, middle, and high-income states by allowing greater agency in vaccine production.
Finally, the issue of vaccine hesitancy was raised. Both Pr. Kapiriri and Dr Essue made note that due to the speed of vaccine creation and rollout, there has been little time to build trust in communities over vaccine safety. As a result, mistrust within disadvantaged members of society has led to reluctance in vaccine uptake. Dr John again highlighted that focus must centre on working directly within communities and framing the importance of vaccination on protecting the collective, especially to younger people who may not be as directly at risk of becoming ill from COVID-19. As a result, collective responsibility and care amongst disadvantaged communities may be improved, in turn tackling the effects of societal inequity.
Looking to the future, key priorities must be considered. Firstly, states on an individual level must become more greatly aware of inequities within their own societies, to improve equity of vaccine rollout and crisis response in the future. In addition, global discussions must take place over the limits caused by IPs, and whether global equity can be improved if these are removed. Thirdly, greater societal trust must be built continually in both global and state health institutions, working on the ground to ensure communities are aware of the collective need to ensure vaccination rollout is successful.
However, with the COVID-19 vaccine rollout still in full swing, how can these lessons be learnt in real-time? Speaking as if the pandemic is over is currently impossible, and thus discussion over points raised in this event must continue and be actively learnt from to ensure vaccine rollout in 2021-2022 works to put equity on the top of its priority list.