As rich countries ramp up their vaccination efforts, there is a lot of concern over the when and how of developing countries also receiving and distributing vaccines in a timely manner and finally getting this horrible pandemic behind us.
The concerns are real, and the task of vaccinating the poorest of the poor requires a massive global effort by rich and poor countries alike. First and foremost, it is a moral argument. Given that the vaccine itself already exists—albeit with different levels of effectiveness—every day that goes on results in preventable deaths that must be avoided.
Instead, the rich countries have engaged in “Vaccine Nationalism,” paying for doses in short supply in quantities that more than cover their own populations. When it comes to saving lives, leaving the distribution of vaccines purely to the market is absurd as no one is safe until all of us are safe.
But beyond the moral argument, there are also compelling arguments on the possible very scary consequences of leaving developing countries behind when it comes to vaccinations. Some of these arguments are excellently spelled out in this piece, which includes the following three points.
First—what by now has become a very real threat—the longer it takes to globally eradicate the virus, the more it will mutate, possibly reducing the effectiveness of the vaccines. This is a very scary scenario, and to me the most important one.
Second, as long as the virus is here, trade flows and global supply chains will be severely disrupted. A recent paper estimates that, if vaccination doesn’t reach the developing world fast enough, these disruptions can cost up the exorbitant sum of $9 trillion to the global economy, and most of that cost will be borne by the advanced economies.
Third comes the important—though often less talked about—fact that prolonging the life of the virus might result in even more poverty, destabilizing even more the already fragile livelihoods of millions of poor people in developing countries. This, in turn—based on historical trends—can result in conflict, undermining global political stability that affects us all. Moreover, conflict will without a doubt reduce the chances of reversing the very negative trends we saw last year in terms of rising prevalent unemployment and increasing poverty rates after decades of improvements.
There’s no doubt that rich countries—perhaps with funding and assistance from the World Bank and regional development banks—must assist developing nations in getting enough vaccines and getting them fast.
But, I believe, these doomsday scenarios are possible, but highly unlikely.
When this pandemic started, many people—myself included—predicted catastrophic scenarios for developing countries. With cases spiking and hospitals overwhelmed in Italy and Spain at the beginning of the pandemic, for instance, what could we have expected for countries with much more fragile public health systems, often living in more crowded spaces and where multigenerational households are common, making it harder to implement social distancing and protecting the most vulnerable? Thankfully, while developing countries are suffering greatly from the pandemic, this catastrophic public health scenario didn’t materialize. Throughout the pandemic and up until today, the vast majority of deaths are concentrated in Europe and North America, as well as in the middle-income region of Latin America and the Caribbean. In Africa, for instance, the Africa Centres for Disease Control and Prevention reports that up until today, there have been 90,000 deaths from COVID-19, in a population of 1.2 billion people. In per capita terms, the U.S. has had about 17 times more deaths, and the U.K. about 20 times more. While measurement in some developing countries can be off and official statistics might be manipulated, it is likely that such large gaps will remain in the data even if corrected.
It is unclear why this is and, in the near future I hope, more research will give us a much better understanding of these trends. I would not be surprised, however, if part of this reality is that developing countries, simply put, know how to deal with infectious diseases better than the populations in rich countries that, for the most part, had never faced a health crisis of this magnitude before. In Africa, for instance, after the 2013-2016 Ebola pandemic, social distancing, elbow bumps, frequent handwashing and even wearing masks, was not unheard of, as this piece argues.
While we must get this pandemic behind us sooner rather than later, it seems that the world has learned to thrive, albeit imperfectly and with a lot of loss and grieving. Most, though not all, of the uncertainty that highly affected markets early in the pandemic has dissipated. And thus, doomsday scenarios seem unlikely.
Look at international trade flows and global supply chains, for instance. In a recent paper, Harvard’s Pol Antras, argues that reshoring and deglobalization are unlikely in the aftermath of the pandemic. Despite a severe slowdown of global trade early in the pandemic, global trade data shows that we are almost back to pre-pandemic levels of trade flows. How much worse can the situation get over the next few months to take us back to the lowest point? Mutations are, of course, the biggest threat right now, so it is possible to see total collapse. But is it likely? I doubt it. If anything, we might expect—particularly as business travel will continue to be depressed for the years to come—that firms will continue investing, if they haven’t already done so, in better software products to better track supply chains not only from direct suppliers, but also from indirect ones (e.g., a supplier’s supplier), as Columbia University’s Amit Khandelwal, an expert on international trade in developing countries, told me in a recent conversation.
Thus, it is the moral argument—to save lives and quickly reverse negative trends—that should drive rich nations and the multilateral system to devote and mobilize every possible resource to extend effective vaccines to developing countries (while also moving much faster with immunizations in countries that already have the vaccines). It is obvious that until the virus is globally eradicated, the economic well-being of the poorest will be fragile and safety precautions will be needed for a while. But there are reasons to be optimistic, and a doomsday scenario is, probably, behind us.