The Biden administration in the US recently agreed to support the intellectual property waiver for COVID-19 vaccines. This volte-face after months of refusal to take a stance on this issue came only after enormous pressure by activists, scientists, journalists, and governments of the Global South, aided by a few allies from rich countries—some who recognized that vaccine apartheid is fundamentally wrong and others who understood that the world can never be safe from the virus if a substantial part of humanity, especially the most at-risk groups, is not vaccinated.
The Histories of Medicine Inequalities
Vaccine distribution has a less than storied past. However, that there is a vaccine divide is not surprising to poor and middle-income countries. The politics of intellectual property (IP) around life-saving pharmaceutical drugs has been contentious at best and ugly and immoral at worst with Big Pharma, backed by elected officials beholden to their generous donations, repeatedly thwarting attempts to waive patent restrictions for essential medicines.
Consider the case of Novartis, a Swiss pharma giant that battled against a cheap generic version of its life-saving cancer medicine (Gleevec) in India’s Supreme Court claiming IP protections after making a minor modification to the old version of the drug- a cynical practice called evergreening which pharma companies use to tweak old formulas slightly to extend patent duration, generally for another twenty years. This practice is the norm rather than the exception. Another famous instance is when western pharma companies blocked access to cheap medication for AIDS in Africa resulting in the deaths of millions. Brazen disregard for human lives, a cavalier attitude to laws, and a cult-like devotion to ever burgeoning profits are the key traits of pharmaceutical companies. This is true for any big capital but is particularly depraved for companies whose products and policies determine whether a person lives or dies an avoidable death.
But was vaccine inequity inevitable? Even before the World Health Organisation declared the spread of COVID-19 as a pandemic, there were incipient but promising signs that this time might be different; that countries may join forces and implement a humane and equitable vaccine strategy to prioritise the most vulnerable populations across the world. Those early signs evaporated faster than hopes of a quick end to the pandemic, thanks to lobbying by Big Pharma, interventions by so-called philanthro-capitalists like Bill Gates (an unaccountable, unelected quasi-state entity due to his enormous wealth) and the disproportionate power wielded by rich countries who, for all the talk about following “science”, were more keen to represent the interests of capital and their own parties rather than pursue concrete steps that minimized global risks. This infographic shows how rich countries were vaccinating one person every second in January 2021 while a majority of poor nations are unlikely to achieve widespread vaccination rates before 2023, illustrating the staggering extent of vaccine hoarding by the former. The bizarre spectacle of millions of the Oxford-AstraZeneca vaccines lying idly in US facilities for months (which it hasn’t approved and will never use) when the world was desperate for supplies and that children, who are at low risk of getting severely sick with COVID, being vaccinated in the US before hundreds of millions of vulnerable adults in poor countries are telling reminders of how shockingly iniquitous the global vaccine response has been.
The Case against Vaccine Hoarding
Why should we be vocal about unequivocally opposing vaccine inequality? Aside from the moral case in which inequality, especially of the deep, widespread, and intentional kind, is inherently wrong, the lopsided distribution of vaccines effectuates millions of avoidable deaths, a long drawn-out end to the pandemic, exacerbation of intra and inter-nation inequalities, constant threats of virus mutations and outbreaks, and economic downturns leading to massive unemployment and deepening immiserations for vast swathes of the human population. The divide between the vaccinated haves and have-nots will solidify measures such as vaccine passports and restricted travel, creating further barriers for those fleeing war, violence, famines, natural disasters, and climate crisis. It is obvious which groups will be most affected by this new form of apartheid, ostensibly in the form of public health but soon to be deployed as another way to keep out the undesirables. When this virus is brought under control, other diseases of racism, xenophobia, and nationalism will continue to run their usual course.
In this fetid and tragic saga of vaccine inequalities, the silence of Western media and activists, especially those who profess left or liberal ideologies, was particularly deplorable. While it is expected that people would first look out for the safety of their own communities, with a few exceptions, there was nary a word of caution against fanatical vaccine nationalism for months. There was a grim lack of discourse around the waiving of IP protections and transferring technology and material for vaccine manufacturing in the Global South. Little pressure was exerted on governments to commit to expanded vaccine distribution, despite extant evidence of the risks of impending death tolls if that was not done. This directly implicates the acute parochialism and hollow internationalism of most progressive politicians, activists, and journalists of the Global North. Such provincialist attitudes don't bode well for the future of international solidarity and are a stark reminder of the tenuous and expedient nature of Western allyship.
The Global South as Eternal Victims
The tendentious arguments offered to justify vaccine hoarding hinged primarily on overt racism and ahistorical claims. Some would argue that since the most effective vaccines have been developed in rich countries, it stands to reason that those countries should be the first to benefit from them. Perhaps so, if one makes the assumption that these countries are advanced solely due to the brilliance, enterprise, and the foresight of their people, blessed with skills and fortitude that their counterparts in poor countries could never hope to achieve. It is defensible if one fails to contextualize the peripatetic ways in which those countries achieved that status. It makes sense if one fails to consider the history of capitalism, colonization, and continued imperialism to date. It also makes sense if one ignores the fact that scientific breakthroughs are akin to a long chain of labor and intellect of several individuals, many of whom were forced to move where capital and funding was.
Part of this troubling aspect is also the dehumanization of the people in the Global South as victims to be saved by the benevolence of rich countries. As Kristin Ross explained in her book May ’68 and its Afterlives, this is a reversal from the 60s and 70s when the newly independent colonies heralded a new, refreshing worldview—anti-colonial, anti-imperialist, anti-racist, socialist, emancipatory— propagated by the Global South citizen who rejected Western modes of thinking and, in lieu, offered a new revolutionary paradigm steeped in universal solidarity and which abhorred all forms of oppression. Sadly, "the wretched of the earth" has now been remodeled as "the wretched of the earth to be saved by West Inc" to serve the interests, moral and economic, of the Western elite. The political subject has become an object of pity. This is a twisted kind of racism that perceives the Global South subject as lacking the necessary skills and temperament, deemed to be the exclusive perquisites of the West. Hence the claim that developing countries are not capable of meeting the desired standards of manufacturing vaccines since it is “complex” for them. There is much evidence to the contrary.
But the Global South isn’t a monolith and it certainly doesn’t need to be saved by those who have exploited its people, expropriated its resources, and invaded its lands. The riches that the West prides upon, the very riches that have allowed them to manufacture those vaccines they are refusing to share with the world, were built upon the oppression of the peoples of the Global South. And their own botched up, highly skewed, egregious vaccine distribution is proof that the world will not be saved by them.