Increasing vaccine equity among lower income countries in the Global South

The US and other European countries continue to develop effective vaccine technologies through both public and private funding. Due to their higher economic standing, they are able to pour money into research, development, and dissemination of these vaccines with ease. However, middle and low income countries cannot afford to do so. They are limited financially and lack the technological facilities to mass produce vaccines. Therefore, there is a widening health equity gap between countries in the Global North versus the South.
          As of now, billions of residents within low and middle income countries (LMICs) have been unable to receive the first dose of the Covid-19 vaccine. The lack of equitable access to vaccine technologies is a form of vaccine apartheid, which is a major social justice issue. One method to reducing this equity gap would be to advocate for the approval of time-limited intellectual property rights waivers. These waivers would allow LMICs to replicate effective mRNA vaccines without legal consequence. Currently, the US and a majority of EU countries are blocking this proposal. The purpose of this research study is to use a global equity lens to examine how corporate interests and other structural factors are influencing high income countries to stand against Covid-19 intellectual property right waivers.

Project Narrative:
Background: As of January 2022, there is a 9.5% vaccination rate in countries in the Global South (Alakija 2022). Over 70% of people in high-income countries (HICs) are fully vaccinated against COVID-19; in low-income countries, that number is 4% (Ye et al 2022). Only 1.2% of the global vaccine supply has been received by low-income countries and 14% by lower-middle-income countries, even though they account for nearly 40% of the world’s population (Kavanagh 2021). At the moment, 11 billion doses are needed to vaccinate the remaining global population. The US and other G7 countries have pledged to donate 1 billion doses, which is only a fraction of the needed amount (Kavanagh 2021). The vaccine equity crisis is driven by biased allocation and insufficient supply. In order to truly make change, HICs must commit to waiving intellectual property rights patents, sharing scientific knowledge, and funding vaccine production and distribution in LMICs.

Project Goals and Objectives:
The overarching goal of this research is to increase vaccine equity among lower income countries in the Global South. One of the means to accomplish this would be to advocate for the approval of intellectual property waivers.

Goal: Using a global equity lens conduct a policy analysis of IP rights in relation to vaccine technologies

         a. Objective: To understand and analyze what factors are influencing high income countries to stand against waivers that would promote vaccine equity
             i. Activities: Conducting a meta analysis of previous studies on vaccine inequities among LMICs , analyzing data trends of Covid-19 in LMICs vs high income countries, creating a timeline of support and opposition of the TRIPs waiver, and researching the key opponents of the TRIPs along with their motives

Goal: Develop a racial equity informed advocacy strategy for public health professionals on both a domestic and global level
        a. Objective: To help public health professionals promote racial justice and health equity efforts in relation to vaccine equity
            i. Activities: Developing social media toolkits designed to inform the general public about the vaccine apartheid, organizing grassroots campaigns against the US Chamber of Commerce, and build coalitions between domestic and international organizations to advocate against the unethical practices of pharmaceutical companies such as Moderna

Procedures/Methods:
The policy analysis portion of this research will be conducted by performing a meta-analysis of 15 studies related Covid-19 vaccine inequity. The data on current Covid-19 vaccination rates will be pulled from the CDC Covid dashboard and the UN Covid-19 dashboard. It will be analyzed for trends between structural factors (race, socioeconomic status, and geographic location) vs vaccination status. Advocacy strategies will be created in partnership with the People’s Vaccine Alliance, which is a grassroots organization committed to the cause.

Deliverables:
1. An assessment of structural and social factors impacting the approval of IP rights waivers
2. A racial equity informed advocacy strategy targeted towards the vaccine apartheid

Impact: 
The lack of equitable access to vaccine technologies affects marginalized communities throughout the world. The South-East Asia region and Latin America now represent 75% of global weekly Covid-19 deaths (Kavanagh 2021). Without adequate vaccination in all countries, the disease will continue to mutate and cause millions of preventable deaths per year.
            Research has shown that the burden of disease from Covid-19 is now falling on the poor, while the wealthy get to move on with their lives. Similar to disease patterns with malaria and HIV, the poorest countries are suffering the most. For example, in India only the official death toll from Covid-19 stands at around 500,000, the real number might be closer to 5 million excess deaths. These deaths occurred after the introduction of vaccines in the Global North (Sam-Agandu 2022). While HICs rush to claim that the pandemic is over, it is still a very harsh reality in lower income countries. The purpose of this research is to help reduce the health equity gap among minority communities globally and illuminate how systemic racism is playing a role in vaccine inequity.