vaccine – UAB Institute for Human Rights Blog

Understanding Vaccine Diplomacy in the Case of COVID-19: A Global Approach to Health EquityUnderstanding Vaccine Diplomacy: A Global Approach to Health Equity

In the landscape of global health, vaccine diplomacy has emerged as a compelling strategy, melding healthcare initiatives with international relations. This approach is pivotal in the ongoing battle against infectious diseases, most recently the COVID-19 pandemic. Vaccine diplomacy involves countries utilizing their surplus vaccine supplies to forge diplomatic ties, enhance global influence, and foster goodwill. This is often done in partnership with private pharmaceutical entities and public health organizations. However, while aiming to address the urgent need for equitable vaccine access worldwide, vaccine diplomacy raises critical questions concerning human rights and health equity on a global scale.

Evolution of Vaccine Diplomacy

The vaccine diplomacy has existed long before the COVID-19 pandemic, but we noted its increased influence during this unique time. Nations like the United States, Canada, and the United Kingdom, possessing robust vaccine manufacturing capabilities, sought to leverage their surplus doses as a means of geopolitical influence. For example, the United States promised to donate over 1.1 billion vaccines by 2023. This approach gained momentum as vaccine shortages persisted across continents, exacerbating health inequities, especially among women and children, and prompting a response beyond national borders.

Photo of vaccine vile.Source: Flickr — Photo of vaccine vile. Source: Flickr

Examples of Vaccine Diplomacy

Vaccine diplomacy has manifested in diverse forms. China and Russia have actively supplied their respective COVID-19 vaccines, including Sinovac, Sinopharm, and Sputnik V, to various nations as part of aid packages or through bilateral agreements. India, known for its significant vaccine production capacity, contributed doses through the COVAX initiative and direct donations to neighboring countries and beyond. These mobilization efforts are valuable to the development and growth of vaccine diplomacy through the lens of aid. This improves the well-being of marginalized groups and pushes national interests abroad.

Photo of kids lining up to get vaccinated.Source: Flickr — Photo of kids lining up to get vaccinated. Source: Flickr

Human Rights and Vaccine Diplomacy

At its core, vaccine diplomacy intersects with human rights, particularly the right to health. Access to vaccines is considered a fundamental human right, and ensuring equitable distribution is paramount to providing equal protection against COVID-19. Yet, the disparities in vaccine access have sparked concerns about the violation of this right for marginalized and vulnerable populations globally. Several countries have taken commendable steps to uplift vaccine diplomacy and do their part to make interventions more accessible. The United States pledged substantial donations of vaccine doses through COVAX and direct allocations to nations facing acute shortages, aiming to bolster global vaccine access. Countries like Sweden and Norway have also committed funds to support COVAX’s efforts in distributing vaccines to low-income nations.

To enhance the accessibility and efficacy of vaccine diplomacy, countries must prioritize transparent vaccine-sharing mechanisms, equitable distribution plans, and fair allocation strategies. Greater collaboration among nations, regulatory transparency, and a resolute commitment to multilateralism are essential elements for ensuring broader vaccine access. This can be done through working alongside pharmaceutical companies, local organizations, and many other avenues.

How to Get Involved

Individual engagement plays a pivotal role in advancing the cause of equitable vaccine distribution. Advocating for fair vaccine distribution, supporting initiatives that promote vaccine access in underserved communities, and raising awareness about the critical importance of global health equity are impactful ways for individuals to contribute. Engaging with policymakers, supporting organizations dedicated to vaccine distribution, and staying informed about global health issues are pivotal steps toward effecting change.

Vaccine diplomacy stands at the nexus of opportunity and challenge in addressing the global vaccine disparity. While it serves as a conduit for international cooperation, its success hinges upon ensuring vaccines reach those most in need, aligning with the fundamental principles of human rights and health equity.

COVID-19 and the Native American Population

In retaliation to a day celebrating the world’s best-known colonizer, the infamous Christopher Columbus, on October 11th, Indigenous People’s Day highlights the culture, struggles, and history of America’s indigenous population. A silent struggle, however, persists: disease.

Native Health Disparities in COVID

The early 1600s brought to America the infamous two Gs—guns and germs—the latter proving the most deadly as bouts of influenza took a toll on Native American populations across what is now the United States. In the age of modern medicine, it comes as a surprise that disease still wreaks havoc on America’s indigenous population. The ongoing COVID-19 pandemic is no exception.

While COVID-19 holds a dizzying death count as its trophy, the disproportionate difference between white people and minorities, including Native Americans, is staggering. In fact, Native Americans can experience anywhere from 3 to 4 times the risk of dying from COVID-19 as compared to their white counterparts.

An animation of what COVID-19 looks like at the viral level — Unsplash

Funding the Indian Health Service

This vast gap is a reflection of poor medical and public health services for Native Americans. Health disparities that plague the Native population include diabetes, heart disease, and rates of addiction to harmful substances. These follow a similar pattern of COVID-19 with Natives being more likely to experience these chronic conditions compared to all other racial categories. These disparities could potentially be alleviated by greater equity in access to medical and public health services, but a fundamental issue in providing this care lies in Native sovereignty. As determined by Worcester v. Georgia, 31 U.S. 515, Native American land, or reservations, are considered sovereign land. While at face value this seems to be a win empowering Natives and acknowledging their right to the land that was once theirs, it creates a vacuum of public services.

Encapsulated by possessors of what was once their land, Native health and well-being are bound by the constraints of the state. A lack of widespread taxes, natural resources, and human resources leaves the reservations reliant upon the ‘external’ state of America for support and sustenance. Most money generated on reservations largely consists of gambling and casino money—practices usually outlawed in the surrounding states. This money only goes so far in providing for the tribe as money often stays within certain families, leaving the rest of the reservation in high rates of poverty. Thus, the main provider of health care for nearly 2.2 million members of the tribal communities, the Indian Health Service, is funded by American tax dollars. And yet, the IHS’s hospital system is severely underfunded and understaffed. The main mechanism created to fight disease seems designed to fail. In this sense, disease continues to persist as a remnant of colonialism, which directly violates the fundamental human rights to accessible health care and to acceptable standards of living.

Vaccination Rates on the Reservation

The only light at the end of the tunnel is the rapid rate of Native American vaccination against COVID-19. While co-morbidities and co-mortalities make it such that if COVID is contracted, Natives will be more susceptible to death, the COVID-19 vaccine acts as an equalizer. Once vaccinated, the likelihood of death by COVID-19 significantly decreases.

Native American tribes have been able to boast proud levels of herd immunity with large tribes like the Navajo Nation at roughly 70% fully vaccinated as of May 2021. This commendable statistic is a result of rallied community effort. Cultural values of supporting the elderly and a strong sense of family and allegiance to the tribe—values typically highlighted in Indigenous People’s Day—worked in favor of creating a climate in strong support of vaccination and vaccine acquisition.

Gloved hand pulling the liquid of a bottle labeled COVID Vaccine into a syringe meant to vaccinate people. — Unsplash

Looking Ahead

While the tide has turned in favor of Native Americans, preventing them from being labelled as another health disparity statistic in COVID-19, it is important to remember and to look towards long-term health care equity and solutions for Natives. While increasing funding for the IHS is certainly a good starting point, robust public health interventions and funding for community programs is necessary. Funding dollars from the top could in theory trickle down, but grassroot rallying and support for public health interventions in a community where cultural values of togetherness and unity already exist could prove to be the needed impetus for transforming not only health care access and quality for the Native American population but also general standard of living that leads to health baselines which are robust to disease.