In the fight against COVID-19, the world is putting an immense amount of resources into developing an effective vaccine. Some scientists and pharmaceutical companies are saying that hopefully we will have a successful vaccine by the beginning of 2021. The problem with such a newly developed vaccine is that there will not be enough for everyone, as it will take time to make and distribute. Wealthier countries have already claimed access to the first doses, leaving poorer countries behind. Moreover, medical colonialism still affects Africa and its distrust towards trials, because of past and recent forceful experiments. However, this complicates the situation even further, as data on clinical trials are needed in all regions, including Africa, to establish a secure vaccine.

According to the World Health Organization, over 48 potential COVID-19 vaccines are being tested in human clinical trials. However, before the doses have been proven to work, the world is facing another barrier. Countries and organizations such as the United States, United Kingdom, and European Union are claiming their rights to receive doses, a complicated struggle that Oxfam senior policy adviser Mohga Kamal-Yanni calls the “lion’s share.” In research performed by Duke University it was found that countries have already secured deals of purchases for 3.8 billion doses, with 5 billion more being under negotiation or preserved. Not all of these investigational immunizations will be accepted, as several of them will most likely fail the clinical trials. As of now, the United States, followed by India and European Union have confirmed most potential doses. 

The United States has claimed access to the vaccine for a long time, pointing out that they have contributed the largest amount of money to research. The America First Vaccine Act was introduced in September by Republican Senator Thom Tillis, an act suggesting that any exports of the vaccine should be prohibited until the demand of U.S. companies has been reached. According to a report given to Al Jazeera, Tillis said in a statement that “once that vaccine is developed, Americans should get the vaccine first, before it goes to other countries … ensuring that they receive a return on their investment.”

The U.S. consumer advocacy organization Public Citizen stated that the U.S. government has invested at least $11 billion to experimental investigations for a COVID-19 vaccine. The claim to secure doses for Americans first can be related to the idea of vaccine nationalism, which is not a new phenomenon. In 2009 during the Swine Flu pandemic, high-income countries who managed to produce a successful vaccine refused to export doses to low-income countries until domestic needs were reached.

Furthermore, a different aspect of COVID-19 relates to a recent history of medical colonialism, where trials have been executed on African populations especially. In the German colonization of Namibia during the 1800s and 1900s, people were taken to concentration camps against their will, where experimental trials occurred. In one camp, doctors sought to investigate vitamin C deficiency by injecting Namibian prisoners with arsenic and opium. Eugen Fischer, a German professor of medicine and a future Nazi, came to visit Namibia during the time with the intention of collecting skulls and skeletons of murdered Namibians that could be used for research. 

Colonialism has shaped the industry of medicine in Africa, as several countries have been exposed to unfair trials by force. According to Al Jazeera, Karsten Noko, a Zimbabwean lawyer and medical humanitarian worker, has written about the way medical colonialism was executed in Africa. Noko argues that medical colonialism during the 20th and 21st century might be different, but it still violates medical ethics, as African bodies have been used in a way that those in the global north would never be. There are several recent examples of this. To begin with, in 1996 the pharmaceutical company Pfizer used 200 Nigerian children to test an experimental drug without any consent from parents. Additionally, blood tests taken from Ebola patients during West Africa’s 2014 pandemic were subsequently transferred covertly to labs as distant as the United Kingdom, without consent from patients.

Noko means that incidents like these, along with a lack of lucidity from pharmaceutical companies regarding trials, evokes distrust among African populations. But at the same time, clinical data based on trials is significant in order to determine whether a vaccine is effective or not. Noko explains “we understand that if people are not willing to consent to clinical trials, then we do not get drugs. That’s not what we want,” while adding “but what I do think we should be calling for … is much more transparency about what happens and much more protection from states.” With a long history of medical colonialism, where African bodies have been used as experiments, transparent medical systems are significant. The lack of trust is valid but ineffective for future reference, and the medical structure in African countries must provide its patients with a safe regulatory system that protects them and their rights. Along with this, African scientists should lead research in their local communities. 

To unify countries’ purchasing power, the public-private vaccine partnership GAVI introduced the COVAX initiative in April. The enterprise intends to distribute purchases of doses among countries, by securing a minimum amount of affordable vaccines through an advanced market engagement. Up until now, COVAX has established a potential 700 million doses of COVID-19 vaccines, which exceeds the United Kingdom, Canada, and Japan. By being part of the initiative poor countries will pay a subsidized price of up to $4 for a two-dose vaccine. At first, COVAX pledged for free vaccines to low-income countries, but the decision was changed in September when GAVI’s board launched a cost-sharing plan. However, GAVI has stated that the requirements are flexible and countries can still argue for why they are unable to pay for the discounted prices. Middle and high-income countries will still pay in full for stocks obtained through COVAX.

Eventually, COVAX wants to get two billion vaccine doses before the end of 2021 and ensure participating nations have enough immunizations to vaccinate up to 20 percent of their populations. Starting on October 19th, 82 countries had marked lawfully binding agreements to join the initiative, which has already raised over $2 billion in funding. COVAX is influenced by a similar initiative from 2005, when GAVI launched a pneumococcal vaccine in lower-income countries. However, it is unclear if COVAX will be enough during the coronavirus pandemic, and if it will help poor countries get a fair shot for a future vaccine. The initiative may not be perfect, but as for now, it might be several countries’ best and only choice.

Arguing that wealthier countries should have access to the first vaccines before others because of their monetary contribution to development is unfair, as poorer countries would never be able to assist with the same amount in the first place. Just because the countries are unable to afford research development, the population should not be punished. A global pandemic has no borders, and it is significant to distribute the vaccine evenly across the world. In order to beat COVID-19, we have to beat it everywhere. Our planet is greatly globalized, and if we fail to contain the virus in one place it has the potential of spreading quickly. Like UN Secretary-General António Guterres said in a report in March, “We are only as strong as the weakest health system in our interconnected world.”