Health inequity and vaccine nationalism undermines health for all
With governments around the world seeking to develop and distribute a COVID-19 vaccine and put a stop to the spread of the virus, one UBC Okanagan researcher says we should resist the urge to engage in nationalist policies for global health issues.
Katrina Plamondon is an assistant professor in UBCO’s School of Nursing and through her work with the Canadian Coalition for Global Health Research (CCGHR) and Canadian Society for International Health, recently collected over 100 signatures of health and policy experts from across Canada calling on governments to engage in an equitable approach to vaccine development.
She explains how health equity is important in battling current and future pandemics and health crises.
What do you mean when you talk about health equity?
Health equity is an aspiration! It’s about striving for a world where, regardless of nationality, social class, education or other social and economic factors, people can live to their full potential, with access to things like quality health care, clean and safe drinking water, access to education and freedom from violence. It is closely tied to the ideals described in the UN’s Universal Declaration of Human Rights and core values that most Canadians subscribe to, and are central to what our government argues for on the international stage.
How has COVID-19 affected equity around the world?
Before exploring the pandemic’s impact on health equity, I think it’s important to understand that systemic and pervasive health inequities were present long before COVID-19 entered our lives. The pandemic simply exposed them. We’re seeing today that navigating life during a pandemic is far more complex for people who were already in a position of social disadvantage.
And of course, the virus itself doesn’t discriminate. Though race-based data is limited in Canada, we know that Indigenous, Asian and other visible minorities are suffering disproportionately greater burdens of both this disease and social and economic impacts of policies related to it. There is no biological reason why Black Americans are hospitalized and dying at disproportionately alarming rates in the US, or why migrant agricultural workers in Canada are over-represented in COVID-19 outbreaks. Issues of equity are systemic and deeply rooted issues around things like systemic racism and how it differentially shapes housing, social mobility, economic opportunities and access to basic services.
How can you wash your hands, for example, if you have no home, or live in a refugee camp with no reliable access to clean water? How can you stay home from work when you’re sick, if staying home means you could lose your job?
You’ve spoken of ‘vaccine nationalism.’ What does that mean?
Governments around the world are under enormous political pressure to develop, manufacture and distribute a COVID-19 vaccine as quickly as possible. Some wealthy countries, including Canada, have signed contracts with vaccine manufacturers to secure doses for exclusive use within their borders. That, in turn, has put further pressure on other countries to do the same. We are all served best when the vaccine is distributed equitably and universally, with science and respect for our shared humanity, rather than nationalism, dictating who gets the first doses and when.
I can’t help but draw a parallel between this national vaccine ‘hoarding’ and the panic to buy toilet paper in the early days of the pandemic. Though often described as irrational and unhelpful, many of us got caught up in the scramble. We couldn’t see that there was more than enough to go around, provided we all took only what we needed when we needed it. Likewise, if we work together to leverage the resources we share globally, aiming to protect our collective global health, everyone could have access to what is needed when it is needed.
What can we do to ensure equitable access to a COVID-19 vaccine?
Before we can consider what to do, we should think about why we should do it. Canada, and all of its citizens, have moral obligations to improve the health of humanity as a whole. There are issues that are inherently global, that affect the health of all people, everywhere. COVID-19 is not the only issue like this, and future pandemics are entirely possible.
Our collective futures depend on our capacity to respond as a global community. What we do today matters now, and long into the future. We need to ensure that health equity is a key component of local, national and global health policies. And Canada has an important role to play. While we aren’t a global superpower, we are an influential middle power and I think we can take global health policy positions, especially around a COVID-19 vaccine, that shows the world how to make sure health of all of humanity isn’t sacrificed for national interests.
Has COVID-19 created an opportunity to rethink public health policy?
There’s no doubt that talking about health equity during a global health crisis can be extremely challenging! I have also never before been so hopeful for the future of humanity. The entire world is singularly focused on solving this emergency with some of the greatest minds working around the clock.
We are at an inflection point where existing systems and structures are primed to be reinvented and improved. That’s something we haven’t seen since the end of World War II. This pandemic offers a real opportunity to create new equity-centred policies and programs that prioritize creating a more balanced, equitable future for humanity.