Vaccines 

Vaccines are perhaps the most important medical innovation. They prevent 4 million deaths every year of over 25 different diseases. However, one out of 5 children still cannot get the necessary vaccines that they need. Why is this? Like everything, it is not a simple answer. Inefficient supply chains, lack of funding, and little outreach to entire populations all play a part. This project intends to look at different factors that influence how efficient vaccines have been distributed to low income countries in the past in order to find the best distribution methods for future vaccines. 

Argument to Vaccinate Low Income Countries 

While some may argue that it is not the responsibility of high-income countries to donate vaccines to low- and middle-income countries, there are a plethora of moral and selfish reasons in favor of helping those countries. First, access to lifesaving medical resources should not only be available to those with more money. Even more so when the resource is not finite. Second, vaccinating other parts of the world not only helps that surrounding area, but also helps the rest of the world. Vaccination prevents future outbreaks and the rise of new variants that can spread and harm other parts of the world. Vaccination protects everyone, not only those who have the vaccination. Furthermore, there is economic incentive to vaccinate the globe. Increased health of countries increases their workforce and economy helping other economies around the world. Vaccines in particular also save countries a lot of money in the long run. The total cost of vaccines is significantly less than the cost of treatment for the diseases they prevent. This money can then be implemented in other ways to boost the economy. 

Vaccine Inequality 

Even though there have been large initiatives to vaccinate the world, vaccine inequality is still apparent. For example, at the end of 2021, 22% of Euopre had received the COVID-19 booster while only 0.1% of Africa’s population had. This is partially because high-income countries hoarded the COVID vaccines. These rich countries bought more than their fair share of vaccines and many ended up going to waste when they could have been implemented in another country. The US alone has wasted over 82 million COVID vaccines (NBC). Another astonishing fact is that “Africa accounts for 23 percent of the world’s overall disease burden yet only 1 percent of global consumption of healthcare goods and services” (brookings.edu). Africa has been left behind and the rest of the world pays the price when new variants arise and preventable diseases spread. 

How does it work? 

Low income countries lack the funds and systems to distribute vaccines like high income countries do. Instead, they get most of their vaccines from donations. These donations are usually facilitated by campaigns formed from varying organizations like WHO, UNICEF, and GAVI. For example, COVID-19 Vaccines Global Access, or COVAX, was formed by GAVI, the Coalition for Epidemic Preparedness Innovations, and the World Health Organization, alongside key delivery partner UNICEF to ensure equitable distribution of the COVID-19 vaccine to low income countries. These countries then administer the vaccines to their population. This however comes with its own unique challenges.  

Problems 

While funding and obtaining vaccines is part of the challenge that needs to be overcome for vaccine distribution, it is not the largest or only problem. Most of the problems stem not from a lack of supplies, but from lack of information. Low-income countries do not have accurate systems to relay how much of a certain medical supply or vaccine is needed. Supply chains work in levels. The nation receives supplies that get distributed down to lower levels such as state, regional, local, etc. These lower levels then pass information upwards to indicate what and how much supplies are needed. However, the correct information usually gets lost as it works its way up the levels. Think of it as a game of whisper down the alley. Another problem is the transportation of resources. Many countries’ governments use their own system of transportation. However, it often breaks down or takes too long to reach its destination. These supply chain problems, coupled with the short shelf life of vaccines and the cold temperatures needed to store them, make it hard for countries with low infrastructure and lack of advanced technological systems to vaccinate their citizens. In fact, only ⅓ of vaccines that reach middle- and low-income countries are used. 

Solutions 

First and foremost, high-income countries and the organizations that facilitate vaccine distribution to them should help the countries set up solid systems to be able to obtain accurate information. That means using systems that do not rely on a consistent power grid, teaching citizens how to use and fix the system, and incentivizing the citizens to maintain and utilize the system. One way to accomplish this is to educate people of influence like church leaders, politicians, or school principals. Their large influence over the population can help persuade them of the importance of vaccines and the distribution of them. 

Improvements to the system include limiting the number of levels in the supply chain, outsourcing transportation, and incentivizing people to relay accuration information in a timely manner. Limiting the number of levels would decrease the number of times information and vaccines has to be transferred, minimizing risk of information changing or vaccines being lost or becoming expired. The more correct information leads to more of the correct amount of supplies being received. Increasing incentives for workers to pass on information from level to level with accuracy and efficiency is also imperative. This can be done by receiving certain benefits, based on the accuracy of the information, for example. Outsourcing transportation has also been shown to increase the amount of supplies and decrease the rate at which they are delivered. Using companies that are designed to deliver resources rather than government owned transportation also increases incentive. Government employees tend to not make as much as private companies, most of which offer other incentives to deliver resources fast and without damage. 

Some other solutions that would help reduce the number of vaccines lost is to use vaccines with a longer shelf life or ones that are produced to be stored at higher temperatures. Another idea is to set up vaccination clinics in high traffic areas such as bus stops or train stations. 

One key thing to note is that these organizations should not try to impose western values or systems in these countries. Instead, they should find what works best for their culture and how they operate. 

While all of these findings are useful, they are also generic. What other factors influence the rate of vaccination for low-income countries? Why do similar countries have such different success rates? Can any of these factors teach a lesson on what works and what does not? Can they be implemented for current or future vaccine campaigns?