Equitable Access to COVID-19 Vaccine: Challenges and Solutions

Victoria Huet
August 04, 2021

When this seminar was held in March 2021, discussant Asst. Prof. Yanis Ben Amor, Executive Director of the Center for Sustainable Development, Earth Institute, Columbia University, stressed the fact that only 5 African countries had started vaccinations: Zimbabwe, South Africa, Morocco, Senegal, and Algeria. The African continent comprises a large part of our global population and remains largely unvaccinated, while parts of the world are above the 70% vaccination threshold. How can we ever hope to put an end to the pandemic in a world with such stark wealth and health condition differences between countries and continents?

There are many challenges to an equitable distribution of COVID-19 vaccinations. When discussing these, panellists were emphatic that “no one is safe until everyone is safe.” More than the problem of periphery or Third World countries having no access to vaccines, Dr. Özge Karadağ Çaman, Public Health Researcher at the Center for Sustainable Development at Columbia University, spoke to an issue closer to home; the concern that refugees and undocumented migrants would be excluded from their host country’s national vaccine programs. Dr. Çaman warned of the virus evolving into a social disease, as social, economic, and cultural factors allow the virus to spread faster in disadvantaged groups. As Turkey hosts the largest refugee population in the world, owing largely to the Syrian conflict, health care for refugees is a critical issue. Dr. Çaman praised Turkish authorities for giving a temporary protection status to forced migrants and refugees, and for the fact that registered refugees have legal access to public health care.

In April 2020, COVID-19 related health services were given emergency status in Turkey, meaning that regardless of a person’s health care coverage in the social security system, they are granted access to testing and treatment free of charge. The country’s national vaccination program started in January of this year, and current vaccination efforts include registered refugees and migrants. However, many challenges have emerged as the process of refugees signing up and receiving the vaccine was impeded by language barriers, cultural barriers, a lack of knowledge about the healthcare system, difficulties in accessing the internet, socioeconomic factors, and legal statuses. Dr. Amira Hamadeh, Regional Vaccination Program and Medical Movement Coordinator at the International Organization for Migration (IOM) in MENA, speaking from the vantage point of the IOM spoke about the hopeful launch of the COVAX initiative: a global scheme endorsed by the UN with the aim of improving equitable access to the vaccine among the world’s displaced persons. However, vaccine programs remain under the national sovereignty of a country’s government, and thus difficulties in enforcing equality measures worldwide have emerged.

Rula Amin, Senior Communications Advisor at UNHCR Regional Bureau for the Middle East and North Africa, emphasized this aspect of inequality; the uneven wealth distribution of the world increases the variability of vaccine costs and availability. For instance, Ms. Amin spoke of how wealthier countries have been hoarding vaccines. Is there a fairer method of distribution of vaccines that can be implemented globally? Ms. Amin expressed doubt that there was any way to ensure supply to all countries; forbearing distribution issues, just in sheer quantity vaccines will only meet the demand for the world’s population in 2023 or 2024. Not only is the world suffering from a lack of trust in the efficiency of the vaccines, demonstrated in a lack of eagerness to be vaccinated and a worldwide spread of misinformation, but variants of the virus pose yet another problem as their immunity to the vaccine is not yet confirmed. Additionally, in countries such as Yemen and Syria where health facilities have been destroyed by conflict, and the countries health care systems at large obliterated, vaccination programs are impossible to set up, let alone develop. These countries would need strong support from an international coalition to be able to distribute vaccinations to their populations.