The rollout of vaccines is going well.
At least, that’s what you’d say if you’re from the UK, USA or Israel. Anywhere else, and you’ve probably got very different feelings about the rollout, with most countries around the world lagging far behind these frontrunners, leaving covid-19 to wreak havoc and take thousands more lives.
This is what happens when vaccine scarcity meets nationalism and global wealth inequality: the wealthiest few win, while the poorer lose out. The developing world is struggling to even get vaccines, with the Covax facility delivering only minimal numbers to lower-income countries. The UK and US, meanwhile, have exploited their near-monopoly on vaccine research and development to create a monopoly on the vaccine doses themselves.
But there’s growing discontent in those countries which don’t fall into the low-income category, but aren’t leading the way either. EU member states are the prime example: in the EU, they’re vaccinating at roughly 30 per cent of the rate of the UK. Just to compound this, most EU member states have gone for a strategy of administering both vaccine doses within a three-week time period, whereas the UK has opted for a gap of up to twelve weeks. That means that, in terms of people vaccinated at least once rather than doses administered, the EU is doing about five times worse.
This is a story of procurement contracts, blood clots, and the aftershocks of the EU and the UK’s bitter Brexit divorce. It is an acerbic microcosm that tells of a world fragmenting along vaccine lines — and descending into conflict.
The seeds for conflict were sown early in 2020. Governments realised immediately that vaccine development and procurement would be crucial to getting their country — and the world — out of the pandemic as quickly and painlessly as possible. The UK, US, EU, China, Russia, and many others rushed to fund vaccine projects in their jurisdictions and buy up doses in advance.
The UK and US had the greatest success in the development of new vaccines, with the Oxford-AstraZeneca vaccine joining those conjured up by US pharmaceutical giants Moderna, Pfizer, and Johnson & Johnson. Both realised that, by funding these vaccine projects, they could leverage better deals, effectively monopolising vaccine supply by the time the vaccines were ready to go late last year.
The UK was also very quick to sign vaccine procurement contracts, reaching well over 300 million doses by the end of last summer from various providers. Among those contracts was the one signed with AstraZeneca, which included a “UK-first” clause. Other contracts, such as that signed with Pfizer, included legal obligations to supply a certain amount of doses within a given timeframe.
These details are the source of the conflict with the EU. The European Commission assumed the mantle of vaccine procurer for the entirety of the EU, in order to ensure that vaccines could be rolled out at equal speed across the bloc to avoid political tensions. But the Commission was ill-prepared for the job, only signing contracts three months after the UK had secured their deals because the EU decided to haggle over the prices — with little effect.
But negotiating prices and leaving it late in the day put the EU into an impossible spot, as their leverage dwindled. Their contracts don’t even have legal requirements for delivering vaccines in a given timeframe, let alone EU-first clauses. Their contract with AstraZeneca, made public after an almighty dispute between the two in January, was a purely “best endeavours” contract, meaning that AZ had no obligation to deliver any vaccine doses.
Therein lies the main problem: AstraZeneca have an obligation to get vaccines to the UK, but no such obligation to get vaccines to the EU. They signed the contracts in good faith, believing they could deliver all doses, whether obligated to do so or not. But, with hitches in the supply chain and problems at manufacturing facilities, they have not been able to do so thus far. With legal obligation only to the UK, they naturally chose to deliver the vaccines here, leaving the EU with none.
The EU and its member states are not happy about this for a few reasons. First, they disagree with the UK that any country should be monopolising supply on principle, and that all countries should share doses roughly evenly. Secondly, there’s anger about AstraZeneca exporting doses from the EU to the UK while the EU has received a total of nil doses from UK factories. Thirdly, the EU aren’t best pleased with AstraZeneca themselves, for agreeing in principle to a timescale which they haven’t been able to meet.
This brings us onto…
The blood clots
Throughout the year so far, senior EU leaders have been a little more than disparaging about the AZ vaccine, with its effectiveness and safety both coming needlessly under fire. The first allegation was that the vaccine was ineffective in older people — without good evidence. The second allegation, earlier this month, was that the vaccine caused blood clots — this time, with evidence to the contrary: that the vaccine in fact slightly reduces blood clot risk!
There’s no need to be neutral or cautious about describing the actions of many EU member states in this regard. Reckless, ridiculous, and unfounded allegations have dampened vaccine take-up rates on the continent, and risked the UK public’s confidence in the vaccines as well. Playing into the hands of conspiracy theorists and covid deniers for the sake of cheap political gain, Merkel, Macron and Co have seriously risked the entire rollout, both at home and abroad.
Many member states suspended the use of the AstraZeneca vaccine, with some now have emerged out of that suspension. In doing so, they have annoyed the British government and AstraZeneca, and endangered more lives needlessly. Europe is now in the grip of a third wave, with a new lockdown in France and Germany saved only by a bizarre U-turn by Angela Merkel on an Easter lockdown within 24 hours of announcing it.
The European Medicines Agency has repeatedly backed up the vaccine’s safety and effectiveness, limiting the damage to EU-UK relations somewhat. But the EU as a whole has burned through plenty of diplomatic capital with this series of moves.
The Big Picture: Brexit, Bans, and Battle
This battle over vaccine supply is just the latest in a long line of disputes between the EU and UK since Brexit was formally completed last year. The wrangling over a free trade agreement, concluded just in time for the end of the transition period on December 31 2020, set the tone for the future relationship, with vitriol, anger, and frustration dominating the public face of the discussions.
In 2021, the Northern Ireland protocol has caused a lot of issues between the EU and the UK, with the EU triggering, and then rowing back on, a controversial usage of its provisions in an attempt to secure vaccines for the bloc. Trying its best not to be outdone in incompetence, the British government then unilaterally extended the grace period that is allowing trade between Northern Ireland and Great Britain to continue mostly unchecked for the time being.
The dispute over vaccines is just a small part of this bitter Brexit divorce.
The EU is now threatening a vaccine export ban for six weeks, which would leave the UK without the capacity to fulfil all of the second doses within the required 12-week timeframe. The EU say that this would be a justified move because it would have the same effect as the ‘UK-first’ clause in the UK’s contract with AstraZeneca, but the British government disagrees.
This is a good demonstration, though, of one of the big downsides of Brexit for the UK, which is now the smaller player in any disputes with the EU, and not a member state whose concerns could lead to it vetoing the bloc’s plans. The UK is powerless to stop the EU from banning exports if that is what it wants to do.
But of course, an export ban from the EU would immediately draw reciprocal action from the UK. This would descend to the bottom quickly, and it is, unfortunately, likely given the combative approach both governments have taken to post-Brexit issues so far. With the components for vaccines coming from all over the place, export bans are sure to reduce supply on both sides of the English channel.
And that’s why both sides would prefer to find a diplomatic solution. Murmurings from Westminster suggest that the government is increasingly considering sharing some of the supply from the Dutch AstraZeneca plant, though this is far from official.
This is to say nothing of the shared interests and aims of the EU and the UK. If they can find a way to work together on vaccines, they would present a much greater threat to India, which has put a universal vaccine export ban in place, denting supply in both the EU and the UK.
But for now, such a solution looks a way off. The inequities in vaccine distribution across Europe — and the world — look set to continue for some time yet. In a world of rising nationalism, deeply divided by wealth, politics has come to ignore the scientific imperative: getting the most vulnerable people in the world vaccinated as quickly as possible.
No-one is safe until everyone is vaccinated. The emergence of new variants of concern from around the world in the last few months has demonstrated the peril in our plans for freedom. All it takes is for one variant that can evade the vaccine to emerge, somewhere in the world, and the whole plan goes up in flames. This is much more likely if some countries go without vaccines while the wealthiest few monopolise supply.
Vaccine inequalities matter. But governments desperate to get out of lockdowns and reboot their economies, with elections on the horizon, don’t seem to care.
This post first appeared on the Politika website.
Joe Zammit-Lucia says
David – what do you suggest re vaccine ‘fairness’? Do you think that governments in wealthier countries should tell their citizens that they will not get vaccinated for some time because they are shipping vaccines to poorer countries? Do you think the majority of their citizens would support that?
The neo-liberal approach of the EU in treating vaccine procurement purely as a commercial negotiation with the pharmaceutical companies has been shown to be seriously flawed. We are now seeing shortages further up the supply chain, such as the bags that the cells are grown in to produce the vaccine having lead times extending to as much as a year. Had the EU followed the UK approach and simply taken the price that countries like Germany had already agreed with the companies and placed orders with money upfront (like the UK) those pharmaceutical companies could have placed their orders earlier and the companies further up the supply chain expanded their production capability earlier. We all knew that we would need some 10 billion doses to vaccinate all the adults in the world; the EU was relying on that capability being in existence without checking whether it was.