Global Dashboard for Vaccine Equity- Impact of inequity: HRW

Vaccination - Photo by Mufid Majnun

COVID-19 vaccine inequity will have a lasting and profound impact on socio-economic recovery in low- and lower-middle income countries without urgent action to boost supply, share vaccines and ensure they’re accessible to everyone now.

The Global Dashboard for Vaccine Equity combines the latest data on the global roll-out of COVID-19 vaccines with the most recent socio-economic information to illustrate why accelerating vaccine equity is not only critical to saving lives but also to driving a faster and fairer recovery from the pandemic with benefits for all. 

It provides new, actionable insights and possibilities for policy makers to dive into the implications of vaccine inequity for socio-economic recovery, jobs and welfare. Analyses can be generated and compared by country, region and globally, and organised per income group.

The Dashboard is a joint initiative of UNDP, WHO and the University of Oxford with cooperation across the UN system, anchored in the SDG 3 Global Action Plan for Healthy Lives and Well-being for All.

What is vaccine equity?

Vaccine equity means that vaccines should be allocated across all countries based on needs and regardless of their economic status. Access to and allocation of vaccines should be based on principles grounded in the right of every human to enjoy the highest attainable standard of health without distinction of race, religion, political belief, economic, or any other social condition.

Globally, the distribution of vaccines is shaped by challenging political, economic, social, diplomatic, and health-related matters. Therefore, accurate and up-to-date data and information are critical components in guiding the international community’s understanding of vaccine equity and shed light on the blind spots essential for achieving the last mile on vaccine equity.

Are vaccines affordable for all countries?

Data from the MI4A COVID-19 Vaccine Purchase Dataset shows that the average cost per COVID-19 vaccine dose ranges between US$ 2 – $ 40. The estimated delivery cost is US$ 3.70 per person vaccinated with two doses, after accounting for vaccine wastage.

This represents a significant financial burden for low-income countries, where the average annual per capita health expenditure amounts to US$ 41 (Global Health Expenditure Database). While vaccination programmes will increase healthcare costs across all countries, it is especially the case in low-income countries as they would need to increase their health expenditure by a staggering 30-60 percent to reach seventy percent of their population under the current pricing and over a period of one year. High-income countries are expected to increase theirs by only 0.8 percent to achieve the same vaccination rate in one year.

COVAX provides a global risk sharing mechanism for pooled procurement and equitable distribution of COVID-19 vaccines to vaccinate 20% of countries population. As a greater coverage is required to ensure a stop to the spread of COVID-19, unless COVAX is able to support LICs beyond 20 percent vaccination rate, the financial burden of vaccinating an additional 50 percent of the population will fall on most vulnerable countries. Additionally, some countries are already delivering booster doses, which indicates that COVID-19 vaccinations may become a recurring expenditure for countries.

Impact of vaccine inequity on economic recovery

High-income countries have borne the brunt of COVID-19 cases and related deaths. But analysis of the latest projections of global economic growth show greater negative economic impacts in low-income and lower-middle-income countries (World Economic Outlook, April 2021; IMF).

There are notable differences in the IMF’s economic forecasts since the start of the pandemic. Though estimates in October 2020 predicted a global economic rebound in 2021, by April 2021 it was clear that economic recovery would not be uniform across country groups, most likely driven by concerns around inequitable access to vaccines.

Driven by increased vaccination rates, high-income and upper-middle-income countries are projected to make stronger than expected recoveries with the latter group expected to make a U-shaped recovery. At the same time, forecasts for lower-middle-income and low-income countries are not encouraging there was a significant downward revision of economic growth in both groups of countries (compared to estimates from October 2020). Both groups of countries are projected to stay on a downward economic growth trend.

There are significant differences in the IMF’s economic forecasts before the development of the vaccines (April 2020), during vaccine development (October 2020), after commencement of vaccine roll-out (April 2021) and finally after vaccination rates exceeded the 40 percent target in many high-income countries (October 2021). The forecasts in October 2020 painted a bleaker picture compared to April 2020 due to a more complete understanding of the economic fall-out of the pandemic. At the same time, promising vaccine candidates in the development pipeline resulted in moderate to strong projections of economic recovery for 2021 for all four country groups. However, by April 2021, it was clear that economic recovery would not be uniform across country groups, most likely driven by concerns around inequitable access to vaccines which is confirmed also in the latest IMF WEO Outlook from October 2021. Driven by increased vaccination rates, high-income and upper-middle-income countries are projected to make stronger than expected recoveries. But forecasts for lower-middle-income and low-income countries are not encouraging as there was a significant downward revision of economic growth in both groups of countries (compared to estimates from October 2020). Both groups of countries are projected to stay on a downward economic growth trend.

To further understand the impact of COVID-19 vaccination rates on economic recovery, UNDP analyzed how vaccination rates by the end of September 2021 in 195 countries impacted GDP forecasts. The analysis compares vaccination rates in April and October with the difference in the GDP growth rates for those months, based on IMF’s World Economic Outlook estimates.

UNDP’s analysis suggests that the economic recovery will be faster in countries with higher vaccination rates. At the end of September 2021, 30 people out of every 100 around the world had been fully vaccinated. The modelling exercise suggest that if one additional person out of every 100 had been vaccinated, global GDP would have reached US$94,709 billion at the end of 2021 which represents an increase of US$93.56 billion in comparison to IMF’s projections. This increase is equivalent to 0.10 percent of projected global GDP for 2021.

In low-income countries where vaccination rates are lagging, the path to recovery will be long and uncertain unless urgent action is taken now by the global community.  By September 2021, only 2.33 percent of people in low-income countries had been fully vaccinated. UNDP’s analysis suggests that, had the vaccination rate been equal to that of high-income countries (54.3 percent), low-income countries’ GDP would have increased by $16.27 billion which represents an increase by 5.16 percentage points in 2021, which could have been used toward other development priorities.

For instance, if 40 percent of the population had been vaccinated in the Democratic Republic of the Congo by September 2021, the country’s expected increase in GDP could have covered 75 percent of its current health expenditure. And the same level of vaccination in Ethiopia could have covered all interest payments on government debt times three. – Human Rights Watch