Universal Access to COVID Vaccines, Tests, Treatments and other Public Health Tools

Apr 2021
United Nations
COVID-19, Vaccines, New Social Contract

*Presented by Shoya Yoshida, General Secretary, ITUC-Asia Pacific, during the ITUC Webinar on COVID 19: Vaccines, Testing, and Treatment - Access for All, 7 April 2021, Virtual

A true test for the global community

COVID-19 is a true test for the global community. It is a test for trade unions on whether they could spare the values that they have been promoting in the past centuries, such as coexistence, equality, tolerance, unity, and social justice.

In the current pandemic situation, we have learnt how millions of workers who have lost their jobs for only a month cannot afford to pay for their children’s education, housing, and food, as well as how fragile a nation’s development is when it relies excessively on demand from global supply chains and gives less priority to boosting domestic demand by raising wages.

Economic damage from COVID-19 is further reinforcing inequalities. The pandemic has had a disproportionate impact on women, racial and ethnic minorities, and people living in extreme poverty. Around the world, women are facing an increased burden from rising demands in total unpaid care work and experiencing the majority of job losses.

Two vaccine scenarios

Northeastern University and Bill and Melinda Gates Foundation estimated the outcomes for two different vaccine scenarios. In one scenario, approximately fifty high-income countries monopolise the first two billion doses of the COVID-19 vaccine. In the other scenario, doses are distributed everywhere based on each country’s population, not its ability to afford the vaccine. Sixty-one per cent of deaths could be averted if the vaccine is distributed to all countries proportional to population, while only 33 per cent of deaths would be averted if high-income countries receive the vaccines first. In short, if rich countries buy up the first two billion doses of the vaccine instead of making sure they are distributed equitably, then almost twice as many people could die from COVID-19.

This modelling was published in September last year. Even months before vaccines became widespread, this study showed the essential challenges of vaccines that we are facing now. The current situation is as this study predicted. Rich countries are overwhelmingly leading the battle for vaccines. 

Vaccine nationalism

Of course, vaccine nationalism has its share of critics. Dr. Tedros Adhanom Ghebreyesus, chief of the World Health Organization (WHO), aptly described the danger of vaccine nationalism in his speech on 29 January this year. He said, “When a village is on fire, it makes no sense for a small group of people to hoard all the extinguishers to defend their own houses,” and “the fire will be put out faster if everyone has an extinguisher and works together in union.”

This is a straightforward analogy, but it is unconvincing in situations where there are not enough fire extinguishers. Everyone wants to protect themselves and their families. This is a human instinct. How many people are morally superior in today’s situation?

Of course, there would be enough vaccines for everyone as more vaccines are being developed, approved, and produced, but for now, vaccines are a limited resource. That’s why we must use them as effectively as possible to save as many lives as possible.


There is also an initiative to ensure the fair distribution of a vaccine called COVAX (COVID-19 Vaccine Global Access Facility), which was launched in 2020 under the initiative of the WHO, UNICEF, and others. COVAX is now planning for high- and middle-income countries to jointly invest in and purchase their vaccines and to receive the vaccines for 20 per cent of the population while providing them to low-income countries free of charge by the end of this year.

Although one of the major reasons why COVAX did not work well was because the United States and Russia had turned their backs to it, in February, President Biden announced a total of four billion dollars in contributions to COVAX.

Aside from the issue of funding, the biggest challenge remains—how to achieve fair distribution. Dr. Tedros is urging high-income countries to send the rest of the vaccines to developing countries once their healthcare workers and the elderly have been vaccinated. It makes sense to prioritise vaccines for people at high risk of infection and aggravation, so it may be possible for countries to cooperate. I personally find it difficult to achieve even this.

Fair distribution

After all that, what is the standard for distribution? It is against the spirit of COVAX to decide on the amount of contribution. If the distribution is based on the infection situation, countries with relatively low proportions of infected people, such as Japan, may be put off. At that time, can public opinion in such a country maintain reason?

The same complaints can occur when distributing vaccines within a country. In low-income countries, where the fair distribution of wealth is lacking and universal access to medical services and other essential public services is not guaranteed to all, it would be a big challenge to ensure the fair distribution of vaccines for those who need them most.

Social dialogue with stronger unions

Here, I end up with the same conclusion.

To make vaccines available and affordable to all and to ensure the fair distribution of these vaccines among and within countries, we need to renegotiate a new social contract and maintain and restore democracy. Needless to say, the social contract can be reinvigorated only if social dialogue is well functioning and lies at the centre of democracy.

To this end, we need strong unions and even stronger unions by building workers’ power.

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