Written by Stefanie Schäfer

Global health inequalities appeared once again on the international agenda during the worldwide Covid-19 pandemic. According to data of the World Health Organization (WHO), to the date of November 19, 2021, Sars-Cov-2 caused the confirmed death of 5,127,696 million people worldwide, thereof more than 850,000 in South-East Asia and Africa (World Health Organization n.d.). Due to the fragile health system, diverse existing health emergencies, and lacking financial resources of the least developed states and developing states, the real number of Covid-19 cases in developing states are difficult to grasp and the state’s response to the crisis is rather limited (Alwazir E. 2021). 

The distribution of vaccines against Covid-19 is one major field in which global inequalities become apparent. According to Mathieu et al. (2021), most developing states, notably in Africa, have just started their vaccination campaigns in April 2021, while the high and middle-income states performed more than three-quarters of the total global vaccinations up until that date. 

To counteract global health inequalities and grant equitable access to vaccines for all states, the WHO as well as its partners, the Coalition for Epidemic Preparedness Innovations (CEPI) and the Global Vaccine Alliance (Gavi), launched the global initiative COVAX as a part of the Access to Covid-19 Tools (ACT) Accelerator (World Health Organization 2021). Its objective is a fairer redistribution of vaccines from high and middle-income states towards low-income states, hence guaranteeing access to vaccines for all people and preventing further Covid-19 mutations through sufficient immunization in all parts of the world. Hereby, the COVAX program consists of two parts: one part for 98 countries that pay for their vaccines, and a second, called COVAX Advanced Market Commitment (AMC), for 92 low- and middle-income countries (World Health Organization 2020). In light of the global scale and importance of this program, the question of the EU’s role in the health initiative arises.

Locating EU’s role in the fight against Covid-19 

The EU and its Member States contribute financially to COVAX through Team Europe, consisting of the EU, the EU Member States, and European financial institutions (European Commission 2021a). The current contribution of Team Europe to COVAX exceeds € 3 billion and hence contributes to the redistribution of 1.8 million doses to the 92 low- and middle-income countries (European Commission 2021b). Thus, Team Europe is among the largest donors of the initiative and can be located at the heart of COVAX aim to achieve higher equality in vaccine distribution (GAVI 2021). 

However, the EU and its Member States’ behavior might weaken the actual role of the former in the global fight against Covid-19. The COVAX system objects to contributing to a generally fairer global system of vaccine distribution by aiming to be the only available tool through which high and middle-income states both purchase their vaccines and donor vaccine for those states, which otherwise cannot afford it. Indeed, managing vaccines only through COVAX would allow better regulation of the limited good, hence avoiding over procurement of vaccines by high-income countries and facilitating access for developing states. In reality, EU Member States follow a double strategy in line with most other high-income states such as the US. Instead of solely relying on a common market system of vaccine allocation, financially strong EU Member States and the EU itself have concluded bilateral agreements with pharmaceutical companies, which allowed them to receive a higher number of vaccines for their citizens than they would have had through a common system such as COVAX (see Deutsch & Sugue 2021; European Commission 2021c). Thereby, they partly undermine the solidarity principle behind the COVAX initiative. The purchase of vaccines through bilateral agreements while equally contributing to COVAX is led by a state-internal dilemma between supplying their population with vaccines while at the same time supporting low-income states in their fight against Covid-19 to reassure a global success of the vaccine campaign.   

Hence, one could argue that the EU’s role in the global fight against Covid-19 is shaped by solidarity only after meeting its own needs, which constitutes a rather two-sided attitude towards the global fight against Covid-19. To implement a real global solidarity system in the vaccine contribution and to prioritize the most vulnerable for the vaccination, the EU and its Member States would need to concede on their bilateral agreement policy. However, due to current limitations in the production of the vaccine, this step could result in fewer available vaccines for non-prioritized groups in the EU Member States. At this stage, it seems highly unlikely that the high and middle-income countries of the EU would be willing to take this step by favoring the global dimension of the fight against Covid-19 ahead of effective national combat of the virus. More likely will be an increase in their financial contribution to the COVAX program, as already has been the case in the last few months. 

To conclude, the EU has an important role as one of the major donors within the current COVAX initiative. However, the EU’s and its Member States’ commitment to the global fight for better vaccine equality is limited by self-interests in the acquisition of vaccines. As long as the EU does not accept cutbacks in its comparable vast supply of vaccines to reach a globally equal level of vaccination among the most vulnerable, the pandemic will most likely continue. For instance, low vaccination coverage will lead to the emergence and spread of new Covid-19 mutations in developing states, which sooner or later reach the EU. To incorporate a central role in the global fight against Covid-19 would require the EU and its Member States to move further away from self-contracted vaccine procurement to more or a sole procurement through a regulated international distribution system such as COVAX. In a globalized world with a global pandemic, real global solidarity might hence be the only way out.  


Alwazir E. (2021). World’s Most Vulnerable Countries Lack the Capacity to Respond to a Global Pandemic. United Nations: Office of High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States. Derived from: https://www.un.org/ohrlls/news/world%E2%80%99s-most-vulnerable-countries-lack-capacity-respond-global-pandemic-credit-mfdelyas-alwazir (Accessed November 21, 2021)

Deutsch J., Sugue M. (2021). Commissions lets Germany off the hook for coronavirus vaccine solidarity breach. Politico. Derived from: https://www.politico.eu/article/germanys-coronavirus-vaccine-side-deal-at-odds-with-legally-binding-eu-pact/ (Accessed November 30, 2021)

European Commission (2021a). Team Europe: €34 billion disbursed so far to tackle COVID-19 in partner countries. European Neighbourhood Policy and Enlargement Negotiations. Derived from: https://ec.europa.eu/neighbourhood-enlargement/news/team-europe-eu34-billion-disbursed-so-far-tackle-covid-19-partner-countries-2021-09-16_en (Accessed November 29, 2021)

European Commission (2021b). EU global response to Covid-19. International Partnerships. Derived from: https://ec.europa.eu/international-partnerships/topics/eu-global-response-covid-19_en (Accessed November 29, 2021)

European Commission (2021c). EU Vaccines Strategy. Derived from: https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/public-health/eu-vaccines-strategy_en (Accessed November 30, 2021)

GAVI (2021). Key Outcomes One World Protected – COVAX AMC Summit. Assured resources for the Gavi COVAX AMC. Derived from: https://www.gavi.org/sites/default/files/covid/covax/COVAX-AMC-Donors-Table.pdf 

Mathieu et al. (2021). A global database of COVID-19 vaccinations. In: Nature Human Behavior, 5, 947–953. https://doi.org/10.1038/s41562-021-01122-8 

World Health Organization (n.d.). WHO Coronavirus (Covid-19) Dashboard. Derived from: https://covid19.who.int/ (Accessed November 21, 2021)

World Health Organization (2020). 172 countries and multiple candidate vaccines engaged in COVID-19 vaccine Global Access Facility. Derived from: https://www.who.int/news/item/24-08-2020-172-countries-and-multiple-candidate-vaccines-engaged-in-covid-19-vaccine-global-access-facility (Accessed November 30, 2021)World Health Organization (2021). COVAX: Working for global equitable access to COVID-19 vaccines. Derived from:https://www.who.int/initiatives/act-accelerator/covax(Accessed November 27, 2021)

Cover Image: Hand Glove Vaccine by Fernando Zhiminaicela, licensed under Pixabay. Link: https://pixabay.com/photos/hand-glove-vaccine-covid-19-6195099/

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