EDITORIAL: Public Health, If Not Public Wealth
The views expressed herein represent the views of a majority of the members of the Caravel’s Editorial Board and are not reflective of the position of any individual member, the newsroom staff, or Georgetown University.
Europe and the United States have administered many more doses per 100 people than countries in the developing world, a factor of having bought up many of the initial vaccine doses. (Wikimedia Commons)
There’s at least one thing the pandemic hasn’t changed: rich countries are still screwing over poor countries.
Wealthier countries representing only 14 percent of the world’s population have already bought up more than half of all promised vaccine doses. Canada infamously pre-ordered enough vaccines to inoculate 500 percent of its population.
Meanwhile, “[nine] out of [ten] people in poor countries are set to miss out on [the] COVID-19 vaccine” in 2021, wrote the global anti-poverty group Oxfam. Just five of those countries—Kenya, Myanmar, Nigeria, Pakistan, and Ukraine—have had more than 1.5 million total COVID-19 cases combined.
Report after report details how various countries will not have the capacity to offer widespread vaccinations to their citizens until 2022, or even 2023. Even with the few vaccines they do manage to secure this year, these countries still will not be able vaccinate more than 20 percent of their populations.
Director-General of the World Health Organization Tedros Adhanom Ghebreyesus warned that the skewed distribution of vaccines places the world “on the brink of a catastrophic moral failure… Even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots,” he said.
Yet this doom-and-gloom forecasting obscures how competently many of these poorer countries have dealt with COVID-19. Some of their public health systems have weathered the pandemic thus far—in sharp contrast to the fumbling healthcare systems of their vaccine-hoarding, wealthier counterparts. Nonetheless, the media in the United States and Europe prattles on about how a lack of access to the vaccine will apparently derail the recovery of these poor countries.
All these vaccine-obsessed reports suggest that there are at least two other things the pandemic hasn’t been able to change: the ability of U.S. and European audiences to uncritically feel bad about the problems they helped create, as well as the inability of those same audiences to give the rest of the world credit where credit is due.
Headlines or Headlies?
Despite the clear actions richer countries have taken to exacerbate vaccine inequality, media coverage in the U.S. and Europe have at times been less empathetic towards—and even condemnatory of—developing countries.
Wealthier countries have hoarded COVID-19 vaccines as developing countries grapple with shortages. (Northern Virginia Regional Commission)
Article titles say a lot, but in the case of an article published by the Washington Post, the title—“Only one of the world’s 29 poorest countries has started coronavirus vaccinations”—left out half the story. In the opening lines of the article, the authors wrote: “In more than 50 countries, most of them wealthy, coronavirus vaccination efforts are well underway, with some 20 million doses already distributed in the United States alone. But most poorer nations have yet to even begin.”
The article offers no immediate explanation for this discrepancy, leaving readers to wonder why poorer countries are apparently doing so much worse in vaccination efforts. Only after several paragraphs recounting Guinea's vaccine deal with Russia do the authors finally explain that the poorest countries have not started vaccinations due to vaccine hoarding by richer countries.
An article published by DW News is similarly titled, “Africa lags in COVID-19 vaccination drive.” From the headline alone, the article seemingly blames Africa for being “too slow" in the race to acquire vaccines. While the article does explain the cause of Africa’s “lag,” its title still places the onus on Africa for the delay. Compared to a BBC article titled “Africa's long wait for the [COVID-19] vaccine,” the DW News headline appears biased and misleading.
In addition to mischaracterizing, perhaps unintentionally, the experiences of developing countries in the vaccine race, some U.S. and European media outlets have also been outright critical of developing countries’ responses to the pandemic. A Wall Street Journal article titled, “Africa, Ill-Equipped and Without Vaccines, Grapples With a Deadlier Covid-19 Surge” opens with interesting examples to “set the scene.” These include, “In Nigeria’s largest city, some public hospitals have run out of oxygen amid a coronavirus resurgence, forcing doctors to make life-or-death decisions. In Zimbabwe’s capital, scores of public-sector health-care workers are falling ill. In the Democratic Republic of Congo, power outages are hobbling the treatment of record numbers of [COVID-19] patients in some hospitals.”
The authors conveniently leave out any examples of positive efforts made by developing countries to combat the pandemic, in some cases even more effectively than developed countries.
No Vaccines, No Problem
Developing countries did, in fact, employ some of the most successful pandemic responses in the world. In Foreign Policy’s compiled ranking of pandemic responses, the top three highest-ranked countries are Kenya, Ghana, and Ethiopia, all countries the West calls “developing,” despite their strongly developed pandemic response apparatuses. (New Zealand, whose success at containing the virus in the early weeks of the pandemic won the country international acclaim, comes in only at number four.) Indeed, the need for the COVID-19 vaccine is less pressing in these areas given the fact that vaccines are often the last resort for mitigation of infectious diseases; Ebola, for example, still lacks a vaccine but is nonetheless largely under control thanks to non-vaccine interventions.
Doctors throughout Africa have proven adept at handling the COVID-19 pandemic, having already weathered Ebola and seasonal diseases like malaria. (Flickr)
Despite the pejorative headlines, Africa’s caseload has remained low throughout the pandemic. Speculation that the low rates are the result of underreporting deaths is apparently unfounded, as the number of excess deaths, the most accurate marker of COVID-19-related fatalities, are also low, according to the Africa CDC. Of course, some factors—a population that skews young, exposure to other infectious diseases that conferred antibodies, large rural populations—contributed to the low caseload and eased the pandemic response, but biological fortune can only go so far.
In fact, much of the praise for the low caseload belongs to governments that responded quickly and effectively, utilizing medical knowledge and WHO recommendations to control the virus. Unlike many Western countries that dallied in shutting down travel and agonized over economic impact, tourism-dependent countries like Ethiopia closed their borders in early March, avoiding much of the first wave and reaping economic benefit in return as they reopened months earlier than developed countries. Mask mandates, too, were a hallmark of the non-Western response—even as U.S. and European leaders downplayed their efficacy; 84 percent of surveyed Africans reported wearing masks in public.
With procedures and apparatuses shaped by responses to Ebola, cholera, and Lassa outbreaks, African countries in particular employed pandemic responses that limited initial caseload and allowed citizens to return to almost-normal life within months.
Doctors in developing countries were also comparatively better prepared for the pandemic than their developed-world counterparts. Well trained in the art of disease mitigation, Nigerian doctors tracked strains, an approach that allowed for contact tracing without the laborious effort of sifting through a victim’s recent locales. In the early days of the pandemic, Senegalese biologists used a WHO recipe to develop a test that produced remarkably accurate results within four hours. In the United States, Vice President Mike Pence spurned the WHO’s recommendations, saddling American doctors with contaminated CDC tests that took days to return frequently erroneous results.
Outside of Africa, other developing countries produced similarly successful results. Vietnam, for example, implemented strict travel guidelines and testing regimens by late January 2020 that required intensive communication between the private sector, hospitals, and the government. Instead of relying on inbound travelers to self-quarantine, all those entering Vietnam quarantined for two weeks, receiving food and temperature checks under biohazard-proof conditions. And, again, Vietnam mandated mask-wearing early in the pandemic to control the spread. Their approach was also heavily dependent on nationalist propaganda and the uniquely authoritarian ability to centrally control wide swaths of society, but their pandemic response is still undoubtedly an epidemiological success.
The data and the facts clearly show that the U.S. and European media’s view that developing governments are unable to respond to threats is misplaced and patronizing. While a convenient and easy argument to make—after all, why shouldn’t a U.S. citizen used to constantly hearing about state failure in Africa naturally assume African countries would fail to respond to the pandemic adequately—it does not reflect reality. Developing countries, and especially African countries most harmed by condescending and neo-imperialistic conceptions, have not only responded forcefully to the pandemic in multiple examples, but they have also contributed greatly to international efforts through innovation, outshining many ‘developed’ countries.
The U.S. response to the pandemic stands as a clear contrast to the responses of developing countries. The United States refused to mandate and enact policies early on, or at all, that have meaningful impacts against the virus, such as social distancing and universal mask mandates. Its failure to accept even the most basic and smallest personal sacrifices to contribute to the fight against COVID-19 has led to the highest number of cases and mortalities in the world.
High proportions of U.S. adults, reaching as many as 40 percent, plan to refuse the COVID-19 vaccine despite its benefits and certified safety. (Pew Research Center)
The United States’ failed response also fuels a dependence on the vaccine as the only solution to end the pandemic. Without any of the other policies more commonly mandated in other countries, the United States has nothing to rely on except vaccination and the distant and elusive hope of herd immunity. The country has found such a pursuit difficult, especially given the strong strand of anti-vaccine sentiment fueled by lies and wild conspiracy theories.
U.S. dependence on the vaccine as the only potential route out of the pandemic, given its refusal to adopt and enforce universal social distancing guidelines and mask-wearing practices, distorts coverage and perspectives of the vaccine and vaccination efforts in other countries. The preeminence of the vaccine leads to the omission of meaningful consideration of other policies that have been successful elsewhere.
If nothing else, this episode clearly exposes that wealth and development do not inherently lead to appropriate preparation and the adoption of effective policies. The richest country in the world, one that consistently brags about its scientific and medical capabilities, was clearly caught off guard, and it has refused to adopt the tough, difficult policies needed to combat the COVID-19 pandemic.
Variants
In light of biased media coverage of vaccines and pandemic response, new COVID-19 variants have raised alarm. The B.1.351 variant, first detected in October 2020 in South Africa, has since spread to more than 30 countries. It appears to spread quickly, showing up in more than 90 percent of genetic sequencing samples from those in South Africa with COVID-19. Since the virus appears to have dangerous mutations, many worry that it will spread throughout Africa and the rest of the world and that it will not be susceptible to current COVID-19 vaccines.
However, despite rising fears, the new variant does not yet appear to be more lethal than others. In addition, South Africa has instituted a ban on traveling into and out of the country, except for essential purposes. And, although nothing concrete has proven whether or not vaccines can protect against this variant, a study (not yet peer-reviewed) by Pfizer and BioNTech claimed that their vaccine is only slightly less effective against variant B.1.351.
Variants have emerged all over the world in countries with huge initial breakouts of COVID-19 cases: South Africa, the UK, Brazil. It is not a sign that Africa is handling COVID-19 worse, or that COVID-19 poses a larger threat. In fact, South Africa closed its borders much earlier than the UK, which only on January 15 stated plans to close its borders.
Conclusion
Countries like the U.S. and the UK should learn from countries such as Kenya, Ghana, and Ethiopia. With their prompt shutdowns, widespread early mask use, and informed vaccine-tracing methods, they managed their COVID-19 responses better than other countries. Yet we continue to ignore their accomplishments in the face of a virus that has pushed U.S. and UK hospitals to their breaking points.
While the media has been eager to discuss the unequal distribution of vaccines worldwide, news outlets have relied on a strange mix of paternalistic racism that predestines the entirety of the African continent to failure in the face of the pandemic. However, they struggle to address the ways that the U.S. and Europe’s discriminatory policies, including the hoarding of PPE at the beginning of the pandemic and the monopolizing of vaccines now, have endangered developing countries. Furthermore, they are even slower to recognize the ways in which, despite the setbacks wealthier countries caused, African countries have relatively succeeded in controlling the coronavirus.
The underselling of African countries’ capability in the face of crises is nothing new, but the way U.S. and European media discusses their responses to the coronavirus exposes just how irresponsible and detached from reality Western exceptionalism can be.
More than 2 million people have died from COVID-19 around the world, and the five countries that currently lead with daily confirmed COVID-19 deaths per million people are the United Kingdom, the United States, Germany, France, and Canada. While the media has tried to capture the points at which their policies failed—from delayed lockdown decisions to the United States’ inequitable and unsatisfactory attempts at a vaccine rollout—they don’t want to recognize that countries they frequently belittle and exoticize are better able to protect their citizens from the pandemic.
Obviously, COVID-19 does not discriminate. The real “catastrophic moral failure” here, however, has been all of the poorly thought-out policies, inequitable plans, and incompetency that led to this unparalleled global tragedy.
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