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Stefania-Ruxandra Pila and Roos van der Laan: A Moral Collective Action Problem

For the past year, COVID-19 has dramatically shaped our lives: from the twists and turns of each country’s decisions on how to tackle the pandemic to a new perspective of what the future might look like starting from December 2020. The critical element to this is the vaccine, which more and more people are now opting for, and has brought to the table a seemingly refreshing element to our future. Unfortunately, the vaccine is not without flaws. Leaving the medical criteria aside, the way the vaccine is distributed further reinforces that power dynamics and solidarity amongst countries are still concerns that need to be delved into on a deeper level. The ethical aspects and assessments inherent to such a massive contribution to a safer future are complicated and ambiguous.

The COVID-19 vaccine should, in its ethical dimension, adopt three principles. The first and most obvious one is reducing morbidity and mortality. The second is to mitigate the impact the vaccine has had so far on infrastructure and the economy, as it certainly was and continues to be of a great magnitude. The third one - quite entangled with the two principles mentioned above - is to reduce inequalities in public health which systematically disadvantage certain groups. Prioritizing approaches to guide the vaccine allocation have been applied across multiple previous pandemics and is aligned with the first principle mentioned. For instance, the elderly and those who provide “instrumental value,” meaning those who conduct life-saving services, are among the first to be vaccinated. The second principle can be realized as long as the number of available vaccines increases, and life slowly goes back to normal. However, the last consideration is by far the most complicated to assess, and the reality so far has been saddening from the point of view of (in)equality.

Many poorer countries are already under severe health burdens. However, due to vaccine hoarding by the more affluent countries, the uneven distribution only deepens the profound global health inequalities. This, inevitably, leads the reader to reflect on how ethical the outcomes of the vaccine really are. Moreover, there are still a few questions that can be raised in such circumstances. Although many clinical characteristics of the virus have been discovered, some relevant aspects of the vaccine and its allocation are yet to be unveiled. Some policies that are already in place, such as the ones concerning the prioritization of vaccine allocation, are still a realm filled with the unknown.

While the real impact of the allocation is yet to be seen, concerns over its possible outcome have already been raised, most notably by WHO Chief Tedros Adhanom Ghebreyesus. According to him, a “me-first approach” in distributing the vaccines across the world “will only prolong the pandemic”. This is because a vaccine is intended to protect the vaccinated person, but indirectly also protects the population of which a certain number of people are vaccinated. While this protection certainly happens within a country or continent, this also works on the global-stage due to natural movement between borders. Thus, the more people who are vaccinated, the better protected we all will be. In addition to this, it is hard to come up with convincing arguments about why Western citizens in more affluent countries should be vaccinated before citizens in developing nations. In fact, there might be more arguments to vaccinate those in countries that have been hit the hardest - medically and economically - first.

When looking back at the earlier days of this pandemic, a lack of cooperation is not foreign to us. We saw similar situations at the beginning of the crisis, except then the objects of interest were ventilators, hospital beds and respirator masks. The question that remains: why is the world falling in the same trap over and over again? The answer is, in fact, simple: a classical economic dilemma that we fail to solve. The distribution of the vaccines is a prime example of Olson’s collective action problem. Here, everyone would be better off with more cooperation, but conflicting interests prevent individuals from taking collective action, resulting in a less desirable outcome. Problems like this arise around many topics, such as environmental policy and voting. However, none seem to be as life-threatening and pressing as the allocation of the COVID-19 vaccine.

As the rate of vaccinations in the EU, the US, the UK and other affluent countries is on the rise, the rest of the world painfully lacks. While this shows severe moral inferiority on our part, it is also not aiding a quicker global stop to the spread of COVID-19. Therefore, large organisations, such as the UN and WHO, should lobby alongside representatives of Asia, Africa, and South America to distribute vaccines better. If not, we all could be stuck in this cycle of lockdowns and other measures for much longer than necessary.

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Written by Stefania-Ruxandra Pila and Roos van der Laan, Amsterdam Chapter of European Horizons.

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