The World

Vaccine Nationalism Is Here to Stay

The EU’s vaccine rollout is a mess—and that’s bad news for everyone else, too.

A gloved hand holds a syringe up to a map of Europe.
Photo illustration by Slate. Photos by Jeffrey Hamilton/iStock/Getty Images Plus and PeskyMonkey/iStock/Getty Images Plus.

Throughout the long, agonizing debate over Britain’s exit from the European Union, one of the very few positions the EU never wavered from was its insistence that there could be no barrier to trade between Northern Ireland and the Republic of Ireland. A “hard border” across the island, it was feared, would pose a grave threat to security in the region. At the end of 2020, Britain and the EU finally signed a trade deal that kept the Irish border open. It only took a month for the EU to try to close it.

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Last Friday, as part of an effort to clamp down on vaccine exports, the EU triggered an article of the Brexit withdrawal deal to prevent COVID-19 vaccines from the EU from entering Northern Ireland—a move that could have resulted in checks being set up on the border. The article allows parts of the agreement to be unilaterally overridden in order to “avert serious societal difficulties,” and the EU’s fear was that, amid vaccine shortages, Northern Ireland would be used as a back door for European vaccine supplies to enter the U.K.

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The EU backed down on the plan within hours, after it was blasted by both the British and Irish governments, but the debacle showed that there are limits to the bloc’s principled dedication to free trade and open borders, at least during a pandemic. “Vaccine nationalism” is here, and it’s probably sticking around for a while.

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Vaccine nationalism is the notion that, rather than work together to defeat the virus as quickly as possible, countries will compete with one another, prioritizing their own populations. That dynamic is particularly obvious between the EU and the U.K. The context for the most recent dispute is that the vaccine rollout in the EU is not going well. While the U.K. has now delivered 16.2 vaccine doses per 100 people, and the U.S. has delivered 10.5, Germany has given out just 3.6 and France just 2.7, according to Our World in Data. Denmark, the bloc’s leading country in vaccinations, has delivered just 5.2 shots per 100 people. (These are total shots, not full vaccinations, which require two doses.) There are a number of reasons for the delay. While the EU has signed contracts for more than 2 billion vaccines, it has been slower than other developed countries to grant regulatory approval to the drugs. For instance, while the U.K. approved the Pfizer/BioNTech vaccine on Dec. 2 and the U.S. followed suit the next week, the EU didn’t grant approval until Dec. 21. It was also slower to negotiate contracts with drugmakers. Unlike the U.S., the EU only offered partial protection to drugmakers for liability in the case of side effects, which also slowed negotiations down. While there’s plenty to criticize about the U.S. government’s COVID response over the past year, it was more proactive than other governments in contracting facilities to provide “fill and finish” services to rush vaccines to market. In fact, Johnson & Johnson recently announced that it would send vaccines due for Europe to the United States for fill and finish, raising EU fears of further delays.

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In all these processes, the EU’s structure—requiring input from member states, emphasizing burden and profit sharing—is not an advantage in terms of efficiency. On the other hand, it is an advantage for smaller, less wealthy European countries that would likely be even further behind if they were required to negotiate on their own.

Brexiteers have been quick to seize on the EU’s struggles as vindication. British Health Secretary Matt Hancock has claimed that the fast U.K. vaccine approval and distribution process shows the advantages of Brexit. This is not true: The approval of the Pfizer vaccine happened while the U.K. was still under EU regulations, which allow member states to do their own drug approvals in emergency cases. And as European officials have pointed out, BioNTech, the German co-developer of the vaccine, received substantial EU funding for its research. Still, the current state of affairs in the vaccine wars at least feels like the sort of thing Leave voters were trying to get away from, and pro-Brexit politicians are likely to continue playing it up.

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Things started to get really ugly in late January when drug company AstraZeneca announced that it was cutting its initial delivery of its recently EU-approved vaccine to the EU to 31 million doses by the end of March from 80 million due to manufacturing delays in one of its European plants, and was accused by the EU of breach of contract. Making things worse, the U.K., where AstraZeneca is based, and where the vaccine has been approved since the end of December, has two factories operating at full capacity and will face no shortfalls. AstraZeneca has refused to divert vaccines produced in the U.K. to the continent, which has provoked the ire of EU officials who say Britain has no inherent right to vaccines produced on its soil. All this comes on top of news that Pfizer is also facing delays at its European plants.

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Under public pressure to address the delays, the EU passed a regulation instructing customs authorities to block vaccine exports to 100 countries around the world, unless they receive explicit authorization from EU governments. Most developing countries, including those that are part of the World Health Organization’s COVAX vaccine distribution scheme, will not be affected by the rule, but the U.K., U.S., Canada, and Australia will be.

The EU’s move has been criticized by World Health Organization leaders as an example of “vaccine nationalism,” and it’s hard to argue with the description. But isn’t there also a form of “nationalism” in the argument that only the EU should suffer from shortfalls in European factories when drugs are being produced just next door?

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Prashant Yadav, who studies global health supply chains at the Center for Global Development, says the EU case “raises some very tricky questions” about the future of global drug distribution. “We have to respect that the vaccine supply chains are intrinsically global,” he says. “But what does a global supply chain mean? If you have a shortfall in one of your sites, who bears the impact of the shortfall?” A truly global model, Yadav suggests, would require what experts call a “turntable” model, where the impact is evenly shared by all parties. In other words, if a factory’s output is 10 percent short, all the countries that were due to receive that factory’s drug will see a 10 percent reduction.

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“If only one region bears the impact, then you have accepted that the supply chain is not really global,” Yadav says.

Health officials worry that the EU’s move will have a cascading effect as more countries put export bans in place to protect their supplies. This could have the most damaging effect in less developed countries that are already facing difficulties securing vaccine supplies. In an address to the World Economic Forum last week, South African President Cyril Ramaphosa decried vaccine nationalism, saying, “Rich countries in the world are holding on to these vaccines and we are saying ‘Release the excess vaccines that you have ordered and hoarded.’ There is just no need for a country which perhaps has about 40 million people to go and acquire 120 million doses or even 160 million and yet the world needs access to those vaccines.”

The resulting shortages aren’t only a problem confined to the poorer countries. New, more dangerous variants of the virus have recently emerged in South Africa and Brazil, which could hamper global efforts to tame the pandemic as they spread.

Yadav also worries that, while the specific disputes caused by the EU’s moves may still be resolved, the precedent it sets will hurt the overall efficiency of vaccine rollout efforts in the future.

“Everyone will remember this for decades,” he says.

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