In an era of increased awareness of Social Justice, COVID-19 demonstrated the dramatic disparity between different regions of the world; COVID vaccine booster doses were made available in certain countries before vast populations of the world could receive their first dose.
In our world, national governments have no long-term incentives to commit to morals and fairness on a global scale. Moreover, giving away scarce and valuable medical resources in the midst of a public health crisis carries its own demerit. In the absence of any compelling motivation to support the citizens of other countries, social justice is perceived as a mere ideology, not an obligation. It is naive to count on benevolence alone as a way to change the status quo.
The lack of direct stimulation to act on global matters can be addressed using an indirect approach. Choices made by larger richer countries acting in the best interest of their own citizens may yield desirable by-products in the form of sustainable support of other countries. Within this context, for a global vaccine deployment strategy to be supported on a regular basis, it must provide a measurable goal that is communicated in the most appreciated international language – the language of the economy.
At the time of writing, the peak of COVID is becoming a memory of the past. However, the concept of indirect interests and desirable by-products remain relevant to coping with future global challenges, and can be demonstrated by looking at COVID data as a representative example.
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Despite being the most tragic aspect of a pandemic, life loss alone can not be the only indication of its severity. A preferable proxy to the severity of pandemics must also take into account the total economic loss that societies around the world experience. A clear
and measurable status of the total loss to society can be obtained using economic tools, including actuarial practicalities to account for life loss. Being the proxy to the severity of pandemics, minimizing the economic loss leads to minimizing the impact of the disaster
associated with the pandemic, thereby maximizing the likelihood for sustainable co-existence with the pandemic.
Since the cost of vaccines is a significant part of the economic loss, the roadmap to co-existence with COVID does not require vaccinating a high percent of the population. Simulations show that a vaccine rate that is just enough to mitigate the effects of lockdowns and sick days on the economy is the one to minimize the total loss to society (life loss included). And since the economic conditions, employment conditions and living standards vary among countries, the optimal vaccine ratio varies as well.
Simulations of the pandemic and the impact of vaccines on the total economic loss show that the optimal vaccine ratio for the purpose of co-existing with COVID in Africa is around 45% – certainly an attainable target. Promoting the idea of vaccinating the population of poorer countries in order to save the global economy may be more appealing and quantifiable to governments than promoting the idea of saving foreign citizens’ lives, and therefore may be granted more attention and collaboration.
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Equity maximization requires a vaccine rate that slightly varies among countries since it depends on factors such as GDP per capita, cost of hospitalization, and population density. Interestingly, countries that are seemingly similar should be vaccinated differently in order to obtain equity.
The case of comparing Angola and Ghana, two African countries with comparable population sizes and GDP, is particularly interesting. By March 2022, a similar percentage of the populations of the two countries were vaccinated (16% in Ghana, 18% in Angola). However, the vaccine ratio required for Ghana to minimize its future economic loss was 50%, while Angola’s was only 40%. Despite the similar percentage of the population that was fully vaccinated in both countries, Angola was fast approaching the halfway point towards reaching optimality, while Ghana was left behind.
Figure 1: a comparison between the currently vaccinated and required vaccine ratios of Ghana and Angola. Despite the similarity between the countries’ current vaccine rates, Ghana has a long way to go before reaching its required vaccine ratio, whereas Angola is already close to half-way there.
The comparison between Ghana and Angola’s vaccination rates stresses the necessity to quantify and manage matters of social justice in preparation for the next international emergency. On a global scale, vaccine allocation strategy that is based on equity and minimized economic loss constructs a roadmap to allocating scarce resources to countries in need, while meeting global fairness criteria. Being based on economic optimization, long-term global costs are reduced, and billions of dollars are saved. Social injustice is addressed by maximizing the impact of each vaccine, thus enhancing the global plausibility to coexist with the pandemic.