WHO Background Guide: Vaccine Equity

Committee: World Health Organization (WHO)
Topic: Vaccine Equity
Conference Year: 2025

Topic Background

Vaccine equity refers to the fair and just distribution of vaccines across countries and populations, regardless of income, geography, or political influence. Historically, vaccine development and distribution have been marked by significant disparities, with wealthier nations often securing early and abundant access, while low- and middle-income countries (LMICs) face delays and shortages. The COVID-19 pandemic starkly highlighted these inequities. Despite unprecedented global efforts to develop vaccines rapidly, distribution was uneven: high-income countries secured large quantities of doses through advance purchase agreements, leading to vaccine hoarding, while many LMICs struggled to vaccinate even frontline healthcare workers.

This disparity has exacerbated global health inequalities and prolonged the pandemic, as unvaccinated populations remain vulnerable to new variants. The WHO’s COVAX initiative, launched in 2020, aimed to address these gaps by pooling resources to ensure equitable access but faced challenges including funding shortfalls, supply chain disruptions, and vaccine nationalism.

Vaccine equity remains a pressing agenda for the WHO in 2025 due to ongoing challenges in distributing vaccines for COVID-19 variants, as well as other preventable diseases such as measles, HPV, and influenza. Additionally, the pandemic underscored the need for resilient health systems and local vaccine manufacturing capacity in LMICs to reduce future dependence on external suppliers. The WHO seeks to advance policy frameworks, encourage technology transfer, and mobilize international cooperation to close the vaccine equity gap.

Key Actors

• High-Income Countries (HICs): The United States, European Union member states, Japan, Canada, and Australia have been major vaccine producers and donors. Their policies on intellectual property rights, export controls, and funding heavily influence global vaccine availability.

• Low- and Middle-Income Countries (LMICs): Countries in Sub-Saharan Africa, South Asia, and parts of Latin America have faced the greatest challenges in securing vaccines. India and Brazil are notable LMICs with vaccine manufacturing capacity and have advocated for technology transfer and TRIPS waivers.

• International Organizations:

  • World Health Organization (WHO): Central coordinator for global health policy and vaccine distribution frameworks (e.g., COVAX).
  • Gavi, the Vaccine Alliance: Key player in financing and distributing vaccines to LMICs, partnering with WHO and UNICEF.
  • UNICEF: Major distributor of vaccines through its supply chain infrastructure.
  • World Trade Organization (WTO): Forums discussions on intellectual property rights related to vaccines, including debates over TRIPS waivers.
  • Coalition for Epidemic Preparedness Innovations (CEPI): Supports vaccine development for emerging infectious diseases, promoting equitable access.

• Pharmaceutical Companies: Pfizer, Moderna, AstraZeneca, Johnson & Johnson, Sinovac, and others control vaccine production and pricing, influencing availability and affordability.

Bloc Positions

1. High-Income Countries (HICs) Bloc:
   Typically includes the United States, EU, Japan, Canada, Australia. This bloc emphasizes the protection of intellectual property rights to incentivize innovation and investment in vaccine R&D. While supporting initiatives like COVAX, they often prioritize bilateral agreements and domestic vaccination. They advocate capacity building but are cautious about broad TRIPS waivers, citing concerns over quality control and innovation incentives.

2. Low- and Middle-Income Countries (LMICs) Bloc:
   Includes Sub-Saharan African states, South Asian countries like India and Bangladesh, and Latin American nations such as Brazil. This bloc demands urgent, equitable access to vaccines and supports waiving intellectual property protections (e.g., TRIPS waiver) to facilitate local manufacturing. They call for increased funding for COVAX and technology transfer to build regional production capacity.

3. Pharmaceutical and Innovation Advocacy Bloc:
   While not a formal bloc of states, countries with significant pharmaceutical industries (e.g., Switzerland) and some HICs align with industry positions emphasizing intellectual property protection, public-private partnerships, and market-based solutions. They stress the importance of regulatory standards and voluntary licensing agreements.

4. Middle-Income and Emerging Economies Bloc:
   Countries like China, Russia, South Africa, and Mexico occupy a middle ground. China and Russia have developed their own vaccines and have used vaccine diplomacy to extend influence. These countries often support expanding manufacturing capacity and some degree of IP flexibility but balance this with protecting their own pharmaceutical sectors.

Past UN Action

• WHO Assembly Resolutions: The World Health Assembly has passed multiple resolutions emphasizing equitable access to vaccines (e.g., WHA resolutions on pandemic preparedness and access to medicines). Specific resolution numbers are not cited here but include calls for strengthening health systems and supporting COVAX.

• UN General Assembly: In 2021, the UNGA adopted a political declaration recognizing vaccine equity as essential to ending the COVID-19 pandemic and called for increased global cooperation.

• WTO TRIPS Council Discussions: Ongoing since 2020, with proposals for temporary waivers on intellectual property rights for COVID-19 vaccines and treatments to improve access in LMICs.

• Gavi and COVAX Initiatives: Launched in 2020, COVAX represents a multilateral effort to pool resources to ensure vaccine availability in LMICs. Despite initial successes, funding gaps and supply constraints have limited its reach.

• WHO’s mRNA Technology Transfer Hub: Established to facilitate sharing of vaccine technology with LMIC manufacturers, representing a new approach to addressing supply inequities.

Questions a Resolution Should Answer

1. How can the WHO strengthen mechanisms to ensure timely and affordable vaccine distribution to LMICs during current and future pandemics?
2. What policies can be adopted to promote sustainable local vaccine manufacturing capacity in LMICs, including technology transfer and intellectual property considerations?
3. How should the WHO coordinate with other international organizations (e.g., WTO, Gavi) to address barriers related to intellectual property rights and vaccine production?
4. What financing models or funding commitments are necessary to support equitable vaccine access and health system strengthening in vulnerable countries?
5. How can vaccine hesitancy and misinformation be effectively addressed to ensure equitable uptake across diverse populations?
6. What accountability and transparency measures should be implemented to monitor vaccine distribution and prevent hoarding or export restrictions?
7. How can the WHO facilitate equitable access not only to COVID-19 vaccines but also to vaccines for other preventable diseases to achieve broader global health goals?

Further Reading

• UN Documents: Official WHO reports, World Health Assembly resolutions, and UN General Assembly political declarations provide authoritative information on international commitments and policy frameworks related to vaccine equity.

• Think-Tank Reports: Research from global health policy institutes such as the Center for Global Development, the Brookings Institution, and the Global Health Centre at the Graduate Institute offers in-depth analysis of vaccine distribution challenges, intellectual property debates, and financing mechanisms.

• News Outlets: Reputable international news sources like The Lancet News, Reuters Health, and BBC Health provide timely coverage of ongoing vaccine equity issues, including diplomatic negotiations, vaccine production updates, and public health responses worldwide.

This background guide aims to equip delegates with a comprehensive understanding of vaccine equity as a critical global health issue on the WHO agenda in 2025. Delegates should prepare to engage with complex questions of fairness, innovation, and international cooperation to craft effective and equitable policy solutions.