BMUN XIV – Health

The question of Vaccine Distribution

Welcome from your chairs

Dear Delegates,

I am delighted to welcome you all to the Health Committee where my co-chair, Carlotta, and I, are very excited to discuss such a pertinent matter in the realm of health.

Although it will be my first time chairing at a conference, I have always loved being a part of MUN and the element of debate due to the breadth of issues that can be covered, and the key skills it helps you to develop; from my own personal experience, not only has it helped me improve my proficiency at public speaking and ability to problem-solve, but it has also given me the opportunity to meet people from around the world whilst focusing on one goal.

Throughout the conference, my co-chair and I will do our best to deliver a really enjoyable and positive experience, and we also hope to generate some healthy debate in the process. We are looking forward to all coming together, whether you are a seasoned delegate or a beginner, and sharing the day encompassing what MUN is all about, having a constructive, fun and memorable time.

So, with introductions given, let’s have a great day full of ‘fruitful’ debate!

Best Wishes,

Scarlett

Head Chair – Health Committee

 

Introduction to the committee

The main aim of the Health Committee is to discuss, and take actions towards, battling any issues regarding the status of health globally. This can range from focusing on the effects of a particular disease and its management, to improving the general distribution of medical resources across multiple countries.

Whether we are debating a topic that only affects a certain population of people or discussing a worldwide problem, such as Covid-19, it is of utmost important to bear in mind that decisions made can alter the lives of multitudes of people. Therefore, the Health Committee plays a very integral part within MUN and matters focused upon requires crucial collective contribution of all member states to decide upon the best avenues to achieve the best outcomes.

This year, we will be debating the question of Vaccine distribution.

History of topic

Although the presence of Covid-19 has boldly highlighted the importance of the question of vaccine distribution, getting access to certain vaccines has been a long-standing problem in many countries for decades. Not only are there problems regarding who should receive accessibility to them first, but there is also discrepancy when it comes to who is responsible for vaccinating certain populations, such as refugees in a country. Even among countries themselves, a popular belief is that the responsibility must be shared as human lives and vital resources are on the line which trump any other factors; as Dr Katherine O’Brien, the Director of the Department of Immunisation, Vaccines and Biologicals for the World Health Organisation, stated during the height of the Covid-19 pandemic, ‘It’s not very efficient or a good use of people’s time for 194+ countries to all be starting from a blank piece of paper.’ This emphasises how important it is for countries to work together to battle this issue even if there is no legally binding contract for all to follow.

Yet, the division between MEDC’s (more economically developed countries) and LEDC’s (less economically developed countries) is huge, and many have a reputation of ‘getting left behind’. With regards to the situation with Coronavirus, Dr Tedros Adganom Ghebreyesus (WHO Director General) stated in February of 2021 that 60% of vaccine supplies had been bought by rich countries which only made up 16% of the world’s population. In a report later in April, when over 832 million vaccine doses had been given, he revealed 82% had gone to upper-middle, or higher-income countries whilst 0.2% of that figure covered low-income countries such as Chad and Benin. Winnie Byanyima (Executive Director of the Joint United Nations Programme on HIV and Aids) related this crisis to the HIV/AIDS treatment difficulty, believing that joint contribution could be the way forward. She recounted that the cost for HIV/AIDS treatment went from $10,000 per patient per year to $100 after global intervention, and how past events should be learnt from. The delay in countries cooperating to fight AIDS took years and cost thousands of lives. Other key figures, such as Dr. Nkengasong, also reiterate how important it is to learn from previous crises with special consideration for Africa, a continent of around 1.4 billion people, which has suffered heavily in the past with a lack of access to vaccines.

With regards to the history of the vaccine itself, one of the first-known vaccines was one that fought against smallpox infections, with credit given to both Edward Jenner and Louis Pasteur. A spike in vaccine development and production was then seen throughout the 20th century and global programmes were put in place to eradicate certain diseases. Here is a list of some of the vaccines that emerged throughout the 20th Century:

  • Whooping cough
  • Diphtheria
  • Tetanus
  • Influenza
  • Mumps
  • Polio
  • Measles
  • Rubella

Global campaigns have proven to be effective, as seen with smallpox, which was declared eradicated in 1980, yet the time, effort and resources required to run them culminate in an eventual lack of progress. For example, it was recorded that just before 2000, 30 million children in developing countries around the world were not immunised from key diseases due to the fact countries just could not afford them. Although the Global Alliance for Vaccines and Immunisation has been created since then, and reduced child deaths by 50%, the work done is never complete and developments need to be constantly made in order to achieve a ‘disease-free’ world.

Events caused by the Ebola virus sharply put into perspective how much work still needed to be done to create a strong and effective immunisation programme in which vaccines could be rapidly developed and circulated after diseases are detected. Thousands of people ended up losing their lives due to slow progression regarding the vaccine. Having said this, the Coalition for Epidemic Preparedness Innovation (CEPI) was created which has helped the situation greatly. Even though advancements may have come a long way since the early 20th Century, every time a new disease emerges, the lack of efficiency that exists in global vaccine development and distribution is acute.

It is also important to regard efforts where vaccine distribution has been effective in particular countries. For example, the distribution of oral cholera vaccines (OCV) has been very helpful in Haiti after a large outbreak was triggered by an earthquake in October 2010; Haiti celebrated 1 year of being ‘Cholera-free’ in 2020. It is clear that, with the collective help of different countries and organisations, big milestones can be reached. In terms of the UN, the Global Task Force on Cholera Control, an organisation of over 50 constituencies to tackle cholera, was put back into action in 2014, and over 70 million doses of OCVs have been administered among various campaigns worldwide.

On the contrary, there are still many instances where a lack of support has resulted in the loss of lives, perhaps unnecessarily, in terms of HIV and Ebola treatment. Around 40 years ago, after the first case of AIDS was reported, there were many delays in rolling out treatment which not only cost lives but made prevention more expensive in the long term. The misconception that disease will only affect one area or country can be strongly argued against when recognising this case. In an ideal world, we could have treated everyone that had HIV and then it would be eradicated, yet 1.7 million people developed HIV in 2019, with over 50% of cases being recorded in Africa.

Taking a more positive note, the recent COVAX initiative, named the ‘global solution’ with the aim to vaccinate the world against Covid-19, stresses not leaving countries out of the loop of progression. With international help, this could help tackle the issue of low-income countries receiving a very disproportionate number of vaccines relative to their population sizes.

Irrespective of the complex procedures that have to be followed in order to supply vaccines, from manufacturing and quality control to distribution, many argue that vaccines are still one of the predominant methods of preventing human infections. For example, just in pharmaceutical companies alone, only 3 of the top 10 companies in 2005 had significant vaccine activity, yet this increased to 8 in 2012. To a large extent, economic, social, political and practical factors hinder the distribution of vaccines to all populations.

Despite this, over 100 countries have a policy which requires the mandatory administration of one or more vaccines to the population, and WHO reported that between 2010 and 2015, vaccines have prevented at least 10 million deaths. These statistics give hope for an effective method of tackling disease, yet progress needs to be made in making it available to a greater number of people.

Finally, the words of Dr Tedros on this issue earlier this year remain increasingly relevant now, and rather pessimistically, most likely in the foreseeable future: “Vaccine equity is the challenge of our time… and we are failing.” Vaccine distribution is paramount, and it is essential action is taken in order to achieve a wider allocation of resources, particularly if the vaccines themselves have been developed and certified as being highly effective.

 

Considerations for debate

Whilst many countries may be willing to make positive contributions towards battling the problems regarding vaccine distribution and ensuring as many people as possible get access to them, each member state will have differing views moulded by geographical location, past experiences with disease, political stance, and wealth. For example, there may arise conflict or a divide between LEDCs and MEDCs with varying opinions, and there may also be dispute between countries who have been impacted heavily by a disease and those who lack experience with them in the past.

Perspectives are also shaped by the relationship the country has with its beliefs on vaccines in general and whether they are safe or effective. For instance, it could be considered whether the slow uptake of the Covid-19 vaccine in France was due to a high sense of unfamiliarity with vaccines since there were reports that they had a relatively high population of anti-vaxxers in comparison to other countries before the current pandemic.

One of the key issues that may come up is vaccine nationalism, described as when wealthy countries limit overall stock of vaccinations by signing deals to purchase vaccines for their own populations via agreements with pharmaceutical companies. Following the term ‘nationalism’, when one country’s needs or interests may be put above others first, this can be a serious problem when it comes to vaccine distribution and has been demonstrated amidst the coronavirus pandemic. Ultimately, poorer countries are greatly affected by this, and, on a wider level, the global economy could lose trillions of dollars by putting them at a disadvantaged position, meaning they get left behind.

Another issue that may be tackled, mentioned briefly previously, is vaccine hesitance. Although vaccines could be made available to an entire population, there is no guarantee that they will all be administered, especially without a governmental policy alongside it, and so debate could circulate around whether these efforts should be backed by laws in order to warrant their success. In some cases, countries may believe that education would be sufficient in order to overcome vaccine hesitancy, but this idea is not universal. Either way, if efforts are made to make vaccines available to a country and the population do not get vaccinated for one reason or another, then time and resources are put to waste.

Finally, another issue that could be explored is making countries that are ‘hotspots’ for disease transmission not entirely dependent on the support of other countries. For example, Dr Nkengason hopes that Africa will manufacture over 50% of the vaccines it uses in 20 years. In this way, not only could the economy benefit from more jobs being generated and greater economic activity, but the continent could partially help itself with regards to the prevention of disease and have a lesser chance of being left behind. However, some countries may be of the opinion that this would not work and would consume greater resources than the help it could achieve.

During the course of debate, these issues may bear importance and remain a central part of discussion, however delegates may decide that there are more prevalent issues or that there is no way to overcome them. Regardless, it is of great importance that any clauses or arguments put forward follow the beliefs and involvement of delegates’ respective countries accordingly.

Recommendations to delegates

When piecing together a clause or an argument to put forward in debate during the conference, it may be valuable to look at past resolutions or policies relating to this issue beforehand in order that delegates are familiar with the extant body of action taken and legislation to avoid repeating what that has already been put in place. Delegates are also advised to explore more of the history surrounding the question, since it has been a problem that has spanned for decades and affected such a great percentage of the worldwide population. Many steps towards the future could be drawn from mistakes learnt in the past, especially in this instance. Finally, it would also be useful to each delegate to fully understand their country’s position.

Key Issues that could be addressed:

  • What would be the best way to tackle the problem of uneven vaccine distribution across the world?
  • What measures could be taken which are not being taken currently in order to maximise the availability of treatment?
  • What are the key problems that have been faced in the past whilst attempting to do this, and how can these be resurrected?
  • Should the accessibility to different vaccines be varied according to different countries and their situations, and how would this be decided?

It is important to note that this is only a brief overview of a very large topic with deep historical roots and different relationships with each country. Therefore, delegates are urged to research further into the issues mentioned on here, or to discover other issues that would be important during debate, paying special attention to the stance of their country and the involvement it has had with worldwide vaccination campaigns.

Delegates are also encouraged to keep up to date with the Covid-19 vaccine uptake across the world which interestingly mirrors the data that has appeared in past disease outbreaks:

Good luck!

 

Bibliography

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Further Reading

The power of vaccines: still not fully utilized. (2017). [online] Available at: https://www.who.int/publications/10-year-review/chapter-vaccines.pdf.

UPDATE WITH THE DEVELOPMENT OF EBOLA VACCINES AND IMPLICATIONS TO INFORM FUTURE POLICY RECOMMENDATIONS. (n.d.). [online] Available at: https://www.who.int/docs/default-source/biologicals/vaccine-standardization/ebola/1-ebola-vaccine-background-document.pdf?sfvrsn=2be75d0d_2&download=true [Accessed 10 Oct. 2021].