The Health Race: Why Some Nations are Left Behind

By Jenee Farrell

Health, the state of total physical, mental, and social well being is the definition, at an individual level, given by the World Health Organization.1 This state of well-being at a population level is public health. With this definition in mind-Is your population healthy? Is your community healthy? Are you healthy? 

The answer for many, in light of the COVID-19 pandemic, may evidently be “no”. Populations all over the world are not healthy but they are progressing towards recovery, some faster than others. And why is that? 

A state of total physical, mental and social well-being depends on the resources that we have to safeguard our health, empower us to make healthy decisions, and take healthy actions. Efforts to progress towards recovery from the pandemic have become an inequitable scramble for resources. It has become a race that favors the rich and powerful, giving wealthy countries the competitive edge and leaving the developing world in the dust. The goal of this race, however, is not to have one winner but for all to get to the finish line. 

Despite the efforts of global public health experts who have urged that vaccines be equitably distributed around the world, we are seeing a handful of wealthy countries securing most of the supplies of the vaccine. High-income countries, while representing 19% of the global adult population, have purchased more than half of all vaccine doses.2 High-income countries own enough doses to vaccinate more than twice their populations while low- and middle- income countries (LMICs), who account for 81% of the global adult population can only cover one-third.2 For a vaccine where there already isn’t enough supply to meet the global demand, why is this inequitable distribution allowed to persist?

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While countries like the United States have put the worst of this pandemic behind them, opening up vaccinations to anyone, at the same time, many countries in the global south are in a state of crisis. Countries like Trinidad and Tobago, whose response to the COVID-19 pandemic resulted in the country being ranked number one in a report published by the University of Oxford on May 1, 2020, is one year later in a state-of-emergency.3,4 As Trinidad and Tobago witnessed the epidemic erupt at a high triple-digit pace in May of 2021, there was no choice but to impose even stricter measures to contain an increase of COVID-19 cases and related deaths, putting them further behind in the race to recovery.5 

Even with efforts of redistribution of doses already purchased by high-income countries, and the creation of COVAX, an international partnership to respond to the challenge of ensuring broad access to vaccines particularly by LMICs, vaccines will continue to be out of reach for most of the global population.2,6 

Experts say, “By donating millions of vaccine doses it bought but doesn’t need and stepping up as a role model for other countries, America could change the course of the pandemic”.7 Albeit necessary, these donations are a temporary solution to a longstanding problem: the imbalance of global power. The concept of imperialism undergirds the entire global distribution of vaccines and underscores how this global race to recovery has been inevitably unjust. The COVID-19 pandemic has highlighted yet another longstanding inequity and the need for an equity-focused global public health agenda.


1. WHO, A. Constitution of the World Health Organization. Am J Public Health Nations Health, 36(11), 1315-1323. Published 1946. 

2. Rouw A, Wexler A, Kates J, Michaud J. Global COVID-19 Vaccine Access: A Snapshot of Inequality. KFF. :~:text=The%20disparity%20is%20even%20more,can%20only%20cover%20one%2Dthi rd. Published May 6, 2021. 

3. Hunte S-A, Pierre K, St Rose R, Simeon DT. Health Systems’ Resilience: COVID-19 Response in Trinidad and Tobago. The American journal of tropical medicine and hygiene. bago%27s%20response%20to,Oxford%20on%20May%201%2C%202020. Published August 2020. 

4. Reuters. Trinidad and Tobago Declares State of Emergency as COVID-19 Cases Surge. U.S. News & World Report. ate-of-emergency-as-covid-19-cases-surge. Published May 15, 2021. Hong J, Thanthong-Knight R, Scott J. It’s Not Just India: New Virus Waves Hit Developing 5. Countries. -deluge-developing-countries. Published May 3, 2021. Rouw A, Kates J, Michaud J, Wexler A. 

6. COVAX and the United States. KFF. Published February 18, 2021. 

7. Weise E, Weintraub K. To protect Americans and help the world, US needs to start giving more COVID-19 vaccine away more quickly, experts say. USA Today. give-more-doses-faster-experts-say/5135290001/. Published May 21, 2021.