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Ending COVID-19 vaccine apartheid through vaccine donations: the influence of supply chains

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Abstract

We study determinants of COVID-19 vaccine donations from recipients’ perspective, especially considering supply chain and institutional weakness (corruption) aspects. Results, based on data from more than 130 nations, show that strengthened supply chains reduced donations. The impacts of corruption and logistics performance likely persisted from pre-COVID times. More corrupt nations received fewer donations per capita, ceteris paribus. The results with respect to economic prosperity support efforts to end vaccine apartheid, and island nations received more donations, as did nations with more bilateral vaccine deals. Finally, donations received through COVAX were driven by qualitatively similar factors, except corruption did not matter.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Notes

  1. Some of the vaccine disparities might be due to vaccine hesitancy across certain population groups (Goel et al. (2023)).

  2. See https://www.paho.org/en/covax-americas.

  3. COVAX stands for COVID-19 Vaccines Global Access.

  4. https://www.bloomberg.com/news/articles/2022-09-22/pfizer-us-revise-vaccine-contract-as-world-demand-plummets#xj4y7vzkg

    https://www.kff.org/coronavirus-covid-19/issue-brief/u-s-international-covid-19-vaccine-donations-tracker/

    https://ourworldindata.org/grapher/covax-donations

    https://www.unicef.org/coronavirus/covid-19-vaccines-why-dose-donations-are-essential

    https://www.reuters.com/business/healthcare-pharmaceuticals/us-cutting-global-donations-pfizer-covid-shots-demand-slows-2022-09-22/

  5. Goel et al. (2021b) examine a different effect of logistics by considering their effects on economic growth.

  6. United Nations Office on Drugs and Crime (2021). COVID-19 vaccines and corruption risks: Preventing corruption in the manufacture, allocation and distribution of vaccines. https://www.unodc.org/documents/corruption/COVID-19/Policy_paper_on_COVID-19_vaccines_and_corruption_risks.pdf.

  7. In some cases, the single dose Johnson & Johnson vaccines were donated – see https://www.unicef.org/cambodia/press-releases/united-states-donates-more-1-million-johnson-johnson-single-dose-vaccines-cambodias

  8. https://ourworldindata.org/grapher/covax-donations

  9. https://www.voanews.com/a/logistics-of-covid-vaccine-donations-to-africa-must-improve-say-distribution-coordinators/6331883.html

  10. These supply chain aspects mainly relate to transportation bottlenecks. There may be other issues like greater absenteeism that can affect supply chain aspects. Absenteeism would partly be captured in the timeliness of deliveries.

  11. Dohse et al. (2023) and Goel et al. (2020) have considered different logistics aspects in other contexts, unrelated to the pandemic (also see Goel et al. (2021b)).

  12. See https://kof.ethz.ch/en/forecasts-and-indicators/indicators/kof-globalisation-index.html for details.

  13. Island nations pose somewhat different supply chain issues than other nations and that is discussed below (also see Arvis et al. (2007)).

  14. We are aware that there are many dimensions of institutional quality, and that there are other measures (e.g., government effectiveness, rule of law, etc.). We are using corruption due to its multidimensional nature and the underlying measure of corruption is comparable across nations. Plus, the main focus of this work is not on this aspect.

  15. Given its multidimensional character, corruption can possibly impact logistics performance as well (Goel et al. (2020)). Such issues are less of a concern in a cross-sectional analysis.

  16. Of course, this cannot fully address how well equity considerations were met in achieving equal vaccine access. A poor nation may have received a relatively large allocation of vaccines, but due to graft, political favoritism, and other considerations, the vaccines were not equitably distributed within the receiving country.

  17. For further details on the methodology used to track vaccine supply, see https://www.imf.org/en/Topics/imf-and-covid19/-/media/Files/Topics/COVID/IMF-WHO/imf-who-covid-19-vaccine-supply-tracker-methodology.ashx.

  18. For further details on the methodology used to construct the Index, see https://lpi.worldbank.org/sites/default/files/2023-04/Methodology_LPI_survey.pdf.

  19. For further details, see https://lpi.worldbank.org/international/aggregated-ranking. The LPI is produced every two years.

  20. https://covid19.who.int/info

  21. Not surprisingly, the pairwise correlations between all four dates reflecting COVID-19-related deaths were quite high, in all cases they exceed 0.96.

  22. For further information on the methodology used to construct the index, see https://images.transparencycdn.org/images/CPI_2022_Methodology.zip.

  23. Not all nations received vaccine donations. In our dataset, 40 countries (out of 131 total) received zero donations during the period analyzed, and 43 countries had zero COVAX distributions. Furthermore, information on the source of donations received by each country does not seem to be publicly available. See Goel and Nelson (2021) for a study of vaccination information in the United States.

  24. Note that the economic significance of the coefficient on the GDPpc variable should keep in mind that it is in logs (Table 1).

  25. It could be the case that the form of the government of the vaccine donor nations might be relevant. However, given the relatively few donor nations and the opaqueness of the supply-side data, we are unable to focus on the behavior of donor nations.

  26. Incidentally, the elasticity of DONATIONSpc with respect to INTLship from Model 2.2 (= −5.66) is almost identical to that with respect to LogisticPERF from Model 1.1 (= −5.64).

  27. Corruption/bribery might also be at play in the formation and execution of bilateral deals (Goel et al. (2021a)). We control for corruption perceptions in Table 4.

    Table 4 COVID-19 vaccine apartheid and donations: the role of government
    Full size table

  28. Various scholars have noted the role of corruption in charitable contributions in a broader context (Goel (2020), McDonnell and Rutherford (2018)).

  29. See Dragomirescu-Gaina (2021), Goel and Haruna (2021), and Goel and Jones (2022) for discussions of other policy responses during the COVID-19 pandemic.

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Acknowledgements

We thank two referees and the editor for useful comments. An earlier version of this paper was circulated as a CESifo working paper # 10723.

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Authors and Affiliations

  1. Katie School of Insurance and Risk Management, Illinois State University, Normal, IL, 61790, USA

    Rajeev K. Goel

  2. Institute for Studies on the Mediterranean/National Research Council, Napole, Italy

    Rajeev K. Goel

  3. Kiel Institute for the World Economy, Kiel, Germany

    Rajeev K. Goel

  4. Department of Economics, University of Akron, Akron, OH, USA

    Michael A. Nelson

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Appendix

Appendix

Tables 6 and 7

Table 6 Countries in the dataset
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Table 7 COVID-19 vaccine apartheid and donations: drivers of COVAX donations
Full size table

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Goel, R.K., Nelson, M.A. Ending COVID-19 vaccine apartheid through vaccine donations: the influence of supply chains. J Econ Finan (2024). https://doi.org/10.1007/s12197-024-09662-1

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