Access to healthcare is a fundamental right for all including refugees. According to Article 23 of the 1951 Refugee Convention, refugees are entitled to the same treatment as nationals of their host State as regards public relief, which includes health care. The unprecedented increase in the refugee population all over the world and the occurrence of a pandemic have coincided to make this right more important than ever.
With the rolling out of the coronavirus vaccine, the immunization of refugees assumes importance as the pandemic has disproportionately affected refugee populations. Refugees and other displaced people belong to the most marginalized and vulnerable members of society. They are particularly at risk during the coronavirus outbreak because they often have limited access to water, sanitation systems, and health facilities.
Over 80 percent of the world’s refugees and nearly all the world’s internally displaced people are hosted in low- and middle-income countries. They frequently face specific challenges and vulnerabilities that must be taken into consideration in COVID-19 readiness and response operations. Keeping the most vulnerable safe means keeping everyone safe. That is why the question of vaccinating refugees becomes an important part of political discourse.
Vaccine nationalism and refugees
Vaccine nationalism is when countries prioritize inoculating their populations before others. From the point of view of public health discourse, it is impossible to break or sustainably slow the transmission of the coronavirus unless a minimum of 70 percent of the population has acquired immunity[1]. That is why the exclusion of refugees, IDPs, and stateless people from vaccination plans carries the risk of ongoing transmission in these populations, with spillovers into the global population.
Refugees, IDPs, and stateless people are more vulnerable to the Covid-19 pandemic than others. According to UNHCR, more than 85 percent of refugees are hosted in low- and middle-income countries, where health systems have often been overwhelmed, with limited capacity to manage persons with severe Covid-19 complications. [2]UNHCR also stated that refugees, forcibly displaced and the stateless are often unable to practice social distancing due to overcrowded living arrangements, and with inadequate access to information and health care services, they remain at a high risk of contracting the virus.
To tackle vaccine nationalism, the UN Secretary-General António Guterres insisted on global access to the vaccine, and the WHO established a universal vaccination plan through its Global Access Facility (COVAX). [3]The initiative gained broad acceptance and 180 countries have signed binding commitments to offer vaccine doses free of charge to low-income countries. The COVAX initiative includes the COVAX Advance Market Commitment (AMC), a financing mechanism to provide donor-funded vaccine doses to 92 low- and middle-income countries that might not otherwise be able to afford them.
This is critical in light of vast global wealth inequalities and the rise of vaccine nationalism. Of the approximately 9.8 billion doses that had been reserved by November 30, 2020, the overwhelming majority were secured by high-income countries, sometimes in amounts greatly exceeding those required for their populations. As of December 18, COVAX had made agreements to access almost 2 billion doses of vaccines, including 1.3 billion for the COVAX AMC. However, while a recent surge in funding pledges helped the AMC meet its 2020 fundraising target of $2 billion, the WHO estimates it needs at least $4.6 billion more in 2021.
The pandemic threatens globalization. Countries have closed borders and suspended immigration. Economic nationalism abounds as protectionist governments urge businesses and consumers to buy local. But parochialism will only come back to haunt us. It will prevent a global solution to the pandemic, deepen the problems of the Global South and feed into mounting migration and refugee crises. To avoid that, we need an internationalist exit strategy.
[1] https://news.un.org/en/story/2020/08/1070422
[2] https://www.reuters.com/article/us-health-coronavirus-migrants-trfn-idUSKBN29Q2A9
[3] https://www.who.int/news/item/18-12-2020-covax-announces-additional-deals-to-access-promising-covid-19-vaccine-candidates-plans-global-rollout-starting-q1-2021
