By Felicitas Holzer, Federico Germani, Ivette Ortiz Alcántara, Julian März & Nikola Biller-Andorno

Equal access to vaccines has been one of the key ethical challenges during the COVID-19 pandemic. Most scholars consider the massive purchase and hoarding of vaccines by high-income countries, especially at the beginning of the pandemic, to be unjust towards vulnerable people living in low- and middle-income countries.

The COVAX facility has been set up at the onset of the pandemic to distribute vaccines to low- and middle-income countries. Despite the promises of COVAX, the facility has been heavily underfunded, and its activities have been promoted by donations from individual countries. This means that each country could still independently decide to hoard vaccines, often left unused, which, instead, could have been distributed to countries lacking purchasing power.

A recent proposal by Andreas Albertsen advocates for a global vaccine tax (“VaxTax”) to remedy the funding problem. High-income countries would pay a contribution, conceptualized as a vaccine tax, dedicated to buying vaccines and distributing them to low- and middle-income countries. Proceeding from this proposal, our new model shows that collecting a VaxTax could have helped reducing vaccine hoarding, and suggests that the integration of such model into international agreements could lead to a more equitable distribution of vaccines between high and low- and middle-income countries.

We thus urge the international community to further expand COVAX’s mandate. Under this scheme, COVAX would collect the VaxTax to further buy and distribute vaccines. The main reason to think of COVAX as an institution managing tax revenues is owed to its central role as a key player in global vaccine justice. COVAX has been established as a global collaborative to accelerate the development, production, and equitable access to vaccines for the global poor. While it would be problematic if a private foundation had similar power, COVAX has the advantage to function as a public body to address global needs.

The success of the VaxTax model relies on the voluntary agreement of countries to participate in a tax scheme and transfer money to COVAX. A tax scheme, therefore, must be first and foremost subject to an international treaty, where countries self-commit to subject themselves to a tax framework and tax scheme. COVAX could take over the coordination of such an agreement.

Now that the potential efficacy of a VaxTax has been proposed, it is in the hands of the international community to push for cooperation and to move forward by giving COVAX the mandate it needs.

Paper title: “Vax-tax”: A Follow-Up Proposal for a Global Vaccine Pandemic Response Fund

Authors: Federico Germani¹, Felicitas Holzer¹, Ivette Ortiz Alcantara, Nikola Biller-Andorno³, Julian März³

Affiliations: Institute of Biomedical Ethics and History of Medicine, University of Zurich

Competing interests: none

Social media accounts of post author(s): Federico Germani’s Twitter handle: @fedgermani