Global Access to Medicines and the Legacies of Coloniality in COVID-19 Vaccine Inequity

This article, written by two members of the advocacy organisation Access to Medicines Ireland, analyses current discourses and practices around global COVID-19 vaccine distribution. As vast imbalances in vaccination coverage continue to characterise global vaccine distribution, we argue that some of the public discourses and distribution mechanisms are coloured by a colonial legacy, which substitutes local capacity building in low and middleincome countries with donations, and substitutes a transparent public debate around how to tackle these inequalities with a discourse that explains them away through perpetuating such tropes as ‘vaccine hesitancy’ or ‘wastage’. Even though such claims have been continually refuted by scientific evidence, the pharmaceutical industry and many high-income country governments keep reiterating them. By dismantling such myths, we point to the legacies from which they have emerged. Flagging the possibility of alternative discourses and practices in global health, we trace the recent history of the access to medicines movement. We argue for a need to suspend intellectual property rights rules around COVID-19 health technologies through the so-called Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver, citing positive exemplars of vaccines developed through an open science paradigm as a counterpoint to the pharmaceutical industry’s claims that such a waiver would have chilling effects on the global pharmaceutical innovation system. We close by highlighting development education opportunities around global access to medicines and universal healthcare.