Christian Ethics and Global Equity in COVID-19 Vaccine Rollout

By: Doug Fountain

February 16, 2021

Responding to: Religion, Bioethics, and COVID-19 Vaccination

Christian Ethics and Global Equity in COVID-19 Vaccine Rollout

For where your treasure is, there your heart will be also (Mathew 6:21).

At the time of writing, 2% of the world’s population has received COVID-19 vaccines. Israel, the United Arab Emirates, the United States, the United Kingdom, and most of Europe lead the way.

There is little evidence that vaccines are rolling out in low- and middle-income countries (LMICs) at the rates needed to stem global infection. As infection rates spiral in these countries, people are also more likely to face long-term economic and social consequences and lose decades of progress on poverty and health. 

Compounding the problem of slow rollout of vaccines in LMICs is the near silence or indifference on the part of global leaders and donors. Few pause to consider the root causes or unique challenges within these countries. We must quickly address: 

  1. insufficient research on vaccine hesitancy; 
  2. insufficient attention to the global supply chain and health worker mobilization; and
  3. insensitivity to authentic concerns and challenges that many of our brothers and sisters around the world face in neocolonial or postcolonial environments.

For many of us, receiving the vaccine will be a moment laden with personal, professional, spiritual, and ethical weight. We join a tiny percentage of the world now protected to any extent from this brutal pandemic. 

This is personally a profound ethical dilemma for me: It is far more likely that I will receive a vaccine than many millions of people who are at far higher risk—simply because I am an American and can access the vaccine. This ethical problem reflects a terrible approach to securing the world’s health. Equitable access to needed care and preventive medicine is a practical and attainable goal that sustains families and communities, drives economies, and stabilizes democracies. 

Equitable access to needed care and preventive medicine is a practical and attainable goal that sustains families and communities, drives economies, and stabilizes democracies.

Despite this, it is a slow and challenging battle to ask for better action, better funding, and better movement to support vaccine rollout in low- and middle-income countries. 

Where does our motivation lie when looking at global distribution of something so life-saving as a vaccine against a world-stopping pandemic? It is only natural to want to protect ourselves from the virus at all cost, which for many motivates us to look towards vaccinations with a “me first” mentality. For many of us, this motivation succeeds in limiting our focus to distributing the vaccine within our borders.

We Americans put ourselves first at an alarming rate. While 83% of Americans support wearing masks, fewer than half actually do so when they are around other people. If you look across studies, reasons that people give for not wearing masks include “I don’t think it makes a difference” or “I’m not required” or “I feel uncomfortable.” Those who do may say, “It’s my way of limiting the spread of the virus.” The differences in views could not be more apparent: One is inherently self-referential, the other is not. 

Vaccines also have their share of skeptics and ethical naysayers: “It’s a way for corporations to get rich” or “I don’t like the underlying science, which may have been derived from technologies developed using cells from a fetus aborted decades ago.” Indeed, looking for ideological and moral purity in the health industry may be disillusioning, and the resulting confusion can slow vaccine uptake. 

We could get trapped in endless conversations about these matters and miss the core issue that has practical and immediate consequences: Vaccines will save lives and restore livelihoods. 

We could get trapped in endless conversations about these matters and miss the core issue that has practical and immediate consequences: Vaccines will save lives and restore livelihoods.

I think we have our ethical perspective in the world upside down. Ethical action must balance reducing disease with investment we seek in holistic personal and community health. There are two elements here: defining health and linking sacrificial giving to the needs of many. 

First, the World Health Organization's own definition of health helps us: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." COVID compromises livelihoods, increases gender-based violence, delays education, and reduces other healthy behaviors. The goal of intervening in COVID begins with reducing death or disease and finishes when the comprehensive well-being of affected populations is secured. Investing in health means more than reducing disease.

Second, ethical response ought to be based on selfless and sacrificial giving. Dr. Jonathan Quick, who leads Pandemic Preparedness and Prevention at the Rockefeller Foundation, recently wrote that Christians have responded to disease outbreaks as far back as a plague in 260 CE. He challenges Christians to be remembered for selfless cura personalis (care of the whole person) and the sacrificial spirit of cura communitas (care of the whole community). 

The quality and degree to which we care for others is a direct reflection of the values within our own heart. What do I value most? Is it my health, my family’s security, the health of people within my country’s borders, or the collective health of our brothers and sisters globally? Where we spend our time, talent, and treasure reveals very deeply what matters in our heart.

We wear masks and avoid congested spaces now not only because doing so can protect us, but because this behavior communicates that we care about protecting others. We obey traffic rules for the same reason. We accept the vaccines that are offered when possible, because we can prevent spreading the virus to someone susceptible, and so we continue working for vaccine equity globally. 

On a national and global level, where do we invest? It is very difficult to get attention on vaccinating the world: Our priority, evidenced by the news, is mostly whether and when “we” get access. Yes, we also need access to vaccines. 

It would help us reflect on what our investment of our time, talent, and treasure reveals about our heart. Investing in others is not simply to reverse a problem, but to promote values of life in its fullest. 

Investing in others is not simply to reverse a problem, but to promote values of life in its fullest.

Invest in the elderly because they are a wealth of experience.

Invest in the person who is homeless and addicted to drugs, because their lives matter and they have tremendous potential for change.

Invest in health workers because they are equipped with powerful gifts that bring healing to people who are shattered.

Invest in the dweller in a sub-Saharan Africa slum, because she embodies the potential to influence countless people by her perseverance.

For where your treasure lies, there your heart will be also.

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