Pandemi Döneminde Milletlerin Zenginliği: Aşı Eşitliği

Koronavirüsün küresel ölçekte agresif bir şekilde yayılması, salgını kontrol altına almaya yönelik aşıların geliştirilmesinin aciliyetini ortaya koymuştur. Çoğunlukla gelişmiş ekonomiler için ayrılan sınırlı üretim ve aşı yetersizliği, 2021 yılının önemli bir kürsel sorunlarıydı. Gelişmekte olan ekonomiler için aşılanma takviminin 2022'nin sonlarına, hatta 2023'ün ilk aylarına kadar uzaması beklenmektedir. Bağışıklığı artırmaya yönelik uygulamaya konan programların bir parçası olarak, aşı geliştirme, lisanslama ve aşıların uygulanması, ülkeler arasındaki sağlık hizmeti kalite farkı, aşı eşitsizliğinin derinliğini ortaya koymuştur. Aşılama, bir yönüyle pandemide halk sağlığının korunmasında en düşük maliyetli stratejilerden biri olarak kabul edilirken, diğer yönüyle aşıların tanıtımı ve sürdürülebilir tedarikinin karar vericiler ve hükümetler tarafından desteklenmesi ve sağlanması gerekmektedir. Gelişmekte olan ülkelerin zayıf ekonomik koşulları nedeniyle bu süreçte vatandaşlarına yeterli finansal ve sağlık desteği sağlayamamışlardır. Bununla birlikte, tüm ülkelerde aşılama yapamamaktan kaynaklanan küresel hasıla kaybı, aşıları küresel olarak üretme ve dağıtma maliyetinden daha yüksek olacaktır. Bu nedenle, hiçbir ülkeyi atlamadan küresel aşılamaya yönelik uluslararası işbirliğinin arttırılması hayati öneme haizdir. Bu makale, yüksek, orta ve düşük gelirli ülkelerde Covid-19 pandemi döneminde aşılamanın ekonomik ve sosyal faydalarına odaklanmaktadır. Aşı eşitsizliğinin sadece sağlık boyutu ile değil, asinine küresel etkinliğini de önemli ölçüde zedeleyecek bir sorun olduğundan hareketle, aşılamanın makroekonomik ve sosyal etkileri tartışılacak ve aşıdan hem ekonomik hem de sağlık açısından daha fazla fayda sağlanması için bazı politika önerileri ortaya konulacaktır.

Anahtar Kelimeler:

Covid-19 pandemisi, Aşı, Gelişmekte olan ülkeler

The Wealth of Nations during the Pandemic: The Vaccine Equity

Aggressive global dissemination of the coronavirus indicated the urgency of the development of vaccines at an unprecedented rate and scale. The limited production and short supply of vaccines which were reserved mostly for the advanced economies were the greatest problems of 2021. For emerging economies, this timeline will stretch to late 2022 or early 2023. As a part of systematic immunization programs, the development, licensing, and implementation of the vaccines against the Covid-19 virus started to address health service inequalities among countries. While on one hand vaccination is regarded to be one of the most cost-effective interventions in public health during the pandemic, on the other hand, the introduction and sustainable supply of vaccines needed to be supported and ensured by decision-makers and governments. Due to the weak economic conditions of developing countries, they could not provide enough financial and health support to their citizens during this period. However, since the global GDP loss from not inoculating all countries is higher than the cost of manufacturing and distributing vaccines globally, there has been a growing demand to international cooperation to have global vaccination without omitting any countries. This paper focuses on the economic and social costs and benefits of vaccinations during the Covid-19 pandemic period in advanced, middle, and low-income countries. Accordingly, macroeconomic and social impacts of vaccination will be discussed and some policy suggestions will be put forth to get more benefits from the vaccination both for economic and health outcomes.

Keywords:

Covid-19 pandemic, Vaccine, Developing countries,

PDF

___

1. Jit M, Hutubessy R, Png ME, Sundaram N, Audimulam J, Salim S, Yoong J. The broad economic impact of vaccination: Reviewing and appraising the strength of evidence. BMC Medicine. 2015; 13:209.
2. Barnighausen T, Bloom DE, Cafiero-Fonseca ET, O’Brien JC. Valuing vaccination. PNAS, Special Feature: Perspective. Ed. Rappunali R, Novartis N, 26 August 2014, 111(34):12313-12319. www.pnas.org/cgi/doi/10.1073/pnas. 1400475111.
3. WHO. COVID-19 vaccines. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
4. Çakar ND, Gedikli A, Erdoğan S. The Global Economic Hibernation: Macroeconomic Indicators and Health Management Policies. Düzce Medical Journal. 2021; 23, Special Issue: 48-60.
5. Erdoğan S, Yıldırım DÇ, Gedikli A. Dynamics and Determinants of Inflation During the COVID-19 Pandemic Period in European Countries: A Spatial Panel Data Analysis. Düzce Medical Journal. 2020; 22, Special Issue: 61-7
6. WHO. No one is safe from COVID-19 until everyone is safe. 2021. https://www.who.int/campaigns/vaccine-equity
7. Çakmaklı C, Demiralp S, Kalemli-Özcan Ş, Yeşiltaş S, Yıldırım, MA. The economic case for global vaccinations: An epidemiological model with international production networks. 2021; NBER Working Papers, Working Paper No. 28395, April 2021. https://www.nber.org/system/files/working_papers/w28395/w28395.pdf
8. Andre FE, Booy R, Bock HL, Clemens J, Datta SK, Lee BW, Lolekha S, Peltola H, Ruff TA, Santoshamj M, Schmitt, HJ. Policy and Practice -Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization. February 2008; 86(2):140-146. doi:10.2471/BLT.07.040089.
9. Mauskopf J, Standaert B, Connolly MP, Culyer AJ, Garrison LP, Hutubessy R, et al. Economic analysis of vaccination programs: An ISPOR good practices for outcomes research task force report. Value in Health, ISPOR Task Force Report. 2018; 21:1133-1149.
10. Ozawa S, Clark S, Allison P, Grewal S, Stack ML, Sinha A, et al. Estimated economic impact of vaccinations in 73 low-and middle-income countries, 2001-2020. Bulletin of World Organisation. June 2017; 95:629–638.
11. Deogaonkar R, Hutubessy R, van der Putten I, Evers S, Jit M. Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries. BMC Public Health. 2012; 12(878):1-9. http://www.biomedcentral.com/1471-2458/12/878
12. Smith RD, Keogh-Brown MR, Barnett T, Tait J. The economy-wide impact of pandemic influenza on the UK: a computable general equilibrium modelling experiment. BMJ. 2009; 339:b4571. doi:10.1136/bmj.b4571
13. EUR-Lex. Notices from European Union institutions, bodies, offices and agencies- Council conclusions on vaccinations as an effective tool in public health. Official Journal of the European Union. 2014; C 438/04, 06.12.2014. [cited 2022 Feb 20]. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52014XG1206(01)&from=EN
14. Remy V, Largeron N, Quilici S, Carroll S. The economic value of vaccination: Why prevention is wealth. Journal of Market Access & Health Policy. 2015; 3(1), 29284.
15. Kirigia JM, Sambo LG, Yokouide A, Soumbey-Alley E, Muthuri LK, Kirigia DG. Economic burden of cholera in the WHO African region. BMC International Health and Human Rights, 2009, 9(8), 1-14. doi:10.1186/1472-698X-9-8
16. Ozawa S, Mirelmana A, Stacka ML, Walker DG, Levinea OS, et al. Cost-effectiveness and economic benefits of vaccines in low- and middle-income countries: A systematic review. Vaccine. 2012; 31:96-108.
17. www.theglobaleconomy.com. Economic growth forecast in High income countries (World Bank classification). 2022.
18. Kim YE, Loayza NV.Economic loss from COVID-19 fatalities across countries: a VSL approach. Applied Economics Letters. 2021; 29(7):644-650.
19. Alon T, Minki K, Lagakos D, Van Vuren M. How should policy responses to the covid-19 pandemic differ developing world? NBER. 2020; Working Paper 27273 http://www.nber.org/papers/w27273
20. Pagés C, Aclan C, Alfonso M, Arroio R, Irigoyen JL, Mejia I, et al. From lockdown to reopening:Strategic considerations for the resumption of activities in Latin America and the Caribbean within the framework of Covid-19. Inter-American Development Bank. 2020; IDB-MG-814. https://publications.iadb.org/publications/english/document/From-Lockdown-to-Reopening-Strategic-Considerations-for-the-Resumption-of-Activities-in-Latin-America-and-the-Caribbean-within-the-framework-of-Covid-19.pdf.
21. Arellano C, Bai Y, Mihalache GP. Deadly debt crises: Covid-19 in emerging markets. NBER, Working Paper No.27275, April 2021.
22. Barnet-Howell Z, Mobarak AM. The value of social distancing is not equally distributed. VOXEU-CERP. 07 May 2020. [cited 2022 Feb 20]. Available from: https://voxeu.org/article/value-social-distancing-not-equally-distributed
23. Barnet-Howell Z, Mobarak AM.The Benefits and Costs of Social Distancing in high- and low-income countries. Transactions of The Royal Society of Tropical Medicine and Hygiene, 2021; 115(7):807-819.
24. Ferguson N, Laydon D, Nedjati Gilani G, …Donnelly C, Riley S, Ghani A. Report 9: Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID-19 Mortality and Healthcare Demand. 16 March 2020. Imperial College London. doi:10.25561/77482. https://spiral.imperial.ac.uk/handle/10044/1/77482
25. Duhon J, Bragazzi N, Konga JD. The impact of non-pharmaceutical interventions, demographic, social, and climatic factors on the initial growth rate of COVID-19: A cross-country study. Sci Total Environ. 2021 Mar 15, 760, 144325. doi: 10.1016/j.scitotenv.2020.144325
26. Baker SR, Bloom N, Davis SJ, Stephen JT. Covid-induced economic uncertainty. NBER, Working Paper No.26983, April 2020.
27. WHO. Vaccine inequity undermining global economic recovery. 22 July 2021. https://www.who.int/news/item/22-07-2021-vaccine-inequity-undermining-global-economic-recovery
28. The World Bank. World Bank Support for Country Access to COVID-19 Vaccines. April 7, 2022. [cited 2022 April 07]. Available from: https://www.worldbank.org/en/who-we-are/news/coronavirus-covid19/world-bank-support-for-country-access-to-covid-19-vaccines
29. United Nations (UN). Vaccinations and COVID-19 Funding for Least Developed Countries. 2021. https://www.un.org/ohrlls/content/covid-19-ldcs.
30. Our World in Data. Coronavirus (Covid-19) vaccinations. 06 February 2022; [cited 2022 March 10]. Available from: https://ourworldindata.org/covid-vaccinations
31. World Bank Group. Poverty and shared prosperity 2020-reversal of fortunes. 2020. [cited 2022 Feb 20]. Available from: https://openknowledge.worldbank.org/bitstream/handle/10986/34496/9781464816024.pdf
32. OECD. Coronavirus (COVID-19) vaccines for developing countries: An equal shot at recovery. 4 February 2021. [cited 2022 Feb 25]. Available from: https://read.oecd-ilibrary.org/view/?ref=1060_1060300-enj5o5xnwj&title=Coronavirus-COVID-19-vaccines-for-developing-countries-An-equal-shot-at-recovery
33. The Economist Intelligence Unit. Coronavirus vaccines: expect delays Q1 global forecast 2021. 2021.
34. The Economist Intelligence Unit. How much will vaccine inequity cost? 2022. [cited 2022 Feb 20]. Available from: https://www.eiu.com/n/campaigns/how-much-will-vaccine-inequity-cost/
35. Çakmaklı C, Kalemli-Ozcan S, Yeşiltaş S, Yıldırım MA. The economic case for global vaccination: An Epidemiological Model with International Production Networks. ICC, Summary for Policymakers, January 25, 2020
36. Duke Global Health Institute. Research News: Will Low-Income Countries Be Left Behind When COVID-19 Vaccines Arrive? Duke University, 2020. [cited 2022 March 20]. Available from: https://globalhealth.duke.edu/news/will-low-income-countries-be-left-behind-when-covid-19-vaccines-arrive

ISSN: 1309-3878
Yayın Aralığı: 3
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez