Global inequities in access to COVID-19 health products and technologies: A political economy analysis

• Published in: Health & place Vol. 83; p. 103051
• Main Authors: Gleeson, Deborah, Townsend, Belinda, Tenni, Brigitte F., Phillips, Tarryn
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2023; The Authors. Published by Elsevier Ltd
• Subjects: Access to medicines; COVAX; COVID-19; COVID-19 technology access pool; Global vaccine equity; Inequity; Pharmaceutical industry; Political economy; Structural violence; TRIPS waiver; COVID-19; Inequity; COVAX; TRIPS waiver; COVID-19 technology access pool; Structural violence; Global vaccine equity; Political economy; Pharmaceutical industry; Access to medicines
• ISSN: 1353-8292; 1873-2054; 1873-2054
• DOI: 10.1016/j.healthplace.2023.103051

This paper presents a political economy analysis of global inequities in access to COVID-19 vaccines, treatments, and diagnostic tests. We adapt a conceptual model used for analysing the political economy of global extraction and health to examine the politico-economic factors affecting access to COVID-19 health products and technologies in four interconnected layers: the social, political, and historical context; politics, institutions, and policies; pathways to ill-health; and health consequences. Our analysis finds that battles over access to COVID-19 products occur in a profoundly unequal playing field, and that efforts to improve access that do not shift the fundamental power imbalances are bound to fail. Inequitable access has both direct effects on health (preventable illness and death) and indirect effects through exacerbation of poverty and inequality. We highlight how the case of COVID-19 products reflects broader patterns of structural violence, in which the political economy is structured to improve and lengthen the lives of those in the Global North while neglecting and shortening the lives of those in the Global South. We conclude that achieving equitable access to pandemic response products requires shifting longstanding power imbalances and the institutions and processes that entrench and enable them. •We apply a model used to analyse the political economy of global extraction to examine factors affecting global access to COVID-19 medical products.•Factors are explored in four layers: social, political, and historical context; politics, institutions, and policies; pathways to ill-health; and health consequences.•Our analysis highlights how inequities in access to COVID-19 products reflect broader patterns of structural violence.•Achieving equitable access to pandemic products requires shifting power imbalances and the institutions and processes that enable them.