The hidden barriers to equitable access – Tackling corruption in the COVID-19 vaccine roll out

In 2021, 11 billion COVID-19 vaccine doses were produced, enough to fully vaccinate every adult in the world. Yet, despite such tremendous advances in development and production of vaccines, there is great inequity in the global distribution of vaccines. Whilst many high-income countries are discussing fourth doses, only 16.19 per cent of people in low-income countries have received at least one dose. With less than a month until mid-2022, it is becoming clear that the world is not going to meet the WHO target of vaccinating 70 per cent of the world’s population by mid-2022. In fact, if nothing changes, it will take another two and a half years for low-income countries to be able to vaccinate 70 per cent of their populations with an initial two doses. There is an urgent need to focus efforts on getting the last-mile planning and distribution of vaccines right. It is critical that processes be put in place which will ensure that the most vulnerable or high-risk groups do not continue to be left behind in the vaccination process due to their socioeconomic status, literacy or access to information.

Over the past year, the Transparency International Global Health (TIGH) Programme has been working with partners in Bangladesh, Uganda, and Zambia to improve equity and transparency in national vaccine rollouts. This report focuses on corruption in the rollout of the COVID-19 vaccine in three different focus countries: Bangladesh, Uganda and Zambia. It aims to shed light on the prevalence of different types of corruption in relation to the rollout, discuss their potential drivers, as well as exploring prospective avenues for their prevention and mitigation.

Download the report here.

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The report reviews three types of corruption in regard to the COVID-19 vaccine rollout: bribery, corrupt fraud and embezzlement and diversion. Our analysis is based on primary data, reports and observations collected as part of our work in the three countries We triangulated findings with a systematic review of peer-reviewed literature as well as online news reports. The report aims to contribute to the rapidly developing evidence base on the COVID-19 vaccine rollout by offering a perspective that has so far often been overlooked and neglected: the widespread prevalence and adverse impact of corruption. Furthermore, it intends to expand our understanding of corruption in the health sector and offer some novel insights into the issue of corruption in vaccine delivery.

This policy brief builds upon the evidence gathered by Transparency International Global Health (TIGH) Programme and partners in Bangladesh, Uganda, and Zambia indicating three hidden barriers for equitable access to COVID-19 vaccines – corruption, lack of transparency, and misinformation. Further details about the research can be found in the report “Transparency and corruption in COVID-19 vaccine deployment: Evidence from Bangladesh, Uganda, and Zambia”. 

The policy brief provides recommendations for Multi- and Bilaterals, Foundations, Governments, Non-Government Organizations and Civil Society on how to address these hidden barriers in order to achieve comprehensive and equitable access to COVID-19 vaccines going forward.  

This research was made possible by funding from the Swedish Ministry of Foreign Affairs