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Vaccine inequality is not bad luck: pandemic control needs redesigning

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16 March 2026
A fair and swift approach to pandemics does not begin only when vaccines and drugs are distributed. By then it is often too late. Research by health scientist Jelle Feddema shows that we need to redesign the global innovation system even before an outbreak occurs.

During infectious disease outbreaks such as COVID-19 and Ebola, the world often innovates at lightning speed, yet life-saving resources often reach countries with fewer resources far too late, while these countries are disproportionately affected. This disparity is not a matter of chance or bad intentions, but the result of a system tailored primarily to the interests of rich countries.

Fragile and unequal system
Although medical advances have saved millions of lives, the corona pandemic painfully demonstrated that the current system for developing and distributing innovations is fragile and unequal. During a crisis, a "race" emerges in which countries with the most resources and production capacity can buy in and scale up first, while the rest are left behind. Feddema shows that investments in research and development often fail to match the greatest global health needs. Moreover, many countries are excluded from leadership in the innovation process and the highly centralized production of medical resources leads to structural dependencies. Global regulations, such as strict rules around patents and ownership of knowledge, and geopolitical tensions further deepen these existing inequalities.

Because all of these barriers are closely interrelated and mutually reinforcing, the researcher argues that we must move away from symptom relief and ad hoc solutions during a crisis. "You win the next pandemic not during the outbreak, but in the years before," says Feddema. "By making agreements, building capacity and sharing responsibility."

Sustainable improvement requires an approach to the innovation system as a whole. That means working now on reforms to global policy frameworks, stronger local engagement and the transition to decentralized production. Building regional testing and manufacturing capacity, for example in Africa or Southeast Asia, significantly reduces dependence on Western countries. Pre-established international funds and firm agreements on faster sharing of knowledge and data are also crucial for immediate intervention in the event of the next outbreak.

Structural investments
Feddema based his findings on literature reviews, policy analyses and comparing the global response to previous epidemics. His conclusions provide an important blueprint for policymakers, international organizations, funders and pharmaceutical companies. Redesigning this system is not only a matter of equity for developing countries, but serves a major global interest. When tests, vaccines and drugs are more readily available everywhere, outbreaks last shorter. This results in fewer lockdowns, significantly less economic damage and lower mortality. This much-needed shift requires decisive policies in the short term and structural investments in capacity for the medium term.

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