Sometimes, treating an illness serves to expose an underlying malaise affecting the entire body. The same has been true for the international response to covid-19. As global vaccination efforts ramp up, it is increasingly clear that the fever of inequality in our so-called liberal world order shows no signs of breaking.

Black people, both in the West and in Africa, have been bearing the burden of this global medical inequality. Much attention has been given to the disproportionately higher infection and death rates in Black communities in the United States. The legacy of medical racism here has also led to vaccine skepticism among Black citizens.

But the biggest threat to marginalized communities is simply vaccine access. Wealthy nations gobble up more than their fair share of available doses. According to Duke University’s Global Health Innovation Center, out of the 7.2 billion confirmed purchases of covid-19 vaccines, 4.2 billion doses have gone to the wealthiest nations. The African Union has procured just 670 million doses to be distributed across a continent of 1.3 billion people. High-income countries, which represent only 16 percent of the world’s population, have taken 60 percent of available doses.

Vaccine nationalism stands to pose an even greater threat to the global recovery from this devastating pandemic. If wealthy countries continue to leave poorer nations behind, we will have another reminder that global power has rarely translated into true global leadership.

Thankfully, African leaders and global health experts have started to speak up. World Health Organization Director General Tedros Adhanom Ghebreyesus warned that vaccine nationalism would lead to a “catastrophic moral failure.” South African President Cyril Ramaphosa said that rich countries should share their excess doses. “Some countries even acquired up to four times what their population needs,” he said recently. Ellen Johnson Sirleaf, who oversaw Liberia’s response as president during the 2014-2016 Ebola crisis, recently told NPR that rich countries need to see vaccines as a “free good on the basis that until everyone is safe, no one is safe.”

It’s clear that the greed of naked capitalism will be the major obstacle to keep the world safe from the virus and its political and economic shockwaves. Researchers at RAND Europe have estimated that inequality in global vaccine allocation could zap $1.2 trillion a year from the global economy in terms of gross domestic product. As my colleague Ishaan Tharoor reported recently, at least 225 million jobs have disappeared worldwide; meanwhile, the world’s 1,000 richest people have already recovered their pandemic losses, but it could take more than a decade for the world’s poorest to bounce back. The pursuit of domestic political goals and profits will not protect rich countries — they must understand that they remain at risk if entire continents such as Africa go under-vaccinated.

Here in the United States, the situation looks bleak in the months to come. For all of its wealth and resources, the country is quickly approaching half a million covid-19 deaths. And despite the fact that the nation has purchased at least 1.2 billion doses of vaccines and vaccine candidates, distribution is still riddled with failures and inefficiencies. In early January, experts estimated that it could possibly take two to three years for America to reach herd immunity.

Meanwhile, African populations that have had success with mass vaccination campaigns in the past must now wait. What compounds the looming moral failure there is twofold. First, for all the hand-wringing about African vulnerabilities, the fact is that resource-strapped African nations have managed mass vaccination and disease containment before. Sirleaf is right to point out that West African countries affected by the Ebola virus got through the threat in part because Sierra Leone, Liberia and Guinea had the support of other countries to ensure that relief and medication was equally distributed between the affected nations.

But the second tragedy is perhaps more painful — the realization that the underlying condition of human societies is the chronic inability to learn from the mistakes of the past. This is not the first time that vaccine nationalism has come before vaccine cooperation. In the case of polio, smallpox and the recent H1N1 flu, lesser-developed countries had to wait until wealthier countries immunized their populations before gaining access.

The Biden administration has pledged to rejoin WHO and says that it will sign on to COVAX, a WHO-backed effort to ensure equitable global distribution of vaccines. But so far, a number of wealthy nations have skirted the WHO’s pleas for countries to not engage in one-on-one bilateral deals with manufacturers that result in limited supply for poorer nations.

All of this leads to the question: Why shouldn’t African countries aim to play the same game as wealthier nations? After all, countries such as China and India went down the path of developing their own immunology capabilities. Today, both India and China are suppliers of vaccine to other countries. Given the sheer number of African countries with smaller economies, cooperation across regional blocs such as the Economic Community of West African States (ECOWAS) or the East African Community (EAC) could provide more resources for vaccine self-sufficiency, rather than relying on the morality and goodwill of wealthier nations.

For unfortunately, after hundreds of years of scientific progress, global commitments on equal access to basic human needs still remain in tragically short supply.

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