Publications

Global vaccine equity remains a central concern in international public health, reflecting long-standing disparities in access to life-saving vaccines between and within countries. This narrative review synthesizes historical, geopolitical, social, and economic factors shaping vaccine distribution and utilization, focusing particularly on low- and middle-income countries (LMICs). Quantitative indicators and qualitative case studies reveal significant inequalities across regions and vaccine types, exacerbated during the COVID-19 pandemic. The review examines international governance frameworks such as COVAX, Gavi, and WHO-led initiatives, assessing their effectiveness and sustainability. Comparative and longitudinal analyses using group-based trajectory and multivariate methods offer frameworks for monitoring equity and benchmarking political commitments across countries. Case studies from Sub-Saharan Africa, Southeast Asia, and Latin America and the Caribbean provide regional insights into systemic barriers, including limited manufacturing capacity, financing shortfalls, and governance inefficiencies. Strategies for improving vaccine equity emphasize regional manufacturing hubs, technology transfer, flexible financing mechanisms, and strengthened donor coordination. The analysis underscores that global vaccine inequity is both a technical and moral challenge rooted in political economy, global trade rules, and power asymmetries. Addressing these inequities requires inclusive policy reforms, sustainable financing, and regional capacity building to ensure vaccines are accessible, affordable, and available to all populations, particularly the most marginalized.