The Roots of the Global South’s New Resentment

How Rich Countries’ Selfish Pandemic Responses Stoked Distrust – By Mark Suzman

This past June, at the closing ceremony of the Summit for a New Global Financing Pact in Paris, South African President Cyril Ramaphosa introduced a topic that, on its face, had little to do with international finance. In remarks to dozens of global leaders, he raised the issue of COVID-19 vaccines. In 2021, when the first COVID-19 vaccines were rolled out, South Africans “felt like we were beggars when it came to vaccine availability,” Ramaphosa said. “The Northern Hemisphere countries … were hogging them, and they didn’t want to release them at the time when we needed them most. That,” he continued, “generated and deepened disappointment and resentment on our part, because we felt like life in the Northern Hemisphere is much more important than life in the global South.”

Ramaphosa is not alone in seeing things this way. In 2021, Strive Masiyiwa, a Zimbabwean businessman and philanthropist—and now a Bill & Melinda Gates Foundation trustee—said that rich countries’ behavior during the pandemic perpetuated “a deliberate global architecture of unfairness.” This deep sense of betrayal has corroded trust among countries, and the geopolitical implications are significant.

Of course, the COVID-19 era encompassed only a few of the litany of broken promises between the global North and the global South. But as richer countries struggle to understand the global South—and especially African nations’ ambivalent reaction to Russia’s war on Ukraine—the lingering effect of abandonment during the pandemic is underappreciated. Two kinds of failings defined the COVID-19 era for low-income countries: the global North’s hesitation to share resources equitably and its unwillingness to treat global South countries as equal partners in addressing a shared crisis. Until wealthy countries take concrete steps toward repair, the rift will only grow deeper.

ONE FOR YOU, NINETEEN FOR ME

During the COVID-19 pandemic, the world’s richest countries largely left poorer ones to fend for themselves. But it didn’t have to be that way—and for a moment, it didn’t look as if it would be. In April 2020, a coalition of G-20 governments, philanthropic groups, and multilateral organizations launched the Access to COVID-19 Tools Accelerator, a collaboration to accelerate vaccine development and ensure equitable access to testing, treatments, and vaccines. The program’s $12 billion vaccination scheme, COVAX, was established to ensure that every country, regardless of resources, had equitable access to COVID-19 vaccines.

From the start of the pandemic, the Gates Foundation argued that lifesaving vaccines, tests, and treatments should be distributed based on need, not wealth, and we helped found and fund the Access to COVID-19 Tools Accelerator and COVAX because of that conviction. The aim was to enable all countries to vaccinate the ten percent of their populations that faced the highest risks from the new coronavirus—such as the elderly and people with significant comorbidities—before any country vaccinated lower-risk individuals. COVAX aimed to deliver two billion doses of COVID-19 vaccines globally by the end of 2021, 1.3 billion of them to low- and middle-income countries. Russia and the United States, then led by President Donald Trump, were conspicuously absent from the list of signatories, but over 180 countries signed up.

To prepare to deliver COVID-19 vaccines, African and other low- and middle-income governments trained health-care workers and worked with global organizations to arrange for the proper tools and equipment. Many of these countries already had expertise in rolling out rapid, successful mass vaccination campaigns thanks to their experiences combating infectious diseases such as measles, polio, and HIV.

Delays in vaccine delivery gave misinformation and conspiracy theories more time to take hold.

COVAX could succeed, however, only if rich countries cooperated and provided significant resources. On both counts, they came up short. For COVAX’s funding model to work, rich countries had to purchase at least some of their COVID-19 vaccine supply from the program, delivering COVAX the revenue to broker more affordable deals for low-income countries. But after regulators began to approve these vaccines at the end of 2020, wealthy countries delayed promised financial contributions and cut side deals with manufacturers, buying up most of the vaccine supply before anyone got a shot.

The negative consequences of these actions were especially visible in Africa, where the Gates Foundation does most of its work. In February 2021, the first COVAX vaccine doses arrived in Ghana and Côte d’Ivoire—three months after countries such as the United Kingdom began vaccinating their citizens—but these doses only amounted to a tiny fraction of what the country needed. By May, 35 percent of people in the United States were fully immunized, compared with 0.3 percent of people in Africa. According to reporting by STAT, wealthy countries—including the United States, which joined COVAX in 2021, soon after Joe Biden became president—pledged to donate 785 million COVID-19 vaccine doses to COVAX. But by September 2021, just 18 percent had arrived.

Delayed delivery did not just keep vaccines from millions of people. It gave misinformation and conspiracy theories more time to take hold, driving a lack of uptake. By the fall, as people in the United States and the United Kingdom received booster shots, 98 percent of people in low-income countries had yet to receive a single dose. The inequity was egregious: in the United States, my eight-year-old son, like many other American children, got his first COVID-19 vaccine before 97 percent of the population of Malawi, even though he faced a very low risk of severe disease.

BAD HANGOVER

African governments were hardly just sitting and waiting for help. In November 2021, South African scientists alerted the world to the Omicron variant. As thanks, rich countries such as the United States and the United Kingdom banned flights from South Africa. Even when Africans led the world in pandemic preparedness, they were treated with contempt.

The Access to COVID-19 Tools Accelerator program did have lifesaving effects. By November 2022, it had delivered 1.8 billion doses of COVID-19 vaccines to 146 countries. It also sent nearly 180 million COVID-19 tests to low- and middle-income countries and tracked and analyzed more than 1,000 clinical trials in a search for promising new treatments. But so much distrust could have been avoided if wealthy countries had kept their promises.

COVID-19’s deadliest phase appears to be over. But low-income countries are still rocked by aftershocks. During the pandemic, high-income countries introduced stimulus funding to buoy their economies and provide social services. On average, G-20 countries committed 20 percent of GDP to these priorities. But low-income countries were able to commit just three percent. To fund essential services in 2020, low-income countries borrowed billions of dollars to keep the lights on while their urgent needs only grew.

Even as the worst of the pandemic’s threat has abated, low-income countries still must spend large sums servicing that debt instead of investing in health, development, education, and climate resilience. In 2021, among the more than 70 lower-income countries eligible for the World Bank International Development Association’s assistance, debt service as an average share of GDP jumped to a level not seen since 1997. According to a recent United Nations report, nearly half the world’s people now live in countries that spend more on servicing foreign debt than they do on health care, a 25 percent rise since before 2020. These debt hangovers are stunting growth. And they contribute to a sense, among the populations of low-income countries, that the world has a double standard.

TRUST DEFICIT

The global North’s unwillingness to fulfill its promises during the COVID-19 pandemic is a particularly underappreciated factor in a growing north-south rift. But it is by no means the only one. A similar breach of trust has marked the world’s response to the climate crisis.

At the 2015 climate summit in Paris, developed countries committed to spending $100 billion a year to support climate mitigation and adaptation in developing countries. But these donor countries have missed this target by tens of billions of dollars every year since. Worse, loans made up 70 percent of funding that wealthy countries promised in Paris. Low-income countries are effectively borrowing money—with interest—to pay for damage caused by wealthy ones.

At the 2021 UN Climate Change Conference in Glasgow, wealthy countries again made a strong promise: this time, to double their spending on climate adaptation by 2025, with the bulk of the funds going to help countries that do relatively little to drive climate change but stand to suffer its most severe consequences. But many high-income countries still have made no specific announcements on what they will contribute, adding to justified skepticism that this promise will be kept. Every delay causes solutions to become more complex and costly.

There has been some progress. In June, Senegal struck a $2.7 billion green energy deal with Canada, the European Union, France, Germany, and the United Kingdom to support Senegal’s economic recovery and make it more resilient to future shocks. That same month, Zambia—which defaulted on its sovereign debt during COVID-19—secured a breakthrough debt-restructuring agreement after lengthy negotiations. But help is slow, piecemeal, and not close to the scale that would match the severity of the crises low-income countries face.

BREAKING THE PATTERN

Many low-income countries now find themselves looking for new partners or wondering if the only viable course of action is to try to solve their problems alone. But the fates of the global North and the global South remain tied.

Thanks, in part, to the debt crisis and fiscal constraints countries’ budgets coming out of the pandemic, this is the toughest moment in a generation for global health and development. At risk are decades’ worth of progress on combating extreme poverty and child mortality across much of Africa, Asia, and Latin America. Countries must work together to take on these challenges, but no substantial progress can be made anywhere without a concerted effort to repair the rift between the global North and the global South. Rich countries do not only have a moral imperative to act. It is in their self-interest to do so, since in a globalized world, inequity anywhere undermines security and prosperity everywhere.

Acknowledging the pandemic-era breaches in trust is a good first step. But repair will take more than apologies or promises to do better next time. More tangibly, leaders in the global North must ensure that the aid they have already publicly pledged reaches its recipients in a timely fashion. Expanding the lending capacity of multilateral development banks would help: these institutions should prioritize giving grants and concessional finance to low- and middle-income countries where other types of capital are unlikely to be available.

The Summit for a New Global Financing Pact in Paris in June was an important step toward addressing low-income countries’ urgent need for financing. But it was never meant to be an endpoint. Its biggest contribution was to create a valuable space for leaders of low- and middle-income countries to assert their expectations. Beyond keeping their material promises to low-income countries, rich countries need to learn to treat lower-income countries’ leaders as true partners. At the Paris summit, Kenyan President William Ruto said African countries long to be perceived as a “part of the solution” for global problems, not a drag on solving them.

If rich countries shed their perceptions that low-income countries remain mere recipients of their charity, they would find strong allies with the expertise to help take on some of the most persistent health and climate challenges. One promising framework is the African Development Bank’s hybrid capital model, a new method of allowing countries to redirect their unused International Monetary Fund asset reserves toward a multilateral development bank, thereby multiplying the bank’s capacity to help struggling economies with their debts and to finance crucial development and sustainability projects.

This creative model emanates from an African-led institution and could set a compelling precedent for other development banks and policymakers worldwide. By emphasizing collaborations like these, the next time the world is threatened by a pandemic, more countries will be ready to respond and rebuild. That would not just benefit the global North or the global South—it would be a win for everyone.

[Foreign Affairs]

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• MARK SUZMAN is CEO of the Bill & Melinda Gates Foundation.