Photo: Prime Minister Mia Mottley of Barbados / PAHO
Read the latest report by Ivelaw Griffith, a Global Americans Fellow, on Vaccination and Vaccine Diplomacy in the Caribbean.
The current pace [of vaccine access and inoculation] will take us a while to reach the herd immunity required to return our economies to productive levels or minimize the emergence of variants.
– Dr. Joy St. John, Executive Director, Caribbean Public Health Agency
Stop listening to Anancy stories. Stop listening to people who are less informed, less educated than yourselves … and false narratives about the vaccines. There are some deep-seated fears and emotions and even religious and ideological views on vaccines … but that argument bears little value in the context of how medicine and science have combined with faith to heal the world.
– Edmund Bartlett, Tourism Minister of Jamaica
The Caribbean and the rest of the world continue to battle COVID-19, the modern-day plague. The scientific, public health, and policy communities within various countries and around the world have marshaled a variety of weapons to counter the pandemic. In addition to critical medical and healthcare staff, these include hand sanitizers, testing kits, oxygen, personal protective equipment (PPE) such as face masks and shields, and ventilators, among other equipment. As the pandemic raged in 2020 and 2021, officials placed a considerable premium on developing vaccines to control, if not prevent, infections and fatalities. Indeed, some scholars posit that “vaccination against diseases, including preventable, contagious, and life-threatening illnesses, is the best public health intervention after water sanitation.” (Ortiz-Prado et al, 2021). Vaccinations have become the central focus in our campaign against COVID-19.
Yet, notwithstanding the growing scholarly literature about the pandemic in the Caribbean (see Byron et al., 2020; Chattu and Chami, 2020; and Blazy et al, 2021; for example), few have specifically studied vaccination in the Caribbean. This study, which is a follow-up to an earlier one (Griffith, 2021), aims to help fill this gap. It does so first by offering an appreciation of the various vaccines being employed, and then examining the role of the World Health Organization (WHO), the Pan American Health Organization (PAHO), and other state and non-state actors involved in global health. The report then focuses on the Caribbean region, with a view to understanding some of the vaccine diplomacy dynamics, notably in relation to the great powers and their combination of humanitarian and geopolitical motives. Cuba warrants—and receives—special attention as a small state that has been punching above its weight in the global vaccine diplomacy arena.
The global vaccination campaign and vaccine diplomacy discussed here fall under the rubric of health geopolitics. Unlike with conventional geopolitics, in health geopolitics nation-states are not the only consequential actors; the range of critical actors is expanded to include non-state actors, such as pharmaceutical companies and multilateral organizations, such as the WHO and PAHO. As Suerie Moon, Research Director and Co-Chair of the Forum on Global Governance for Health at the Harvard Global Health Institute, writes: “Europe, developing countries, the WHO, and the pharmaceutical industry are also key players in this complex, multilevel game. Normative authority, reputation, and scientific knowledge have become strategic sources of power” (2020).
The vaccination campaign is full of challenges, not just in scientific production, given the rapid emergence of COVID-19 variants, but also in terms of access, equity, and acceptance. The head of the Caribbean Public Health Agency (CARPHA) and Jamaica’s tourism minister are candid in highlighting elements of the complexities and some of the challenges in the epigraph. This report addresses these challenges, probing some of the institutional factors that militate against effective public health service delivery in general and vaccine delivery in particular, and the multifaceted problem of vaccine hesitancy. However, before we begin the vaccination factor journey, it is useful to remind ourselves of the nature of the region’s pandemic profile.
Ivelaw Griffith is a Fellow with Global Americans and the Caribbean Policy Consortium who has published extensively on Caribbean security, drugs, and crime. His next book, Challenged Sovereignty, will be published by the University of Illinois Press.
Note from the author: I am grateful for the valuable comments on the first draft by Scott MacDonald, Francille Griffith, and Volderine Hackett.