Not all are equal when it comes to vaccination against Covid-19. Israel speeds ahead, followed by Britain and the USA, with other European countries bumbling along in their wake. Developing countries, or most of them, are a long way behind. This has provoked some harrumphing. “None of us are safe until we are all safe”, it is said. According to this idea the vaccine should be distributed in a world programme based on individual vulnerabilities. This gets general murmurs of approval from liberal types, or at any rate those are not in government. No wonder conservatives think liberals are soft in the head.
There are deeper philosophical and ethical questions behind this, but it would be useful to start with two facts which don’t seem to get mentioned in this context. The first is that vaccine manufacture is well behind the ambitious targets set earlier in the year. The headlines may be dominated by the massive scale of orders placed by the British government and others, but delivery is another matter. According to Tim Harford in the Financial Times some 800 million doses were promised in 2020. but only 20-30 million were actually delivered. There are no surplus stocks sitting around in national inventories while the needy are unvaccinated. The second fact is that death rates in the developed world, and Britain and the USA in particular, are very high. Britain’s is the highest in the world, we are told. In the developing world death rates are much lower. Some of this may be down to weaknesses in data gathering and government denial, of course. But mostly it is because their populations are much younger, on average, and so less vulnerable. And Britain and the USA both have an obesity problem. So if you are going to start with a worldwide vaccination programme, why wouldn’t you begin with the USA and Britain anyway? Is there really a worldwide injustice here?
Looking a bit deeper there is then the question of practicality. Collective efforts are often inefficient. In Europe the EU’s joint procurement is well behind that of newly separate Britain’s. A centrally organised world programme doesn’t bear thinking about. It’s bit like the lockdown sceptics’ idea that we should protect the vulnerable and let everybody else live their lives unrestricted (or restricted only by their own fear). At fist sight you might think it looks a good idea, but it doesn’t survive any closer inspection at all.
It’s worth a thought as to why this might be. One problem is accountability. The more complicated a project, and the more people involved, the more the need for accountability slows things down. And at the world level accountability has always been a problem. There is also the question of information. The further away you are from the sharp end, the poorer the quality and the less effective decisions tend to be. Committees and collaboration have their place; they even have heir place in worldwide vaccination programmes. But not in leading the emergency effort to get as many people vaccinated as fast as possible. here allowing national governments to act independently is going to get more shots into arms more quickly.
This leads to an important philosophical and ethical issue that liberals would do well to think about more deeply. How often do we hear pleas that needs of African peasants (we often focus on the rural poor and overlook ballooning urban poverty for some reason) should be just as much concern to us as the problems of our immediate neighbours? The fact that we neglect poor people in faraway places is regarded as a moral failure. And yet when rich people, or people in rich countries, try to help poor people far away, it so often ends badly. Aid ends up helping the wrong people, or distorting market and governance structures to their detriment, or simply comes over an example of patronising post-colonialism, reinforcing ethnic stereotypes. The exercise often seems to be guilt-tripping with little wider practical utility, beyond raising the status of certain NGO types. Of course the first premise of the liberal argument is sound enough: that all people on earth are morally equal. This is not a given, but there are all manner of reasons, moral, spiritual and pragmatic, why we should believe this. But this needs to be complemented by some form of proximity principle. It is quite right to be more concerned about those closer to us than those further away. It isn’t a moral failure. We can imagine a sort of hierarchy of family and close friends, neighbours, fellow countryman and so on. Such a hierarchy invites a whole series of problems, though. Western liberals, me included, agree that race or ethnic identity should play no part in it, of course, but this isn’t universally accepted (look at what is happening in China or India). Should Britons be more concerned about Latvians than Moroccans because of some form of European or Christian identity? And a lot of aid made by rich countries to faraway places is beneficial to humankind; I give to several charities and support the UK’s generous aid budget. It’s a bit of a nightmare, which is doubtless why many liberals try to short-circuit the discussion by denying any kind of proximity principle. But that doesn’t work either.
I am no moral philosopher,so I am not going to attempt an answer to these tricky questions. I rely on intuition. To me there is nothing wrong with countries focusing on vaccinating their own citizens as a top priority, even if richer countries end up getting ahead of the queue (which won’t be entirely the case anyway; India, for example, is the world’s leader in the manufacture of vaccines and is as nationalist in its priorities as anybody). That does not mean it is right to sabotage other countries’ efforts, or to hoard unused vaccine stocks. And once the urgencies of your own country have been dealt with, it is right to devote national resources to aiding other countries where the need is greater. I often disagree with the current British government’s moral priorities, but I think they have this one roughly right.