Canada is winning the vaccine lottery. Other countries aren't so lucky.

Canadians are very lucky. Just a few months after the vaccination campaign was assailed by politicians and pundits as a disaster, this country of 38 million people had received 23 million doses of a COVID-19 vaccine as of Thursday morning. Millions more doses are expected in the coming weeks.

Canada caught up to the United States this week in terms of the share of the population that has received a first dose. In terms of total doses administered per capita, Canada ranks third in the G20 and seventh among the 37 OECD countries.

According to a tally posted this week by Blake Shaffer, an economist at the University of Calgary, Canada ranked 13th among the 151 countries in the world with more than a million people in terms of doses administered.

Canadians can feel good about their luck. But any celebrations should be tempered by the knowledge that not everyone is so fortunate — and the fact that COVID-19 will remain a threat as long as it's circulating anywhere.

"Just because you're born somewhere in a country that has fewer resources doesn't mean that you shouldn't have access to life-saving treatments," International Development Minister Karina Gould said in an interview that will air Sunday morning on the CBC's Rosemary Barton Live.

The Liberals are going to have to live up to those words. And now that there are fewer countries ahead of Canada in the race for vaccines, it might be easier for Canadians to see how many countries have always been behind us.

Vaccine anxiety in early 2021

The panic of a few months ago was not entirely unwarranted. Even if an every-country-for-itself scramble is a terrible way to vaccinate the world's population against a global threat, Canadians could be forgiven for wanting their government to perform respectably in an unseemly competition.

But the most catastrophic forecasts were obviously premature and the metrics for measuring success needed to be properly calibrated. There was never much sense, for instance, in comparing Canada to places like the Seychelles, a country of 100,000 people that used a Chinese vaccine that is not approved for use here.

It's also fair to ask whether the federal government should have done some things differently to ensure a faster or more plentiful supply — though there's still no widespread agreement on what those things could have been.

But the experience of these last six months showed Canadians how fickle global vaccination can be. Some countries — like the United States, the United Kingdom and Israel — enjoyed advantages that were not easily replicated. Canada's supply was briefly impaired because a factory in Belgium was shut down for retooling.

Underneath the panic was an unacknowledged question: Why should the average Canadian be more entitled to a vaccine than the average citizen of any other country on Earth?

Wealth has its privileges

"I think it's a time for Canadians to be feeling grateful and understanding the privilege that we hold as one of the wealthier nations," said Ananya Tina Banerjee, a professor in the department of epidemiology, biostatistics and occupational health at McGill University.

Banerjee — who has family in India, the current global epicentre of the pandemic — tweeted this week that immunization should not be framed as a "vaccine Olympics" between Canada and the United States.

When vaccine distribution is measured on a continental basis, the disparities become glaring. In North America, 56.4 doses have been administered per 100 people, according to tracking by Our World In Data. Europe is second with 41.4 doses.

For South America, the rate falls to 23.3 doses. In Asia, it's 17.6 doses. In Africa, just 1.97 doses have been administered per 100 people.

Measured by wealth, high-income countries have administered 52.3 doses per 100 people, while low-income countries have administered 0.64.

Robyn Christine Waite, director of policy and advocacy for Results Canada, said this sort of inequity is not unique to COVID-19.

"There have long been deadly divides [between higher and lower income countries] in health outcomes and access to services such as the tools needed to control and treat disease," Waite said. "The one thing I will say is that the pandemic has definitely shone a massive light on the inequities."

In the case of HIV and AIDS, for instance, antiretroviral drugs came to Africa long after such treatments had been available in North America and Europe.

Enlightened self-interest

Waite suggested that COVID-19 could be "pushed to the corners of the world" eventually and forgotten about in wealthy countries, becoming a "neglected disease of poverty" like AIDS, malaria or tuberculosis.

Mitchell Hammond, a history professor at the University of Victoria, said earlier outbreaks of diseases like smallpox and polio provide examples of what we would now call "vaccine diplomacy" by the United States and former Soviet Union. At the moment, the immediate and ongoing crises within their own borders has made it harder for some countries to assist others, though China has emerged a significant exporter of vaccines.

But Hammond identified two distinctions that might motivate wealthy nations to do even more now: the interconnectedness of the modern world and the fact that COVID-19 has shown an ability to produce new and more dangerous variants.

Beyond the obvious moral argument, this is an argument for self-interest. Until COVID-19 is eliminated everywhere, it threatens everyone.

Canada contributed $440 million to COVAX (a program that allows high-income countries to purchase vaccines for themselves and lower-income countries) and $1.3 billion to the G20's Access to COVID-19 Tools (ACT) Accelerator, which distributes vaccines as well as other supplies.

Wealthy countries, including Canada, are also under pressure to waive intellectual property rights to vaccines and assist in the transfer of technology.

Canadians themselves already have benefited from vaccine-sharing. In March, the United States agreed to lend Canada 1.5 million doses of AstraZeneca's vaccine. Before that, Canada accepted some of its allotted doses from COVAX.

In an ideal world, the global vaccination effort might have been coordinated through a program like COVAX. Countries like Canada that pursued their own deals with pharmaceutical companies have been accused of undermining COVAX. 

The Trudeau government has promised to share Canada's excess doses and Gould told Rosemary Barton Live that there might be more to say about that "fairly soon."

As Waite suggests, Canada could now defer or forgo the rest of its COVAX allotment. To date, Canada has received approximately 900,000 doses of the AstraZeneca vaccine through COVAX. That would leave another million doses due to arrive in the weeks ahead.

"[Procurement Minister] Anita Anand should make that happen ASAP," Waite said.

With the country now enjoying the good fortune of a solid supply of vaccines, Canadians should be prepared to help the rest of the world catch up.