A person in Soweto, South Africa receives an injection as they participate in a clinical trial for a Covid-19 vaccine in June 2020.  © 2020 Siphiwe Sibeko/AFP via Getty Images

Today marks World Health Day with the World Health Organization (WHO) calling for increased government investment and cooperation to tackle global health inequities. Government policy and practice primarily determine the equity or otherwise of health outcomes both within and between countries. But the actions of pharmaceutical companies also have a huge impact on whether people have access to affordable life-saving health care.

Structural weaknesses in countries’ healthcare and social safety nets contribute to massive disparities in access to lifesaving support.

To chart an equitable exit from the Covid-19 pandemic, governments should ensure universal and affordable vaccine access or they risk further entrenching inequality and eroding human rights. Vaccine roll-out has so far largely mirrored the inequities that marked the rest of the pandemic: rich governments made opaque deals and prebooked the vast majority of scarce vaccine supplies, while also opposing efforts to temporarily waive complex global trade rules that could give us the best chance of universal and affordable vaccine access for all. This has increased the risk that the pandemic — as well as the inequality and rights abuses that have flourished — will continue in many countries for years to come.

Responding to the pandemic — via social distancing, quarantines, and business closures — has had an enormous economic impact. Low-income workers, who are often unable to work remotely, were disproportionately affected. Economic support during the pandemic has helped, but many people in need were left out. And government reliance on poorly designed or neglected technological infrastructure to distribute benefits has delayed and denied access to support while causing privacy problems.

Health care workers faced serious health and safety risks. Older people, people with disabilities, and women shouldered extraordinary burdens due to neglectful and discriminatory policy decisions. Schools around the world closed, shutting out an estimated 1.4 billion students, who may fall behind with some maybe never returning to education.

Health as a human right — enshrined in the WHO charter — means Covid-19 vaccines should be available to everyone. It means water and sanitation for everyone, social protection for everyone, and health care for everyone.

Covid-19 vaccine developments have shown that science can create technologies to save lives at a miraculous pace. Now it’s time to ensure everyone benefits — to end this pandemic and protect the right to health more broadly.

Equity is not a miracle, but fundamental for protecting rights.