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The coronavirus vaccine rollout has unveiled deep-rooted inequities on a global scale. According to an analysis published in The Lancet earlier this year, high-income economies with around 16% of the world’s population have secured over 70% of doses of the five major coronavirus vaccines for 2021.

But rich countries’ hoarding is not the only problem hampering vaccine distribution and equity. Vaccine corruption in the Global South is further fueling vaccine inequity, deepening the international health crisis.

Previously, corruption has been linked with adverse health outcomes, although robust evidence is scarce. A 64-country analysis published in the Journal of Economics and Finance suggests that corruption diverts funds from much-needed investment in essential public services, including health care. An econometric analysis of data from 80 municipalities in the Philippines reveals that corruption has a strong negative correlation with immunization rates and a positive correlation with vaccination delay in newborns. Likewise, a multicountry analysis from Africa hypothesizes a link between corruption and delay in the introduction of new vaccines.

A wave of vaccine corruption scandals have shaken the global COVID-19 vaccine rollout. In numerous low- and middle-income countries, politicians and high-ranking officials have abused their power to cut the vaccine queue. For instance, the Peruvian political elite received the jab months ahead of the national vaccine rollout.

Moreover, politicians are reportedly offering vaccine bribes to lure people into voting for them. In Lebanon, political leaders have arranged private vaccine drives for their constituents, allegedly to help get elected.

Reports of vaccine smuggling have also surfaced. The Philippine President’s security aides were inoculated with smuggled coronavirus vaccines, confirmed the country’s defense secretary, calling it “justified.”

Furthermore, there have been reported cases of vaccine theft by people in positions of responsibility. In Indonesia, a prison doctor and three others were charged for stealing more than 1,000 vaccine doses meant for prison inmates and selling them for about $17 each.

Such corruption creates a conducive environment for black market activity. Earlier this year, Kaspersky reported Pfizer-BioNTech, Moderna, and Oxford-AstraZeneca vaccines being sold on the dark web, with prices ranging from $250 to $1,200 per dose. Mexican police in April uncovered a clinic that gave 80 people shots containing distilled water for $1,000 each. Alarmingly, fake vaccination certificates are also for sale. In Zimbabwe, a nurse colluded with a pest controller to sell them for $25 to $50 each.

These despicable practices can be crippling to the global health effort and contribute to the vaccine divide. Such corruption breaches WHO protocols developed to ensure those who need vaccines most get them first.

It also undermines confidence in public institutions. Mistrust in institutions may translate into vaccine hesitancy and a decrease in vaccination coverage, further widening the vaccine gap. Moreover, rising demand for fake vaccination certificates and illegally acquired shots can trigger a vicious cycle of vaccine inequity and corruption.

Perhaps even more worryingly, individuals partaking in vaccine corruption can serve as virus carriers. This may have detrimental consequences for efforts to stem virus spread, especially with regions like the European Union planning to normalize cross-border travel using vaccine passports.

Global partnership is critical to uprooting this corruption. At the same time, local governments, businesses, and whistleblowers can work together to crack down on black markets.

All levels of government should actively work on strengthening oversight and accountability processes. They should also consider employing vaccine tracking and certificate authentication systems using QR codes and blockchains. In addition, they should develop public campaigns to raise awareness around the issue and the legal consequences of corruption.

Equitable vaccine access is paramount to successfully contain the pandemic. To quote the poet-philosopher Allama Sir Muhammad Iqbal, “Unity of thought without unity of action is imperfect.”

Muhammad Jawad Noon is a medical doctor working as a research fellow in economics at Georg August University of Goettingen. He was a recipient of the German Medical Award in 2020.