These two sides of the effort are dangerously interconnected. The untrammeled spread of COVID-19 through large, vulnerable populations worldwide increases the risk that new variants will emerge and then roar through pockets of undervaccinated groups in the U.S. The harm done by a now-preventable disease throughout the world is a humanitarian crisis in its own right. But we are also creating an enormous risk. Every new variant carries with it the possibility of a devastating turn in the pandemic‚ a mutation that further weakens the efficacy of the vaccines, or that causes the disease to be more severe in children and young adults.

It is tempting to push such fears aside and to insist that we “learn to live with” the virus. But adapting to a world where COVID-19 is endemic should not mean complacency about the global inequities that are already stark and only getting starker. In the words of the International Monetary Fund, “The world is facing a worsening two-track recovery, driven by dramatic differences in vaccine availability, infection rates, and the ability to provide policy support.” As these gaps widen, success in managing the pandemic is starting to correlate more clearly (if still imperfectly) with national income. In the United States, more than 60 percent of the adult population is fully vaccinated. In Indonesia, that number is only 11 percent. In India, it’s 9 percent. In countries such as Vietnam, Tanzania, and Nigeria (as well as many others), it is still below 2 percent. This two-track recovery, where protection against the disease mirrors wealth and power, unfortunately reflects a historical pattern that is several centuries old. The world’s only hope lies in breaking it.