Geopolitics of Vaccines in a Multipolar World

A World-Systems Analysis of Dependency, Agency, and Health Sovereignty in Kenya

Abstract

This study employs Wallerstein’s world-systems theory to critically examine the structural inequities embedded within the global administration of vaccines. It argues that the political economy of immunisation, particularly in Kenya, reflects a Euro-American biomedical hegemony, reinforcing a core-periphery dynamic in which high-income countries control production, intellectual property, and regulatory standards while low- and middle-income nations remain dependent importers. Through a case study of Kenya’s immunisation program, we illustrates how this dependency is institutionalised via mechanisms such as TRIPS agreements, donor-driven funding from entities like Gavi and USAID, and the dominance of Northern NGOs in setting the global health agenda. However, the analysis also acknowledges the limitations of a rigid core-periphery model by highlighting the rising agency of semi-peripheral and peripheral states such as China, India, Cuba, and African Union initiatives like the Partnership for African Vaccine Manufacturing, which are developing scientific autonomy and challenging entrenched hierarchies. The COVID-19 pandemic is presented not as the origin of these disparities, but as a revelatory moment that exposed existing vulnerabilities while simultaneously accelerating shifts toward a more multipolar global health order. The study concludes by calling for research and policies that support vaccine justice and recognise the growing capacity of the periphery to resist biomedical hegemony.