The rapid development of safe and effective COVID19 vaccines has been an unprecedented scientific achievement and offers a promise for a healthy postpandemic future. However, inequitable vaccine access has jeopardised that vision, and our global governance institutions have failed to anticipate, prevent, or redress this inequality. As of March 21, 2021, 78% of 447 million deployed doses of COVID19 vaccines were in only ten countries.1,2 Nearly a quarter of the world’s population might not have access to these vaccines before 2022.