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An Economist Best Book of 2025
"Fair Doses is an unflinching insider account of how science, politics, and human nature collided in the battle to vaccinate the world." —Atul Gawande, surgeon and author of Being Mortal
How vaccines became the world's most powerful and widely distributed health intervention, and the inside story of the challenging race to deliver COVID-19 vaccines globally.
Fair Doses is a story of vaccines: how they came about, why they are important, and how they have been made globally available—although our quest for vaccine equity is still ongoing. In this fascinating deep dive into vaccines, Dr. Seth Berkley, an internationally recognized infectious disease epidemiologist and public health leader, offers an inside view of the challenges of developing and disseminating vaccines for a broad swath of illnesses, from Ebola to AIDS to malaria and beyond.
COVID-19 was a lesson about the devastation a novel virus can bring on our world. When the first signs of this new infection appeared, Dr. Berkley co-created COVAX, a global initiative aimed at ensuring equitable vaccine distribution. The COVAX team had to navigate vaccine nationalism, vaccine diplomacy, intentional disinformation, political forces, and the conflicting incentives of vaccine companies in its race against the virus. In record time, the group organized 193 countries, raised more than $12 billion, built the world's largest portfolio of COVID-19 vaccines, and delivered two billion doses to 146 countries.
Future pandemics are an evolutionary inevitability, and future global response needs to be much faster and more equitable. Drawing from his personal experience, Dr. Berkley lays out a bold vision of preparedness that will help the global community take advantage of rapid advancements in science to make our world safer from infectious diseases.
"A fascinating account of the race to distribute the [COVID-19 vaccine] around the world."
— Nature
"Berkley argues with lucidity that equitable vaccine access is a moral imperative and an epidemiological necessity, and that failure to achieve it prolongs a pandemic. . . . Berkley’s narrative is both illuminating about this history and serves as a wake-up call about the predictability and scale of the threat ahead.”
— Lancet
"A vital, occasionally provocative read from one of global health’s most influential figures."
— LinkedIn Newsletter: The Public Health Diplomat
"Fair Doses shows how the world’s leadership engaged with COVID-19, warts and all. The values, the wheeling and dealing that saved lives, and the decisions that shortened the pandemic are all here. The book is also a sharp warning that we are less ready now to confront a pandemic than we were when COVID-19 entered our lives."
— Science
"The story of vaccines, as told by an infectious disease epidemiologist. During the covid-19 pandemic, Seth Berkley fought against political resistance and nationalism to help distribute 2bn vaccines across the world."
— The Economist
“Seth Berkley led the effort to bring Covid vaccines to the world during the worst pandemic in a century. . . . In his book, Berkley says he aims to set the record straight — and explain who stood in the way and who helped.”
— Politico
"Part memoir, part wider history, and written in a style reflecting the urgency of the time. The author, as head of an organisation that has vaccinated more than half the world's children, saving some 14 million lives, is well placed to tell the tale. . . . The author's passion for vaccine equity is clear, and he gives a compelling account of all the factors at play that ensured poorer countries were last in line when it came to an all-out scramble for life-saving medicines in the midst of pandemic panic."
— The Irish Times
"Candid and realistic."
— Health Affairs
Preface
Timeline for COVID-19 and COVAX Response
Introduction
1. Why Vaccines?
2. The Vaccine Equity Challenge
3. Forging a Career in Vaccines and Global Health
4. Working on the Most Difficult Vaccine
5. Gavi, the Best-Kept Secret in Global Health
6. Launching COVAX
7. Planning for COVAX Global Distribution
8. The Ups and Downs of Vaccine Delivery
9. Financing and Supporting COVAX Delivery
10. Sharing COVID-19 Vaccine Doses
11. Winding Down COVAX While Building Up
12. Lessons Learned for the Inevitable Next Time
Epilogue: Back to Uganda
Acknowledgments
Notes
Bibliographic Overview and Selected Readings
Index