While rich countries are doling out booster shots of the COVID-19 vaccine, many poor countries have vaccinated less than five percent of their population. And, while many leaders agree that vaccinating the world is the only way out of the pandemic, vaccines are still not moving around the globe in a rapid and equitable manner.

This is because “we live in a hierarchy of health,” says Priti Krishtel, a health justice lawyer and cofounder of I-MAK, a nonprofit focused on building a more just and equitable medicines system.

On the latest episode of The Dose, Krishtel argues that unequal access to vaccines is rooted in a long-standing system of incentives that governs drug development and allocation. She says rethinking the drug patent regime and other incentives — and working together to ensure every country gets a fair allocation of vaccines — is the way to end this and future pandemics.