Vaccines and the common good

KEVIN HARGADEN :: Even for a pessimist like myself, it feels like we are on the home straight out of the pandemic. This morning alone (Thursday, May 6th) we had the first doses of the J&J vaccine in Ireland », the European Commission passed 150 million vaccinations », we have solid data that suggests the existing variants are not resistant to our vaccines », and it looks like the Olympics can take place because Pfizer are going to vaccinate all the competitors ».

But perhaps best of all – potentially historic – the American government appears to have thrown its weight behind a waiver (temporarily) of the intellectual property rights of the vaccines developed in the USA ». Shares in Moderna, Pfizer, and Novavax dipped at this news, reminding us that Mammon does not factor avoidable human fatalities as a positive. Those firms will simply have to be consoled with their massive profits, the promise of further massive profits, and the morale and PR gains that will come from having played their part in defeating this crisis.

There are still lots of obstacles to be overcome – America is clearly a superpower but it needs the support of other nations, including Ireland and our EU partners. And the waiver simply sets in motion an enormous technological and logistical effort as complex manufacturing and delivery systems will need to be established.

Considering the current roll-out of vaccines across the world shows us why this would matter. An initiative called COVAX », led by the Bill and Melinda Gates Foundation (partnering with the WHO and many others), has been at the forefront of the efforts to improve the access to vaccines for those in the developing nations – which suggest about five of every six vaccines have thus far gone to the developed world. COVAX was established to ensure vaccines got to every country on the planet. It functions as a sort of investment pooling system, allowing developing nations to access donations of surplus vaccines or to tap into seed funding to initiate vaccine orders. But it is important to note how it does not function. It is not a concerted, coherent attempt to vaccinate the globe. Indeed, its ultimate ambition is only to provide coverage for 20% of developing populations. This means it does not meaningfully aim at reducing the risk of variants and hastening the true end of the pandemic. Neither is it intended to develop capacity for vaccine production in the developing world, nevermind catalyse the infrastructure, logistical capabilities, or diagnostic and research functions that are so sorely needed.

While every effort is to be welcomed, it is hard not to recognise a familiar pattern here. COVAX looks increasingly like a return to the old, failed aid systems that the West has used to patronise the South. Because it is susceptible to vaccine hoarding and because it does not liberate vaccine production, COVAX’s efficacy has been limited. It has managed to deliver just 53 million doses thus far ». There’s a long way to go to vaccinate the billion or so people in the developing world they hope to help!

We should not be surprised that this program lacks a fully humanistic ambition when we remember the role that is played by philanthropy. While firmly wishing to bypass any attack on the individuals involved, especially at a difficult time in their personal lives – and even more fiercely wanting to resist any spurious support to preposterous conspiracy theories that might be found on the murkier pages of the internet – it is important to think critically about the Gates Foundation.

On the surface, it is positively a good thing that rich people give their money away. Indeed, I have written a complex book that argues that »! But there are political, ethical, and even pragmatic reasons to be sceptical about the effect of such giving. As Linsey McGoey demonstrates in her examination of modern mega-philanthropists, No Such Thing as a Free Gift », philanthropy on such a massive scale has distorting effects on whatever democracy hosts it. One example of the many she gives is the early interest of the Gates Foundation in American education. A direct consequence of all that giving has been a generational shift in US education policy towards standardised testing, charter schools, and inventivised pay-schemes for teachers. This has not transformed outcomes, except perhaps for already advantaged children. Allowing a person to re-shape an entire nation’s educational system – the New York Times suggested once that Gates had more power than the Secretary of Education – because they are wealthy (Gates has no training in pedagogy and was never a teacher or school administrator after all!) cuts at the very foundations of what a republic is meant to be.

In recent years, Bill and Melinda Gates – neither of whom has any training in public health – have turned their attention to global medicine and COVAX is a part of that initiative. Just as with education, the passions – some would say blindspots – of these individuals are on display as the creation of metrics and the collation of measurements is a technique so central to the endeavour that it becomes almost a philosophy. What can be measured becomes what matters. As people who got rich from spreadsheets, this makes sense psychologically. But as a response to a pandemic, it falls short. Just as we would all be much better off if we taxed the very rich instead of allowing them to funnel their surplus cash into pet projects, we would be better off by far if we recognised that overcoming the pandemic is an opportunity to accelerate the development of systems, cultures, and capacities in the developing world that would have knock-on benefits too great to every capture in a database. The release of the patents does not establish such an all-embracing vision, but it is a necessary step.

Fundamentally, COVAX, as one might expect for a program funded by the Gates Foundation, promises equity and access but which actually supports a continuation of market profitability for the large corporations and vaccine supremacy for the large nations.

Since it broke the record for the highest number of new cases ever recorded in a single day on April 24, India has broken that record six more times. The curve of the seven-day average is firmly on the rise, indicating that things will get much worse before they improve. India is a nation with vast capacities for pharmaceutical production. They even have their own vaccine ». But they have been stymied in their own roll-out because they have had to negotiate licenses, vaccine nationalism means they cannot access raw materials, and the prevalent market culture, shaped in part by COVAX, has meant that many of their doses have been exported for commercial deals. What is unfolding in India is a humanitarian crisis. It will not be the last one we see as a result of Covid-19.
Joe Biden’s decision will be a political masterstroke. It is likely to be very popular with the American electorate » and it is the kind of action one would expect from a nation that prides itself on being the leader of the democratic world. This should prompt three important points for reflection:

When we consider the role of democratically unaccountable bodies like the Gates Foundation in sustaining the restrictive concerns with intellectual property rights when it comes to vaccines », we might ask whether these billionaires would be serving the common good better by paying taxes instead of donating to pet causes and manipulating critical global policies?

The drug companies that are so jealously guarding their “intellectual property” acquired these assets because of research conducted in publicly-funded universities. Perhaps the pandemic is the appropriate time to start a new culture of state-directed, common good research in pharma? We have seen what scientists can do when given resources. Why not keep giving them resources? »

Finally, and most importantly, we should ask ourselves why Ireland is lagging on this issue. Simon Coveney has suggested that he is open to some patent flexibility ». But for a nation that prides itself on its global perspective, should we not be standing in solidarity with the 100-plus developing nations that are calling for this waiver?

Relying on market competition to get us out of a pandemic is a kind of insane religious fundamentalism. Market competition is an excellent way to distribute televisions and breakfast cereals, but as the crematoriums of India struggle with the vast numbers of corpses being delivered, the idea of protecting patents at the continued cost of human life is sacrilegious. President Biden has made a first step which is fully in line with Catholic Social Teaching commitments on the common good. There are many more steps to follow, but for that very reason Ireland should be rushing to join the USA, India and South Africa, along with Kenya, Eswatini, Mozambique, Pakistan, Bolivia, Venezuela, Mongolia, Zimbabwe, Egypt, and scores of other nations in backing this waiver.