COVID-19 patients in American hospitals has surpassed 100,000 for the first time as supply networks will be attacked by gangsters hijacking supplies, and there will inevitably be the problems of guaranteed purity and authenticity. Distribution will get compromised and regulation will be stressed.
CNN: The United States reported at least 2,658 coronavirus deaths on Wednesday, the highest number of new deaths in a single day since the pandemic began.
The coronavirus pandemic has inspired a great deal of scientific research into developing a COVID-19 vaccine. Developing a vaccine is one thing, but making it widely available is another issue—one that involves thorny questions of ethics, intellectual property rights, global trade and recouping research costs.
— INTERPOL (@INTERPOL_HQ) December 2, 2020
As COVID-19 has revealed, even some of the wealthiest countries in the world were totally unprepared to deal with a pandemic. One prominent issue has been national shortages of vital medical products and technologies, coupled in many countries with a lack of domestic production capacity. Dependent on global supply chains at a time of unprecedented demand, governments have tried to persuade (or even require) domestic manufacturers to increase production or to begin manufacturing everything from medical ventilators right down to disposable gloves and gowns, with mixed results. At the same time, many producing countries have imposed export restrictions to prevent domestically-manufactured products being sold abroad.
Vaccine development has long been characterised by profound market failure (or, more accurately, the failures that happen when markets behave as we would expect). Amongst other things, reliance on the market has resulted in vaccine development for emerging and re-emerging infectious diseases (ERIDs) not being prioritised.
One reason is the high costs involved in the development of new vaccines, with estimates of the cost of a single vaccine being up to $1.1 billion once the costs of unsuccessful R&D efforts is factored in. Pharmaceutical companies can generate a much greater return on investments by focussing on other markets.
A second problem is perhaps even more acute: the problem of ‘missing markets’. Most ERIDS primarily afflict lower income countries, whose governments and populations are simply too poor to provide the ‘effective demand’ that would make it economically rational for pharmaceutical companies to focus on diseases such as Lassa fever, Nipah virus, Chikungunya or – until recently – Ebola virus. COVID-19 is relatively unusual for an ERID in having had a major impact on rich countries too. But even so, there will be enormous political pressure for a vaccine to be patent free, and some countries may impose compulsory licensing. Significant profits are certainly not guaranteed.
Third, vaccine production (even more so than other pharma markets) is dominated by an oligopoly of four firms: GSK, Sanofi, Merck and Pfizer. These firms sit atop a pyramid of smaller public and private research enterprises, including universities and small biotech firms. Although there has been a gradual growth of smaller producers around the world, these four are the only forms with the real capacity to bring new vaccines to market and produce them at huge scale. This commercial dominance has had significant downstream effects on who is researching what, and where.
Finally, for new diseases like COVID-19, we cannot by definition have a vaccine ready in advance. The race to rapidly create one requires the rapid and open sharing of information and data, the command of platform technologies and production facilities, and the type of coordination that market competition between firms does not engender.
The question is whether nation states, politicians, science, business, and the public at large can organize themselves in such a way as to deliver a high-quality vaccine at affordable prices to all of the world’s 7.8 billion inhabitants.
constructing and distributing a vaccine may solve a set of political and economic problems while also creating a set of new ones. We imagined that an effective inoculation would be a cause of celebration. It may turn out to be a symbol of global injustice and a trigger for grievance across the world.
The powerful actors in this drama are the nation states and their publics, and Big Pharma. The global public health regime is a thin film. The WHO has a budget smaller than that of a single large hospital, one sixth that of the public health department of the U.S. state of Maryland. Under pressure, the result is something close to anarchy. This, you might say, is the norm in international relations. But, as constructivists scholars of IR remind us, anarchy is what we make of it. The question is whether nation states, politicians, science, business, and the public at large can organize themselves in such a way as to deliver a high-quality vaccine at affordable prices to all of the world’s 7.8 billion inhabitants.
It is a matter of urgent practical necessity. It is a question of legitimacy—of international and domestic order. It is also a decisive question for the future.
COVID-19 is bad. But it is not, after all, the proverbial “big one”—other, far more lethal, diseases are easily imaginable. We are certain to face more such global challenges, not just in public health but in climate policy as well. Our era, now widely described as the Anthropocene, is one in which we must reckon with the blowback from our comprehensive and destabilizing transformation of the natural environment. This blowback may come in the form of forest fires, parched summers of extreme heat and drought, the battering of mega hurricanes, or, as we have now experienced, the accelerated mutation of zoonotic (ie: non-human to human) viruses. We will need to rearrange the way we live, work, play, travel, feed, and house ourselves.
— Adam Tooze (@adam_tooze) September 20, 2020
Then there’s just the usual racist idiots:
— philip lewis (@Phil_Lewis_) December 3, 2020
“You’re not mopping fast enough. (Laughter) That’s a socialist mop. (Laughter and applause) Grab a mop — let’s get to work.” – Barack Obama (2009); “Soyez réalistes, demandez l’impossible!”