Politics and profits
WE will not be able to put the Covid19 pandemic behind us until the world’s population is mostly immune through vaccination or previous exposure to the disease.
A truly global vaccination campaign, however, would look very different from what we are seeing now. For example, as of January 20, many more people have been immunised in Israel (with a population less than 10 million) than in Africa and Latin America combined.
Notwithstanding recent questions about the effectiveness of the initial single dose of the vaccine, there is a clear disparity in vaccine rollouts internationally.
That is a problem. As long as there are still reservoirs of a propagating virus, it will be able to spread again to populations that either cannot or will not vaccinate. It will also be able to mutate to variants that may be more transmissible or more deadly.
Counterintuitively, an increase in transmissibility, such as has been found with the new UK variant, is worse than the same percentage increase in mortality rate. This is because increased transmissibility increases the number of cases (and hence deaths) exponentially, while an increase in mortality rates increases only deaths, and only linearly.
Evolutionary pressure on the virus will inevitably favour mutations that make the disease more transmissible, or the virus itself more vaccineresistant. It is clear, therefore, that every nation’s interest is in universal vaccination. But this is not the trajectory we are on.
Fortunately, in the countries already vaccinating, the vaccine is (mostly) not allocated by wealth or power, but by prioritising those facing the highest risk. At a country level, however, national wealth is determining vaccine rollout.
Yet in the past we have managed to eradicate diseases worldwide, including smallpox, a viral infection with much higher death rates than Covid19.
Two barriers prevent us from rapidly pursuing a similar goal for the current pandemic: big pharma is profitdriven and therefore keeps a tight lid on the intellectual property it is developing in the new vaccines; countries find it difficult to see beyond their national interest. Not surprisingly, politicians are committed only to their own voters.
We don’t have a global system to confront either of these problems. Each vaccine’s patent is owned by its developer, and the World Health Organisation is too weak to be the world’s Ministry of Health.