The politics of vaccines
Deidre Samson
There can rarely have been a greater clash between commercial self-interest and ethics than in the case of COVID-19 vaccines. Perhaps the debate it has engendered will contribute towards an accelerated shift in mindsets regarding doing what is right in the interests of the common good.
Considering our experience with the pandemic, as well as the potential for other globalised ‘shocks’, we may well need to learn from our experience and institutionalise our learnings to benefit from them in future.
The pandemic has demonstrated a number of positive shifts from what was and wasn’t possible in the past. The speed with which numerous vaccines have been developed is testimony to the power of human ingenuity, coupled with the power of advanced computing, only possible in the era of the Fourth Industrial Revolution.
It’s also a tribute to the co-operation between pharmaceutical companies, regulators and governments to fund research, accelerate development, rollout trials and fast-track market access. This co-operation, as well as the work of collaborative structures such as COVAX to enable a more equitable supply to the world’s poorest nations, have all contributed to new leading practice that can be replicated if need be going forward.
But no matter how much progress has been made, the reality is still that big pharma has protected its intellectual property at the cost of thousands of lives across the globe. Global access to vaccines is still horrendously out of balance with developed countries ordering far more vaccines than they need whilst poor countries wait at the back of the queue for supply. As the Guardian confirms, ‘Supplies are low after rich countries bought more vaccines than they needed to, leading to predictions that many low-income countries may not be able to reach mass immunization until 2024.’ (Ahmed, 2021).
South Africa and India have been at the forefront of the fight at the World Trade Organisation to allow countries to bypass intellectual property rights to boost local production and speed up vaccinations. There is also an inherent logic in an exponential increase in the supply of vaccines around the world. As is evidenced by the rapid global spread of the UK and South African variants, if one country still is unable to vaccinate its people, it raises the danger that a local variant morphs into another global contagion. The economics simply don’t hold up. Should a pharmaceutical company’s profits be more important than creating the preconditions for global economic recovery? Especially when that company’s vaccine success has largely been funded from the public purse, albeit the public of another country?
At least there is good news. Three recent developments have pointed towards new possibilities that may be game changers in pharmaceutical responses to a crisis. Africa is about to roll out vaccines to 35 low-income African countries, eligible for free vaccines from the COVAX facility, following the WHO listing of the AstraZeneca-Oxford vaccine for emergency use. But availability of the vaccine is only a part of the challenge. More work needs to be done to manage the logistics and supply chain, reach refugees and migrants and finance vaccination campaigns.
More good news is that University of Cape Town scientists are about to start the Phase 1 clinical trial of the hAd5 T-cell COVID-19 vaccine candidate this month after approval from the SA Health Products Regulatory Authority. Linda Grey, president of the South African Medical Research Council confirms ‘It is exciting for South Africa to partake in this innovative trial. This will be the first COVID-19 vaccine trial in South Africa, and one of only a handful globally, to test a candidate that targets the nucleocapsid as well as the spike protein.’ (UCT News, 2021)
What can also be considered as the cherry on the top of good news is the reality that South Africa is the first country in the world to roll out the Johnson & Johnson vaccine. Not only does it not require the low temperature freezers and can be stored in regular refrigeration, but it only requires a single dose (so, only half the medical infrastructure), it’s cheaper and it could be packaged in Port Elizabeth by the second quarter of 2021.
This opens up a range of possibilities. With the support of visionary pharma companies, sufficient funding and the leveraging of capabilities developed to combat COVID-19, could South Africa become the hub for vaccine research, development and production in Africa? Could we focus on development for the African context, crowdsourcing in expertise from around the world to supplement local expertise whilst simultaneously designing logistics and cold chain solutions as part of the process? Could we apply this expertise to perennial problems such as TB and malaria, finally ridding our continent of these scourges?
It would appear that we have much of the expertise, the facilities and will to succeed. Could the capability we have built for COVID-19 be the real lasting legacy that will benefit Africa for years to come?
- Deidre Samson is a futures consultant and new knowledge market executive at the Institute for Futures Research (IFR) at the University of Stellenbosch Business School.