How to check "Save the World" on your bucket list?
Welcome to the Planet Republyk project!
I strongly recommend that you read Chapter 0 before this one, if you haven't already, so that you know exactly what you are dealing with.
As for the future, it's not about predicting it, but about making it possible.
Antoine de Saint Exupery
On Sunday, March 15, 2020, the German daily Die Welt revealed[i] that the U.S. administration had attempted, with lavish offers to the German company CureVac, to obtain exclusive rights to a promising vaccine against the coronavirus disease (COVID-19) (SARS-Covid 2) that its researchers were trying to develop. The Trump administration made no secret of its goal: to distribute it only, or at least primarily, in the United States. Fortunately, Berlin objected and so did the company. Five days earlier, the World Health Organization (WHO) had declared that the COVID-19 epidemic had reached the stage of a pandemic.
During this pandemic, international organizations such as the WHO[ii], the United Nations (UN)[iii], the World Bank, the International Monetary Fund (IMF)[iv] and the International Labor Organization (ILO)[v], to name but a few, deplored the slow reaction of nations to the crisis, but above all, the lack of international cohesion[vi] in the health and economic response. Unfortunately, all this contributed to the magnitude of the hecatomb and to the economic debacle that followed the rapid spread of COVID-19.
States were simply not ready. Mainly because this type of threat does not specifically concern them. In democracies, there is no political gain to be made by the parties in power by devoting significant resources to this kind of hypothetical issue when other, much more concrete, current issues are likely to tip the balance in the next election, depending on whether or not they are addressed. Governments therefore have other priorities. Priorities that rarely go beyond the horizon of the next election. Humanity has collectively paid a high price for this short-sightedness.
A sovereign entity, with free rein, with the power to intervene, legislate and coerce, across the globe and with substantial budgets, should make these hypothetical global threats its priority. The SARS-Covid 2 crisis has eloquently demonstrated, if we needed further proof, that the UN and one of its organs in particular, the World Health Organization, are not such entities. Rather, they have become, as Le Monde titled a series of articles on the subject in April 2020, the "symbol of the world's disorder"[vii].
If an international team of specialists, equipped with state-of-the-art equipment and substantial resources, under unified leadership not accountable to any state, foundation or private creditor[viii] that would place it in a conflict of interest, had been put into action from the beginning, in Wuhan, China, the epidemic would never have left that area.
And when the pandemic was declared a few weeks later, the law of the jungle that prevailed between states in the race for masks and other medical equipment (while nations such as France, Italy, Israel, Canada and Sweden had equipment stolen[ix] by other countries at the very door of the warehouses or directly on the tarmac of Chinese airports) could only accentuate the crisis.
I am a patriot of humanity. I am a citizen of the world.
Charlie Chaplin
These national egoisms continued, in the last months of 2020, to the detriment of any morality or even economic logic, when a few rich countries representing only 14% of the world's population guaranteed themselves delivery of 53% of the first doses of the nine major experimental vaccines[x].
Some of these states even secured delivery of enough doses from different manufacturers that they could have vaccinated their population five times over[xi]. All of the 2021 production of the Moderna vaccine and 96% of the Pfizer/BioNTech vaccine was purchased by these few wealthy countries.[xii]
By mid-February 2021, in a joint statement, WHO and UNICEF estimated that of the 128 million doses of vaccine administered to date, more than three-quarters had been administered in a dozen rich countries, and that in 130 countries, representing 2.5 billion people, not a single dose had been administered.[xiii]
By advocating what has been termed vaccine nationalism, the richest states were ensuring the protection of segments of their populations at low risk of developing severe complications, while in many other less affluent peoples the most vulnerable continued to die en masse. It would have been much wiser, from many points of view, to vaccinate as a priority the 20% of the world's population[xiv] most at risk, i.e. the elderly and/or those with a high rate of co-morbidity, as well as health care professionals[xv].
Anticipating this situation, some international NGOs and the WHO set up an international pooling mechanism in June 2020[xvi]. Covax (COVID-19 Vaccines Global Access Facility) aimed to accelerate the design and production of SARS-CoV-2 vaccines, but above all to guarantee fair and equitable global access. Nearly 200 states signed up for this initiative, which was funded by the few wealthier countries in the group[xvii].
"A few" because many rich countries, including China, the United States, Great Britain and Russia, did not join, rejecting the very foundations of the program and opting to give priority to immunization for their own populations. [xviii] Other rich countries joined, but hypocritically and in total contradiction with the very spirit of the COVAX initiative, entered into bipartite agreements with pharmaceutical companies for the supply of vaccines[xix].
As a result, by January 2021, the small sums of money that had been agreed to up to that point would have enabled only 3.3% of the population of the 145 poorest countries in the world to be vaccinated by the following summer.[xx] The four deputy directors general of the World Trade Organization (WTO) had reminded us the same month that as long as world markets were not secured by the eradication of the pandemic, the economies of the rich countries would also suffer, as demonstrated by a report[xxii] from the Eurasia Group on the impact of Covid 19 on the economies of 10 of the richest countries in the world.
The WHO, well aware of the apprehended catastrophe, had demanded in August 2020 an international coordination[xxiii] of the purchase and distribution of Covid-19 related medication for the whole globe. Politically unable to demand this, it was of course refused. A few months later, South Africa and India, dismayed by the prices charged to small countries for vaccines by the pharmaceutical companies and the cannibalism of the rich countries, urged[xxiv] in a joint letter the World Trade Organization (WTO) to waive certain provisions of the Trade-Related Intellectual Property Rights Agreement regarding the treatment of Covid-19 until the majority of the world's population had developed immunity. This was simply common sense in the context of a global pandemic. Dead letter.
Given the context of global security breaches as well as the massive public funding of research for vaccine development (some 20 billion dollars[xxv] as of May 2021. AstraZeneca/Oxford University, Moderna and Pfizer/BioNTech have received more than $5 billion in public funding![xxvi] ) states could and should have forced the pharmaceutical companies to make their technologies, methods and formulas public in order to harness the appropriate industrial infrastructure for mass vaccine production around the globe. But how could the rich states even want this? The countries where the headquarters of these multinationals are located, the only ones that could demand it, consider them national treasures.
And the pharmaceutical companies themselves should not have been expected to show humanism or simple common sense. To be reasonable. To be content, given the exceptional situation, with the break-even point for the design and production of vaccines.
A group of schoolchildren would be more likely to be reasonable if you held their end-of-school-year party in the local candy store...
The Little Moderna pharmaceutical vaccine was 100% publicly funded. Yet, at nearly $50 a dose, Moderna's vaccine is the most expensive on the market. The company has even been awarded the Shkreli Lemon Prize, which aims to highlight the worst cases of enrichment in the health care field[xxvii].
The reason AstraZeneca's vaccine sells for about $5 a dose[xxviii] is that Oxford University, the company's lead partner, has demanded that it be sold at no profit while the pandemic lasts. (This could explain, in part, the international smear campaign against this bad player who did not respect the first rule of the capitalist creed, which is to determine the value of a product, i.e. the maximum amount that its potential customers will be willing to pay...)
The States could have set the same kind of conditions.
And even though most of the funding for research into COVID-19 vaccines comes from public funds worldwide, governments are paying astronomical amounts for the doses. Marc-André Gagnon, an associate professor at Carleton University's School of Public Policy and Administration, denounces this as "paying twice for the same vaccine"[xxix].
As of February 2021, none of the major pharmaceutical companies producing a vaccine had yet registered[xxx] in the "Covid 19 technology access pool", a WHO program aimed at sharing knowledge and technologies on COVID-19 vaccines, tests and treatments. Taking advantage of the context of a pandemic to reap billions in profits is an obscenity that should be shouted from the rooftops.
The pharmaceutical companies were probably even contemplating with appetite the idea that the slowness of the vaccination process on a planetary scale (in which they were part of the problem) would favour the emergence of variants resistant to the first vaccines[xxxi]. The big greedy circus would then just have to get back in the saddle for another round.
With the periodic emergence of variants, how long would we be in this bad play where the unbridled greed of Big Pharma dictates the game?
And this was not the first time, during this crisis, that these multinationals acted as enemies of the global common good. During the first wave, when the whole world was watching, dumbfounded, as the Lombardy region in Italy was being slaughtered, Big Pharma could do nothing better than threaten to sue doctors in a Brescia hospital for counterfeiting respirator valves that were out of stock[xxxii].
They also stood in the way when the world's largest artificial intelligence companies offered to pool their immense data processing capabilities with the scientific community in order to identify more quickly the most promising molecules for the creation of a vaccine.
Ara Darzi, Director of the Institute of Global Health Innovation at Imperial College London, denounced their attitude as follows: "Like the toilet paper speculators of the early days of the crisis, they keep their precious data hidden in their digital attics where it is not accessible to the scientific community with the only excuse that this information is a commercial secret[xxxiii]."
In January 2021, Tedros Adhanom Ghebreyesus, director general of WHO, eloquently summarized the potential impact of the navel-gazing pandemic:
The longer we wait to provide vaccines, tests, treatments to all countries, the sooner the virus will take over, with the emergence of many potential variants, with an even greater risk that today's vaccines will then become ineffective [...] I'll be blunt: the world is on the brink of a catastrophic moral failure - and the price of that failure will be counted in lives and livelihoods sacrificed in the world's poorest countries.
Despite the rhetoric of fair access, some countries and companies continue to favor bilateral agreements, circumvent the COVAX mechanism, drive up prices, and try to get to the front of the queue. This is not normal. Forty-four bilateral agreements were signed last year, and at least 12 have already been signed this year.
The situation is compounded by the fact that most manufacturers have favored regulatory approval in the rich countries where profits are highest, rather than submitting full dossiers to the WHO. This maneuver could delay deliveries through COVAX and create exactly the scenario that COVAX seeks to avoid: that of stockpiling in large quantities, a chaotic market, an uncoordinated response, and continued social and economic disruption.
Not only does this "me first" attitude leave the world's poorest and most vulnerable people at risk, it is also counterproductive. Ultimately, this will only prolong the pandemic, the restrictions needed to contain it, and the human suffering and economic hardship.
Vaccine equity is not only a moral imperative, it is also a strategic and economic imperative.
Will our children and grandchildren ever know "the world before"?
And if so, for how long before the next human-induced global catastrophe?
Will we only do better next time?
An independent scientific panel commissioned by the WHO to examine the international response to the pandemic attributed, in its final report[xxxvi] of May 12, 2021, the rapid spread of Covid-19 to the delayed reactions of states and poor international coordination.
A "myriad of failures, poor policy choices, delays, hesitations, denials and gaps" allowed the epidemic and then the pandemic to unfold, the report concluded. Ultimately, according to the 13 experts and scientists on the panel, the 3.3 million deaths blamed on covid in more than a year could have been prevented, but too much time has passed between the notification of the first cases in late December 2019, the WHO's declaration of a public health emergency of international concern on January 30, 2020, and the response of states.
In the hope that this will be the last pandemic, they recommend that governments and the international community immediately adopt a set of reforms to transform the global pandemic preparedness, alert and response system. They propose, among other things, the creation of a Global Health Threat Council that would have the power to immediately release information on epidemics without having to seek approval from countries, and the establishment of a new global surveillance system based on full transparency.
On this issue, as on many others, we need to stop playing the fireman's apprentice and question the substance of the matter. This is what this book proposes.
The pandemic has at least had the benefit of giving a big kick in the anthill by revealing the darkest flaws of capitalism and nationalism.
The sanitary crisis of the coronavirus disease, from its origin, most probably linked to the trade of the flesh of an endangered species; to its fulgurating and global propagation; to the response of governments and companies is only one of the most recent illustrations of the fact that humanity is not doing well.
That the planet itself is not doing well. Yet, we don't seem to be able to come together to find solutions or, if they exist, to implement them. The COVID-19 has shown us, more than ever, that we are all brothers and sisters of blood and fragility on this increasingly small sphere.
That sometimes nationalism or the sacrosanct laws of the market for certain issues affecting the entire biosphere, simply have no place. That they are obscene and harmful.
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That's it for episode 1.
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[i]Danielle Renon, "Pandemic. Trump won't have exclusive rights to a German coronavirus vaccine," Courrier international, March 15, 2020.
[ii] World Health Organization (Europe), "COVID-19: "We are still in the eye of the storm," Onu Info, April 16, 2020.
[iii] United Nations, "Covid-19 drugs and vaccines: General Assembly calls for more international cooperation," UN Info, April 21, 2020.
[iv] World Bank, "World Bank and IMF Spring Meetings 2020: Development Committee Communiqué," press release, April 17, 2020.
[v]International Labor Organization, "Global action to combat COVID-19 crisis is fundamental to prevent jobs disaster, ILO tells G20 ministers," Press release, April 23, 2020.
[vi]Luc de Barochez, "Faced with the coronavirus epidemic, nations disunited," Le Point, March 12, 2020.
[vii] Philippe Bernard, Carrie Noten, " L'ONU, symbole du désordre mondial ", Le Monde, April 29, 2020.
[viii] Paul Benkimoun, Frédéric Lemaître, Marie Bourreau, " Les liaisons dangereuses entre l'OMS et la Chine ont marqué la crise du coronavirus ", Le Monde, 27 April 2020.
[ix] Henry Samuel Paris, "US buyers 'pull out cash on runway' to secure masks bound for France," The Telegraph, April 2, 2020.
[x] Oxfam International, Press Release, "Nine out of ten people in poor countries will not have access to COVID-19 vaccine next year," December 9, 2020.
[xi] Ibid.
[xii] Ibid.
[xiii] Unicef, Press Release, "In the race for COVID-19 vaccines, win or lose, it will be together," New York/Geneva, 10 February 2021.
[xiv] WHO, Press Release, "Vaccine Access and Allocation: How to Ensure Fair and Equitable Distribution of Limited Vaccine Supplies," 12 January 2021.
[xv] WHO, Executive Summary, WHO SAGE Value Framework for Allocation of COVID-19 Vaccines and Prioritization of Groups for Vaccination, September 14, 2020.
[xvi] WHO, Press Release, "New momentum for global response to COVID-19: countries around the world officially join COVAX mechanism," September 21, 2020.
[xvii] AFP Dispatch, "Covid-19: UN Covax scheme unveils first countries to receive vaccines," Le Monde, February 3, 2021.
[xviii] Alexandra Phelan, "Les États-Unis et la Chine, grands absents de Covax, l'initiative mondiale d'accès aux vaccins", Courrier International, 23 September 2020.
[xix] Bernardo de Miguel, "La estrategia de vacunación de la UE se agrieta y varios países buscan salidas unilaterales", El Pays, 2 March 2021.
[xx] AFP dispatch, "Covid-19: UN Covax unveils first countries to receive vaccines", Le Monde, 3 February 2021.
[xxi] World Trade Organization (WTO), press release, "Deputy Directors General call for greater cooperation to improve vaccine availability," February 1, 2021.
[xxii] WHO, press release, "Equitable access to COVID-19 vaccines is expected to generate $153 billion in benefits in 2020-2021, rising to $466 billion in 2025, in 10 most economically advanced countries, according to a Eurasia Group report.", December 3, 2020.
[xxiii] WHO, Statement, "Statement by INCB, WHO and UNODC on Access to Internationally Controlled Drugs during the COVID-19 Pandemic," 14 August 2020.
[xxiv] WTO, Communication from India and South Africa, "Waiver from certain provisions of the trips agreement for the prevention, containment and treatment of covid-19 communication from India and South Africa", 2 October 2020.
[xxv] Excerpt from Marc-André Gagnon's interview with Annie Desrochers on Radio-Canada's Le 15-18 program, January 22, 2021. https://ici.radio-canada.ca/ohdio/premiere/emissions/le-15-18/segments/entrevue/340408/prix-citron-shkreli-industrie-pharmaceutique-covid-19-coronavirus
[Ibid: "Nine out of ten people in poor countries will not have access to the COVID-19 vaccine next year," Oxfam International, December 9, 2020.
[xxvii] Ibid. Marc-André Gagnon to Annie Desrochers on Le 15-18.
[xxviii] Ibid.
[xxix] Ibid.
[xxx] Maurice Cassier, " Instituer les vaccins contre la covid 19 comme des biens communs mondiaux? ", La vie de la recherche scientifique, Sncs Fsu, January 23, 2021.
[xxxi] Alexandre Counis, "UK plans variant vaccines for fall," Les Echos, February 8, 2021.
[xxxii] Thomas Lemahieu, "Les 5 mythes entretenus par Big Pharma pour protéger son business", l'Humanité, 19 December 2020.
[xxxiii] Ara Darzi, "The race to find a coronavirus treatment has one major obstacle: big pharma", The Guardian, April 2, 2020.
[xxxiv] WHO, Speech by the Director-General of WHO, "Keynote address by the Director-General of WHO to the 148th session of the Executive Board", 18 January 2021.
[xxxv] Valérie Borde, "Will the variants stretch the pandemic much longer?", L'Actualité, 16 April 2021.
[xxxvi] AFP dispatch, "According to the WHO, the pandemic could have been avoided", Luxemburger Wort, 12 May 2021.
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