How Globalization Brought Us COVID-19 Vaccines (And Better Public Health Overall)

Setting aside my own globalist sentiments, is worth noting that all the top COVID-19 vaccines are products of international collaboration, and a testament to the fruits of globalization.

The Oxford-AstraZeneca vaccine (marketed in some places as Covishield) is the most straightforward example, as it was developed in a partnership between Oxford University in the U.K. and the British-Swedish multinational pharmaceutical company AstraZeneca.

The Pfizer vaccine, which was the first to be confirmed 90% effective, was developed by a German company, BioNTech, founded and led by a Turkish-born married couple of leading immunologists. Pfizer, which was founded in the U.S. by German immigrants, helped provide vital resources for logistics, clinical trials, and manufacturing.

Moderna, which also ranks highly in efficacy (for what that’s worth), was co-founded by a Canadian and is led by a Frenchman. Its breakthrough was attributed to the pioneering work of a Hungarian biochemist who helped develop the world’s first genetically engineered vaccines—and who now works at BioNTech.

The Johnson & Johnson vaccine, like Pfizer’s, was also developed in Europe with the backing of American resources, by Janssen Vaccines in Leiden, Netherlands, and its Belgian parent company Janssen Pharmaceuticals, a subsidiary of J&J.

Heck, even Russia’s “Sputnik V” vaccine—which was technically the first to be developed—has turned out to be more efficacious than initially believed (much to my own surprised and that of many epidemiologists, apparently).

While the pandemic exposed the many perils of an interconnected world, it has also shown the even greater peril of trying to go it alone when it comes to major challenges and threats that disregard political boundaries and nationalities.

I’m hardly the first or only person to notice this: As long ago as 1851, when the Industrial Era helped rapidly globalize trade, travel, and war—and with them, more rapidly and widely spread diseases—the first of several “International Sanitary Conferences” was convened by the Ottoman Empire to coordinate containment strategies for infectious diseases—even among rivals and former enemies. It was the first time that a formal process of international collaboration was devised for public health; but as we’re learning, it remains even more relevant nearly two centuries later.

Of course, one doesn’t have to be a “globalist” to appreciate the logic of multilateralism (in public health and generally). One study in the medical journal BMJ examining the international response to COVID-19 argues:

The reasons for collaboration remain clear, logical, and have endured essentially unchanged from their original conceptualisation in the 1800s. Three of the most central are as follows. Firstly, the many ties between nations create collective health risks that are difficult to manage independently. The rapid spread of SARS-CoV-2 shows the close connections between countries, and the poorly managed economic and social costs are further evidence of their shared fate. Secondly, sharing knowledge and experience accelerates learning and facilitates more rapid progress. Information and knowledge on pathogens, their transmission, the diseases they provoke, and possible interventions are all areas in which researchers and public health professionals can benefit from the experience of others. Thirdly, agreeing on rules and standards supports comparability of information, helps establish good practices, and underpins shared understanding and mutual trust. All three reasons drive nations to collaborate and are reflected in their creation of WHO, a central authority, and its World Health Assembly (WHA), which serves as a forum for countries to share information, debate issues, and take collective decisions.

Little wonder why, despite the rise of nationalism and insularity (which predate the pandemic but was exacerbated by it), some global survey data suggest that a majority of people believe that more global collaboration would help reduce the impact of COVID-19. Far from idealistic, it is simply pragmatic to throw everything we have at his problem, regardless of which national jurisdiction the resources or knowhow happen to be located.

I’ll leave the final word to the above-mentioned study in BMJ, which I think makes a sober, evidence-based case for multilateralism, which is all too often treated as Utopian or naïve rather than realistic and practical:

The covid-19 pandemic painfully shows the reasons why nations are better off when they cooperate and collaborate in health, and also reveals the hazards of their incomplete commitment to doing so. Member states have prioritised themselves by restricting WHO from meaningful oversight of national information and endangered global health security by competing for vaccines rather than allocating them equitably. The inability to verify national data or advance its own estimates is just one of the many crucial dimensions in which WHO is prevented from maintaining the primacy of technical competence over the self-interested obfuscations of some member states. WHO’s independence is compromised also through the manipulation of its budget. The patchwork of institutions active in health reflects the limited, ad hoc agreement among powerful countries. Although generally global institutions have performed well in their missions, their often limited mandates leave the world’s people inadequately protected from new threats. In a pandemic, the cost is expressed in lives and livelihoods. More than 10, 000 people were dying daily at end of 2020, and the world economy was forecast to lose $5tn or more in 2020 alone. The imperative of finding collaborative and collective solutions—solidarity—has never been more obvious, or more urgent, for covid-19, climate change, non-communicable diseases, and the many other pressing and grave challenges that hinge on collective action.

Meaningful international collaboration is a critical part of the road ahead and calls for immediate action in three areas. Firstly, member states must end the systematic weakening of WHO—end ad hoc institutional fragmentation in global health and end budgetary manipulation. Secondly, they must support the independence of WHO—increase its core budget and build its authority over trade and travel related issues, including compulsory licensure for pharmaceuticals. Thirdly, states must uphold fairness, participation, and accountability by granting WHO powers to hold members accountable, including for overcoming deficiencies in national data, and by decolonising its governance to address the undue influence of a small number of powerful member states.

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