The Covid-19 vaccine: panacea or enigma?

As the deadly Covid-19 virus continues to climb the grisly charts, an intense race is already on, globally, to discover the next vaccine, the next panacea. For many, perplexing questions arise: "What's in it for us?" and "Is this frenzy really about saving lives or is it about the age-old calculus of greed, money, and power?" What does the vaccine really mean for the developing world? Let's try and break it down.

Who will come up with the vaccine?

There are many players in the game, mostly from the financially well-endowed nations with top-class biotech scientists, state-of-the-art research establishments, and reliable institutional oversight. Some players, conducting clinical trials, are poised to announce the news of a discovery.

How does this matter to us? With China and India in the game, developing countries may be rooting for them for two simple reasons: accessibility and price. The key question will be, "Can we trust their products?" If the vaccine is produced by the developed world, their products may be trusted, but are the people behind them trustworthy?

How soon will the vaccine be available?

Early 2021 is a much bandied around date. A recent BBC news item suggests earlier availability: "Drugs giant AstraZeneca has announced it is ready to provide a potential new coronavirus vaccine from September" to the tune of 400 million doses.

Sceptics charge that companies will be unable to deliver so soon but manipulate information to make gains elsewhere—for example, the stock market! Scientists have also cast doubts about early trials, suggesting that scant data can be unreliable.

If history is any guide, time to market a new drug spans years. Why then should anyone believe the animated claims of an early breakthrough? Perhaps such claims may be intended to divert attention from the daily pall of death and to keep an irate world calm where agitations born of fear and uncertainty are beginning to intensify. If this wrath erupts, another mammoth epidemic of social disorder may be at hand to contain.

Who will benefit from the vaccine?

Ideally, the human race should benefit. But let's face it: in the global (and local) order of how lives are valued, some more than others will have priority. To many, some human lives may matter less than other life-forms (does George Floyd ring any bells?). Such audacity is in plain view; but a countervailing resistance to this deplorable attitude can be ominous.

The R&D is also conducted in a limited number of advanced nations; surely they will have first dibs. And while the scientific community invokes the term "global vaccine," national leaders are not likely to be global: their own populations will have to be immunised first. President Trump makes no bones about it: America first.

Moreover, R&D capabilities may be advanced in China and India, but are they likely to be altruistic? China has a population of around 1.3 billion; their focus will undoubtedly be local. India, if it is able to produce the vaccine, also plans to make it available for its own countrymen first.

Where does that leave the multitude from the developing countries who do not have the expertise, R&D budgets or advanced facilities? With access in serious question, what are their self-preservation options? Masks and social distancing seem to be the only reasonable answers.

What of quality?

Interestingly, there is a growing global reservation about vaccine safety, fuelling the anti-vaxxer movement. In the developing nations, whose people have served as guinea pigs in the past, their concerns are: i) Will the vaccine actually work, given the perceived rush to market? ii) With limited number of trials, in multiple populations, across the world, will the vaccine be effective for all? iii) Will nanochips really be inserted with the vaccine: the global population control conspiracy theory?

The fast-track approach in some countries has also garnered suspicions that regulatory bodies will be lax in ensuring quality. Thus, trust is of essence, especially if the early batch, couched in altruism, is shipped out to the developing world for testing. One can imagine the virulent backlash if there is a breach of trust.

Who pays and how much?

This question is probably unanswerable at this stage. In the West, however, people with low incomes who lack insurance can get free or low-cost drugs through assistance programmes. Such support programmes do not exist in the developing countries where only the rich can pay the high prices. How will the Covid-19 vaccine be priced: greed-based or solace-driven? Battered by daily survival challenges, the developing world is already wary about any new price burdens.

Will the knowledge be shared? 

Local production will be the key to safeguarding the multitudes in the developing world. But this knowledge is unlikely to be shared—voluntarily and/or altruistically. Only some arcane Faustian bargain may work, bound by straight jacket production contracts and inscrutable deals. But, with big money at stake, and markets to skim, the legal force of patents and the politics of power will surely take precedence. The developing world can only sit and watch from the sidelines.

Some countries are accused of using cyber thieves to steal the knowledge from targeted laboratories. For the developing countries, they simply do not have the craft; even if they did, they would not dare!

Is there the capacity to deliver?

Will there be enough trained healthcare personnel to vaccinate the global population? There will be a huge need for healthcare workers, facilities and training, supplemented by a variety of equipment. How quickly can these resources be marshalled? Are governments even prepared or likely to spend on building such capacity? This, again, places the vaccine out of reach of many.

If the goal is humanitarian, vaccine development will best come about through global cooperation, information sharing and resource pooling. But there are many stakeholders—scientists, companies, investors, lobbyists, regulatory bodies, and the governments themselves. In their clash of interests, the humanitarian goal, if any, will be the first casualty. An unbridled and self-seeking tribalism also casts its dark shadow on the world today, where the prevailing spirit is winner-takes-all.

Again, the poorer nations lose. What then is their fate? I turn to our "so-called" houses of knowledge—the universities and research institutes—that could have carved out frontrunner positions in biotechnology, social sciences and a plethora of related fields. With a presence for decades, some nearing even a century, solutions should have come from them instead of waiting for handouts. But all they have done is vie for professoriates while professing nothing. And the knowledge they fare continues to do little for the people they pretend to empower and protect with illusory solutions.

Syed Saad Andaleeb is Distinguished Professor Emeritus, Pennsylvania State University; former Vice Chancellor, BRAC University; Distinguished Visiting Professor, IBA, University of Dhaka; and Founder-Chair, Research A2Z, Bangladesh.

Contact: ssa4@psu.edu