Debunking the Arguments for Vaccine Apartheid

“Wait your turn” is not epidemiologically sound

Photo: Vishal Bhutani/Unsplash

The Biden administration’s (carefully worded) support for a WTO IP waiver on vaccines may not be the full-throated support the issue warrants, but it was still a complete reversal of decades of subservience to Big Pharma, and the industry is waging all-out war.

The arguments against allowing poor countries to make their own vaccines are a mix of racist condescension (“poor brown people are too primitive to make high-tech vaccines”), misdirection (“patents aren’t the problem”) and bad faith (“we don’t have enough materials”).

Writing for Counterpunch, Sonali Kolhatkar teases apart each of these arguments. Take the argument that poor countries can’t make vaccines — laughable on its face, given India’s centrality to the world’s vaccine supply.

The problem isn’t that India doesn’t know how to make vaccines — the problem is that India’s brutal, variant-driven outbreak has caused the country to hit pause on exports, halting the supply of vaccines to much of sub-Saharan Africa.

The idea that poor countries are especially prone to unsafe practices that make people hesitant to get vaccinated is pretty rich, given the U.S. experience, where government cronies raked in millions of dollars while spoiling millions of vaccine doses.

Countries in the Global South can make their own vaccines, but only if the WTO green-lights it. It’s not enough for Moderna to promise not to enforce its patents, because the WTO can still do it for them, raining down terror on poor countries.

Pharma has some very high-profile champions, and chief among them is Bill Gates, who evidently sees defending “IP” in principle as the key to advancing his ideological agenda, both personally and through his foundation.

I discussed Gates’s ideology in depth in this interview with Luke Savage for Jacobin, where I explore the core idea of “IP” as an ideological construct: that the law should empower firms to control their customers, competitors and critics.

IP is the tip of the spear for all right-wing ideology, which Corey Robin clearly identified in The Reactionary Mind: the belief that some people are born to rule, and others to be ruled over, and any attempt to thwart destiny makes us all worse off.

That’s why Gates personally intervened to scuttle the Oxford team’s plan to make its publicly funded vaccine research free to all, coercing them into doing an exclusive license deal with Astrazeneca.

AZ promised to sell vaccines at cost to the Global South…once it’s done providing doses to rich countries. This is also the premise behind Gates’s COVAX initiative, whereby poor countries can register for donations from philanthropists, corporations, and wealthy countries.

As Gates describes it: “Some of the rich countries including the U.S. and the U.K., even this summer will get to high vaccination levels and that’ll free up so that we’re getting vaccines out to the entire world in late 2021 and through 2022.”

That’s the deal that Gates — and other COVAX boosters — want: poor people shouldn’t expect to help themselves. They should “wait their turn.” Some are born to rule, some are born to be ruled over, and upending this natural order will do no good.

Whether driven by greed, racism or ideology, this is not a folly the world can afford. Allowing continued spread through the 125 poorest countries (pop 2.5b) will kill hundreds of thousands, if not millions. 2021 is on track to have a higher Covid death count than 2020.

Even if you identify with the rulers, and not the ruled-over, this is madness. Every time the virus infects someone, it undergoes millions, even billions of replications. Each replication carries a small chance of mutation.

Each mutation has a small chance of becoming more virulent, more lethal, more vaccine-resistant. No one is safe on a half-vaccinated planet. You can’t declare only one end of the swimming pool to have a “no pissing” end.

The fact that COVAX backers claim that once the rich world has been vaccinated there will be capacity to vaccinate the rest of the world reveals the bad faith in the argument that the world doesn’t have the raw materials to make vaccine doses for all.

Adopting COVAX instead of a WTO waiver means that access to vaccines can come with strings attached — demands to privatize publicly owned infrastructure or knuckle under to other demands. A WTO waiver would put poor countries in charge of their own destiny.

The Gates camp is big on being in charge of your own destiny — if you’re one of the born rulers. Just listen to how Gates and ghouls like Howard Dean talk about how strong protections for their privileges provide the “incentives” needed to produce live-saving vaccines.

Never mind that mRNA vaccines owe their existence to tens of billions of dollars in public investment, with the monopolistic pharma companies only coming in after all the risk was shouldered by what Mariana Mazzucato calls “the entrepreneurial state.”

It’s a point that was beautifully made by Rep. Katie Porter with one of her trademark whiteboard-based Congressional grillings of the CEO of pharma company Abbvie during a hearing on price-gouging.

Porter asks the CEO how much money his company spends on R&D, marketing, compensation, and stock buybacks and other forms of financial engineering. She already knows the answers, and has circles of colored construction-paper ready to show the relative spending.

A brief clip of Porter’s grilling of Abbvie’s CEO, cutting from his uncomfortable visage to her triumphant brandishing of a white board whose several small circles are dwarfed by a vast blue circle reading ‘Stock-buybacks and dividend.
A brief clip of Porter’s grilling of Abbvie’s CEO, cutting from his uncomfortable visage to her triumphant brandishing of a white board whose several small circles are dwarfed by a vast blue circle reading ‘Stock-buybacks and dividend.

All of this builds to a triumphant climax in which Porter affixes a vast blue circle representing “Stock buybacks and dividends” to her Whiteboard of Justice, a circle so big it dwarfs everything else on the board.

The vaccine manufacturers absorbed billions in public cash and have told their shareholders to expect a rosy future in which they charge $175/dose for annual boosters. Their CEOs took home tens of millions in bonuses based on those promises.

Those are the true stakes here: not “IP” as an incentive for those who were born to rule to deign to develop the medicine we all need. We get that from public funding, from competition, and from the scientists who do the real work — not the executives who privatize it.

The cost of letting poor countries control their own epidemiological destiny is depriving monopolists of that control.

The advantages of putting vaccine manufacturing in the hands of the Global South, on the other hand…

Those are the true stakes here: not “IP” as an incentive for those who were born to rule to deign to develop the medicine we all need. We get that from public funding, from competition, and from the scientists who do the real work — not the executives who privatize it.

The cost of letting poor countries control their own epidemiological destiny is depriving monopolists of that control.

The advantages of putting vaccine manufacturing in the hands of the Global South, on the other hand…

  • Saving millions of lives
  • Preventing vaccine-resistant, more lethal variants
  • Giving people control over their own destiny rather than making them beg with multinational corporations and elite philanthropists for their very lives

Cory Doctorow (craphound.com) is a science fiction author, activist, and blogger. He has a podcast, a newsletter, a Twitter feed, a Mastodon feed, and a Tumblr feed. He was born in Canada, became a British citizen and now lives in Burbank, California. His latest nonfiction book is How to Destroy Surveillance Capitalism. His latest novel for adults is Attack Surface. His latest short story collection is Radicalized. His latest picture book is Poesy the Monster Slayer. His latest YA novel is Pirate Cinema. His latest graphic novel is In Real Life. His forthcoming books include The Shakedown (with Rebecca Giblin), a book about artistic labor market and excessive buyer power; Red Team Blues, a noir thriller about cryptocurrency, corruption and money-laundering; and The Lost Cause, a utopian post-GND novel about truth and reconciliation with white nationalist militias.

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