The Plague Cycle

Listen to this episode

S1: This ad free podcast is part of your Slate plus membership.

S2: Hello and welcome to the league fiscal edition of Slate Money, your guide to the business and finance news of the week, which is going to be very clag centric this week. I’m Felix Salmon Axios. I’m here with Emily Peck of Huff Post. Hello. And we have the one and only Charles Kenny. Welcome, Charles. Hi. Introduce yourself and tell me about the new book you have out.

Advertisement

S1: My name is Charles Kenny. Sorry, you know that I’m a senior fellow at the Center for Global Development, which is a think tank in Washington, D.C. And the new book is called The Plague Cycle.

S2: It’s about how infectious disease has basically dominated the history of the planet. Everything you see in the planet from which countries are rich and which countries are poor and racial makeup and how men and women are structured comes back in some way to the history of infectious disease. It’s a great book. We’re going to talk a bunch about that. We’re going to talk about how covid is changing things in terms of trade, in terms of migration, in terms of women’s participation in the economy. We’re going to talk about vaccines. We’re going to talk about how best to optimally distribute them and how close we are to that. We’re going to have a whole Slate plus segment about IP in vaccines. It’s a fascinating conversation. I’m really happy with this one. So do stay tuned for Charles Cannis. Insights into everything Clag related coming up on Slate Money. So, Charles, you were writing this book long before covid came along, and then I guess the first question would be, did anything change? Did you look at covid and go, wait, hang on a sec. This is more relevant than ever. This is like this. This pandemic is weirdly unlike all of the stuff that I’ve been writing in the book or which way did it go?

Advertisement
Advertisement
Advertisement
Advertisement

S3: I guess I get I get credit for the fact that I was writing a book that ended saying, you know, look, they really could be another big pandemic and we need to prepare better for it, then we’re preparing for it. I lose credit for the fact the book didn’t come out before that pandemic hit. And frankly, I probably lose a bit, too, on the grounds that I was coming up with numbers about, you know, who it’s going to cost two trillion to respond. I mean, clearly, I was underestimating the potential scale of the thing. So sort of adding covid to the story was fairly straightforward. I lost the ability to say, I sort of told you so.

Advertisement

S2: Give us the big picture arc of history kind of story that you’re telling in this book, because it is it does seem we’re reading this book that basically everything that has happened in human history can be explained quite parsimonious just by pointing it plagues and pandemics.

S1: Yes, there is that book a while ago, A History of the World in six glasses of whiskey or something. I tried to do the same with plagues. Really, the books over in a broader sense is about is about connections that lots of people living close together and trading and interconnected is both the force for sort of human progress, but it’s also the force for the spate of horrible diseases, indeed, the emergence and spread of horrible diseases. And so kind of weakening the link between infection and connection is what allowed us to create the modern world, which is more connected and ever, which is great and fantastic. And one of the reasons we live in such a healthier, wealthier world than ever before in history and even last year. But it also means we’re more exposed ever to the risk of an infection that can spread more rapidly and spread further than ever before.

Advertisement
Advertisement
Advertisement
Advertisement

S4: One thing that struck me about the book, too, was, I mean, it’s such an optimistic, but you wouldn’t think a book called The Plague Cycle would give me hope. But it really puts it into perspective. And I believe you’re saying in the book that it’s not as bad as some of these other plagues have been. The response has been faster, and we have the tools to fight it in a way we obviously didn’t have in the past.

S2: At one point in the book you got, you kind of say, well, for much of human history, this wouldn’t even have counted as a plague. It’s kind of like minor.

Advertisement

S4: Can you talk more about that? Make us feel better?

S3: The response of it could be looked at in two ways. One is it was an absolute catastrophe. And we had tools that could have stopped this thing faster with far fewer deaths, with much less economic and social upheaval. And the other way of looking at it is we kind of responded to it better than we have. Any plague previously in history now partially tells you how low the bar was in the past. Right. But covid one for all it’s been horrible is no black death. You know, the Black Death was killing a third, maybe a half, maybe even two thirds in places of the European population back in the 14th century. And covid never had sort of that potential. But he did have. And sadly, we’ve seen the potential to to kill millions and we have tools to respond to that now that we didn’t we didn’t ten, fifteen years ago, let alone, you know, 100 years ago. So ten, 15 years ago, we probably would have developed a vaccine against covid, but it would have taken a lot longer. A hundred years ago. We already knew some of the techniques that we misused this time. So we knew about masking. We knew about social distancing. We knew about restricting travel, you know, all that kind of stuff. We we did it not terribly effectively during the 1918 flu pandemic, but we we didn’t know as much as we know now. We certainly couldn’t have rolled out the tests nearly as fast as we did with covid-19. So sort of from all sorts of point of view, we were in a much better place than we were. We managed to use some of that knowledge and some of that technology, but just not nearly well enough. And I sort of hope the lesson for next time is the technology is fantastic. It helps get us out of this situation faster than ever before. But we still need to get better at kind of the old fashioned stuff, the masking, the the social distancing and so on until those technologies come online.

Advertisement
Advertisement
Advertisement
Advertisement

S2: Can you talk a little bit about the irony here that The New Yorker recently had a long piece about this, that the pandemic seems to have been by far the most damaging, causing the most infections, causing the most deaths in places which used the bleeding edge technology in terms of testing and everything else to its greatest extent. So, you know, you have lots of testing. In the UK, in the US and incredibly high mortality rates, and you have very little masking, very little testing in places like India with very low mortality rates. So it’s all that testing really helping.

S3: It is incredible how much we still don’t know about why mortality rates and infection rates around the world vary like they do. It’s not clear why Africa is doing so well, for example, and it’s probably some combination of actually they had a reasonably rapid response compared to much of the world. And in terms of shutting things down in the first place, it might be about whether it might be about previous infections. We didn’t notice that as it happened. Give you some protection against covid-19. There could be a whole bunch of factors. And it’s amazing how little you know, even today we know about what’s behind it. I would say that testing is great and we should be doing a lot more of it in the United States. In the UK, testing is really particularly helpful when there aren’t very many cases out there. So, you know, the Vietnamese and the South Koreans of this world probably haven’t tested as much as the US and UK because they haven’t had to test as much as the UK and US because they controlled this thing at the start. And so the track and test regimes didn’t have to involve millions of people involved, thousands of people. And that’s what makes them manageable. That’s what means you can plausibly track and test and then isolate everybody who gets the infection and control, stop it in its tracks and in the US and the UK. Yeah, sure. We tested a lot of people, but it was after the disease was already completely out of control. And so I guess the lesson there is make sure you don’t get to the point where the infection is out of control, put in the social distancing and so on very early on before the problem becomes simply unmanageable.

Advertisement
Advertisement
Advertisement
Advertisement

S4: One thing you note in the book a few times is that some of the solutions that we come up with to these plagues and infectious diseases are worse, make things worse. So brings out the nativists and the bigots. Also, you seem to suggest that shutdowns aren’t always the best solution either. And I was wondering if you could talk more about that. Like looking back now, a year later, did the shutdowns go too far? Should we have done less of that even? I mean, the US never really locked anything down technically, or bits of it, like New York shut down for a while.

S2: There was regional, but like Germany is still largely shut down.

Advertisement

S3: And there is the problem again, I think had we shut down early and hard, that would have led to a shorter shutdown and less deaths than shutting down partially and late. And there’s a sort of there’s a lesson there for the planet. Right? The way you make a pandemic a non-issue is you deal with it before it gets big. And that means if it starts in China, you deal with it in China and you get the world as a whole doing everything they possibly can to shut the thing down in a way where it begins. Now, China didn’t help with that, but nor, frankly, did the rest of the world. So I think for next time, we need to do a lot better at shutting it down immediately where it starts rather than sort of waiting around. And partial solutions are no solution to this problem. So I am in favour of of Lockdown’s I can’t believe what Governor Abbott did in Texas, this line about how he is freeing Texans to go about their way. Well, the ones who are going to die as a result of the end of the masking mandate. And we need these restrictions right now. But they are massively expensive. They have horrible social and economic costs. They are the worst solution apart from no solution. And Abbott has got no solution. And I think that’s a disaster. But preferably we’d be using better solutions. And that’s that also speaks to the to the issue of travel bans. I’m not against travel bans sort of altogether. I think if if I was the New Zealand government at the moment, if I was the government of Vietnam at the moment, if I was running Taiwan at the moment, I’d be saying at least, you know, that needs to be strict quarantine and multiple testing before you’re allowed into my country because my country doesn’t have covid hardly at all. And so I think travel bans have their place. But in the United States, what we did and I think in Europe largely what happened was we introduced partial travel bans late covid was already here. The only effect the travel ban pretty much was to make a whole bunch of people fly back as fast as they could to the United States and wait for hours in crowded halls with no masks to get through and overburdened customs systems, which is sort of the perfect way to make sure that we spread covid as fast as possible. And indeed, I think it’s probably one of the reasons New York was hit so hard so early was because of introducing this partial travel ban.

Advertisement
Advertisement
Advertisement
Advertisement

S2: Let me ask you about the economic consequences of the pandemic and of the associated responses to the pandemic, because what we’ve seen on the one hand had big differences between countries in terms of how bad the pandemic has been. We’ve also seen very big differences between countries in terms of how the. Economies have reacted and the U.S. economy, for instance, seems to be doing pretty well, all things considered, much better than we thought it would be doing this time last year compared to much of Europe, for instance. And can you does that make sense to you? Is there like an intuitive way to explain that?

S3: I don’t have one. It amazes me how in the past, the economic effect of sort of a short term economic effects of pandemics have been remarkably small. I mentioned in the book that the you know, the Black Death hits the third to other people are dropping dead everywhere in the 100 years war is going on at the time and it stops for a couple of months and then they’re back to the fighting. So, you know, business as usual, minus half the army. And that does seem to be sort of a pattern through history that actually the economic impact is smaller than you might expect. I hope we see that worldwide with covid. But there are just these signs that especially in some developing countries, the effects are going to go on for a while, partially because they won’t get the vaccines as fast as rich countries do, but also that, you know, they piled up a bunch of debt over the last couple of years or so, in part in response to that to the global crisis and the slowdown in trade and so on and so forth. And so those effects are going to go on. And so, you know, I’m sort of optimistic we will bounce back. And as you say, in the United States, it seems like the bounce back has happened fairly fast. I think probably because, as you were mentioning earlier, we never really locked down properly over much of the country. So it look all right in the United States economically, perhaps, perhaps next year, the year after, in a way that places it down harder, might actually look a little bit worse. The flipside of that is that you’ve got to ask what would have happened if they hadn’t knocked down? And what would have happened is a lot more deaths. And, you know, beyond just a human tragedy of that, you know, that’s not good for the economy.

Advertisement
Advertisement
Advertisement
Advertisement

S4: I wonder, too, in the US, I mean, we are doing well overall, but there are certain populations that won’t be bouncing back for a long time. The long term employment is up. A women’s labor force participation, which we’ll get into later, is 1980s levels. I imagine the gender gap in pay has shrunk a little bit just because so many people on the low end have just lost their jobs. So I wonder if, you know, it’s like the disadvantaged people in the US and around the world are going to feel this for a while while, you know, everyone else at the top will bounce back quickly.

S3: Absolutely. This in all sorts of ways, this crisis has been a force for growing inequality and doing some work led by my colleague Megan O’Donnell at the Center for Global Development on sort of the gendered impact of covid worldwide. And one of the things that she’s been reporting on is you can look at the immediate mortality impact and it looks like it’s probably globally worse for men than women, maybe because of comorbidities, maybe because of, you know, men take more risks as a general rule worldwide. Maybe it’s genetics we don’t quite know, but maybe all of that. But if you look at the social and economic impacts, that they definitely have been worse for women almost everywhere and they’ve been comparatively worse for women. The worst covid outbreak has been. So, you know, the more there’s been cases, the more there’s been shutdowns, the more the gap between men and women open up. And actually in Latin America is one of the places that looks the worst in this regard, that you’re really seeing huge gaps open up in employment. There are already gaps before obviously before covid, there were already gender gaps in employment, but now they’ve they’ve grown further. And I’m with you that that is going to be an ongoing effect, partially because all of the businesses have just shut down. And, you know, it takes time to start a new business. And so given there seems to have been this sort of gendered impact partially on the grounds of of who traditionally takes care of children, but it seems to be more than that. It also seems to be the kind of businesses that women run, for example, seem to have been more affected. And with you that that’s the kind of effect that’s going to go on for longer. I’d say another sort of broader thing is just back to the arc of the book, if you will, that this is a story about connections. I really honestly do believe that the defeat of, in fact, or at least the victories we’ve had against infection in the past, the has called for connections that have made urbanization sort of safe for people. You know, it used to be that cities were deathtraps and the only way they get populations up was by importing. People are now actually cities on average, a safer than rural areas. Cities are just a massive force for economic progress. It used to be that trading, especially with the tropics, was just deadly. And now Americans die of the same things abroad as they die off here because they’re all dying of strokes and heart attacks and stuff, because largely we’ve dealt with the infectious threat and that kind of connectivity is just really central to economies. And we’ve had a year and a half of that kind of connectivity largely going away. You know, people aren’t meeting each other in bars and at conferences and. Restaurants and so on, either in cities or traveling across the world to do that. And beyond that, the economic cost, which I think is really big, I think we’re probably going to see a dip in innovation over the next few years. We’ll see fewer new firms founded and so on and sort of a human tragedy. I met my wife in a country in which I was not born, and I am delighted that I was able to travel somewhere else to meet her. There are millions of us and I think it’s something like a quarter of us. Marriages involve partners from different countries, although that didn’t happen over the last year. That’s, you know, sort of thousands of romances that didn’t come. Millions of romances. It didn’t occur. And so I don’t want to say that there won’t be if I’m with you, though, there will be social and economic effects that that attended and worked for groups that already further behind there will be long term impacts in terms of the quality of life. I’m still comparatively optimistic, if you will, will come back. I mean, some people are talking about the death of cities, and I think it was just massively overplayed. Some people are talking about a decade long covid related recession. I don’t think we’ll see that.

Advertisement
Advertisement
Advertisement

S2: I was just looking at a story about how real estate transactions in Manhattan in February were up 73 percent like everywhere. The rebound of cities story, I think, is happening quicker than anyone thought it would be. But I want to zoom back a bit on the gender impact of infectious disease, because this is one of the most interesting parts of your book. Explain how women’s participation in society has been driven by plagues.

S1: It’s a story that starts when history starts, which is to say agriculture and civilization, I think, were really terrible for women. We went from a situation in Hunter-Gatherer societies where it seemed mostly there was comparative gender equality. And that’s partially linked to the fact that there was less need for the average woman to have seven or eight kids just to keep population stable immediately and get into agriculture and civilization. You get this wave of infections, you know, whole new infections that never existed before that that jump species from animals and evolve and so on. Measles and smallpox are a whole range. And these diseases end up largely affecting the young, killing off children at massive rates and more than half of children dying before the age of five.

S3: Most places, most of the time through history. And so just to sort of keep population stable, suddenly women have to spend nearly all of their 20s and 30s giving birth to children or nursing them, as I say, just to sort of keep population stable. And the book I sort of point out the Code of Hammurabi, where, you know, this early, early set of laws from one of the first cities and women are treated like property. And, you know, that doesn’t seem to have been the case in Hunter-Gatherer societies. It does rather quickly become the case in early civilization. And, you know, the situation gets a bit better over time. And one of the upswings with some irony is after the black death in Europe, where you kill off half the workforce, it makes labour more valuable and classic supply and demand situation. And one of the results is more women are brought into the labor force, in particular to look after livestock. And the conditions of their employment includes staying without child. And so average age of marriage go up. Sort of quality of life for everybody goes up because it means average incomes increase. But in particular for women, you know, they are now sort of free to be in the workforce a bit and having slightly fewer, fewer children that are slightly healthier. So this mass calamity kind of in the long term at a somewhat positive effect on women.

Advertisement
Advertisement
Advertisement

S4: Yeah, I definitely highlighted when I came to the place in the book where it said civilization has been bad for women. It started out as a bad deal for women. I was like, I knew it.

S1: But I also I mean, I do think that the sort of the reversal has, you know, the fight against infection is one of the many factors behind somewhat improved, still a long way to go gender equality worldwide that, you know, we’ve gone from a situation where the average woman was having seven children to one where the average woman worldwide is having sort of two and a half. It’s not just sort of the child bearing and rearing issue there. This is also about the health impacts that the proportion of women who died as a result of childbirth was horribly high. It was sort of a third who suffered some sort of injury as a result of multiple childbirth. It’s just a massive drain on, you know, sort of the ability of women to take equal in society. I mean, so, you know, bad for men, terrible for women. And that problem has far from gone away, especially in the developing world. But it’s a lot smaller than it used to be. Maternal mortality. Morbidity has gone down a lot because each individual birth is less risky. Thank you. Antibiotics and so on. But also, women are having fewer children on average. So there are fewer births to go wrong, if you will. And so I do think that’s a that’s a really powerful. Force behind gender equality. I’d also say behind sort of the sexual revolution and sort of the idea that sex can be fun for fun as well as for procreation, that probably is partially driven by that change. But, yeah, you know, the fight against infection is a fight for women’s rights.

Advertisement
Advertisement
Advertisement

S4: Yeah. Fight for women’s rights. And like you were saying before, fight for the city can have healthy cities without healthy residents, which is something we’re sort of talking about last week. Also, I feel like it keeps coming up. But you had that great strand in your book just about until civilization prioritised the health of the majority. Things didn’t go very well. And I feel like we’re at that crossroads again now because we need to prioritize the health of the majority. And there are all these troubling little strands, you know, where women aren’t doing as well or where the poor aren’t doing as well. And that’s where you really need to focus the health response for everyone’s success.

S3: Basically, yes. If the last year hasn’t taught us that our health is connected and the health of one is the health of all, I don’t know what work. If you look at the city of Rome in the height of the empire in the early, early centuries, A.D., and you look at senators and their families, not the ones who died in a war or, you know, being stabbed on the way to the forum. But the ones who who died of peaceful causes, their average age of death is 30. Now, we have Roman cookbook’s from the time and by golly, they knew how to put a meal together. It’s not that these people were malnourished, if anything, probably quite the opposite. It’s that the sort of the public health situation was grim. They were all dying from infectious diseases because they were living in a city of a million people or pack together some sewage system, some clean water, famously, you know, the aqueducts and so on. But but basically, you know, with very few public health interventions, no vaccines, no antibiotics. And so, you know, the rich died, too. And so with you, the sort of moral reasons we ought to be responding to this pandemic, thinking again about do we really want to have this huge gap in the quality of health care between rich and poor, between black and white and so on in this country and globally, but not just for moral reasons, for purely self-interested reasons? You know, we’ve really got to think about universal health care.

Advertisement
Advertisement
Advertisement

S2: So let me I wasn’t intending to go here, but I think I feel I need to ask this in terms of vaccine distribution, there’s definitely a school of thought that says all of the vaccines should have been sold to one global agency that would then distribute them to individual countries, according to exactly what you’re talking about, like, you know, optimizing outcomes for the planet. And instead, what we wound up with was this like dog eat dog world a little bit like actually when in the early days of the pandemic, when all of the different states were fighting with each other to get PPE and everyone to say this is dumb, the federal government should just buy all the PPE and then allocate it rather than having the states try and outbid each other, because that doesn’t help anyone except for a few middlemen. How far are we right now from an optimal allocation of vaccines?

S1: This is one of these better than ever before. Terrible. Nonetheless, cases I keep on coming back to it looks plausible, like we really will vaccinate a lot of the world within two years, two and a half years of the pandemic starting, which is pretty impressive. I compare, for example, AIDS, where I hope we’ll have a vaccine soon, but we’re a lot more than two years since the start of the AIDS pandemic. You know, if you go back further, obviously for a lot of pandemics, we didn’t have a vaccine at all. So, yeah, human progress. On the other hand, as you point out, we’re doing disastrously at prioritizing. We have Kovács. We have this international scheme to make sure that some vaccines get to the poorest countries. And, you know, I think we’re up to a few million by now, which sounds great. But on a planet of seven billion doesn’t get you that far. We also seeing China and Russia actually. And indeed, I think to date, most of the doses that have hit low and lower middle income countries have come from China and Russia donating or selling vaccines. So, you know, we’re making some progress, but not nearly fast enough. I don’t know how much we could have done better given where we started, which is to say Kovács, this system to make sure that some of the vaccines were purchased and sent to developing countries wasn’t set up until the pandemic had begun. And what you really want is a kovács to pre-exist and so that it can get to the front of the queue when it comes to buying these vaccines.

Advertisement
Advertisement
Advertisement

S3: Because the problem isn’t that Kovács and indeed various other purchases, you can’t purchase vaccines. It’s that they’re at the back of the queue, that the vaccines will come sometime next year. And so what we want is this international system to be up and running. So it’s there in time to be one of the first. People making pre purchase orders for vaccines for next time, so I kind of hope Kovac stays around after after the covid-19 pandemic and we sort of have the muscle there to use next time we need it. So we do better.

S4: Could you just explain what Kovács is?

S3: Because it’s sort of a group purchasing mechanism. Donor countries, rich countries are giving money to this international organization linked to the World Health Organization that’s buying up a whole load of vaccines and largely donating some selling those vaccines to poor countries. It’s a great thing and I’m really glad we set it up. We set it up, I think, in March or April last year. So, you know, early, quite quick for an international organization to be set up, but still too late compared to their already the UK and the US and Canada and whatever had put in millions and millions of orders for more vaccines than they could ever use, you know, so they kind of got to the front of queue. The other problem is the pricing problem, that it’s quite easy to move yourself up the queue. You promised to pay a lot more money. So Kovács by itself is not the solution to the issue. If it can be outbid by countries that get desperate. And I think we’re a long way from the sort of perfect solution. You’re talking about Phoenix, frankly, because the idea that the world at the moment is going to set up an institution that basically tells the United States and and the United Kingdom and China, you can’t have more than 10 percent of your population vaccinated and we vaccinated 10 percent of the population of the rest of the world. You know, I. I wish we were in that kind of world, but we’re not.

Advertisement
Advertisement
Advertisement

S2: And the other weird thing that I that I learned from Bloomberg BusinessWeek this week is the the nineteen point fifty per dose that the United States is paying for the phase of vaccine. I mean, we in America managed to get much more adverse effects than anyone else. We did get to the front of the queue. We’re paying nineteen fifty per dose. What’s interesting to me is that that’s the lowest price per dose that any country is paying anywhere in the world. As far as I can tell, the Israel, which also got to the front of the queue, had to pay thirty dollars. There was a lot of opacity about how much other countries were paying, but it looks like in the European Union the price is closer to thirty dollars and it is to twenty.

S5: And if you look at the kind of reports coming out of places like Argentina and Brazil in terms of how much they are having to pay, like is going up from there. And then you had the Pfizer CFO on on the earnings call in February saying, yeah, well, we’re in a pandemic right now.

S1: So we have to kind of give concessionary pricing and have me a 20 percent profit margins. But eventually we should be able to sell this stuff for like one hundred and fifty or one hundred and seventy five, because that’s how much vaccines go for. Yeah, it’s a mess. And it’s a mess in part because, I mean, we don’t know what’s going on. So some of the differential pricing is about the fact that some countries pay some of the upfront costs. So they pay for some of the research and development and they paid for some of the trials and so on and so forth. So they you know, they they put money on up front. And so it’s better a lower cost at the other end. Some of this is about timing. So, you know, people who are trying to jump to the front of the queue are paying, paying more sometimes, although not always. And some of this is about the ability to deliver. Some of this is about who takes legal responsibility if it all goes horribly wrong.

Advertisement
Advertisement
Advertisement

S2: So if there are a bunch of people who take the vaccine and claim they got sick because of it or take the vaccine and actually genuinely did get sick because of it, God forbid, you know, who is it who’s in charge of dealing with that problem is a complex contractual point, which can have an effect on pricing and various other things, although although let’s be clear that in reality, like every single vaccine contract, to a first approximation, the certainty that I’ve ever heard of in terms of covid has amazingly ironclad clauses, basically saying that, you know, Pfizer or Madonna or whoever is never going to be held responsible for side effects. Certainly in the United States, there is actually a federal entity that pays out if you get sick from taking a vaccine. What’s fascinating is that even when countries agreed to those contractual clauses, like there was a story about Argentina, Pfizer was still saying, well, yeah, but there might be some residual legal obligations. And so what we want is like a lean on all of your foreign embassies so that if there’s any residual obligation, we don’t need to sue you. We can just seize your embassy.

S1: And you’re like, maybe Pfizer is creating a problem where there isn’t one. But as you are suggesting, Pfizer is at least acting as if there might be a problem. And, you know, it makes these contracts more complex and can do weird things to pricing. What’s really annoying, and I am incredibly frustrated about, is we’re having this conversation largely in the dark because most of these contracts, despite the fact nearly all of them are between. A public entity and a pharmaceutical company and all of these contracts are not published. Now, there was this sort of battle a few weeks ago between the EU and AstraZeneca, which sort of ended up with the contract being published in the E.U. So. Yeah, yeah. Well, in favor of contract transparency, sadly, that has not become the norm, even though that demonstrates it’s quite possible to to make it happen. And I really think we need to have these contracts in the public domain, not only to help answer questions like why is it Country X is paying more than Country Y now? At the moment, actually, to be honest, I worry about prices, but not that much. If you look at the sort of economic returns are getting vaccines and people’s arms at the moment, it’s getting multiples, the price. So I’d be willing to pay more to get the vaccine faster in my arm, please. But there are a whole bunch of other things that come up in contracts like are you allowed to sell to other people? Are you allowed to license to other people? You know, what order is the vaccine going to be delivered to you rather than other people? Is there all these details in there that actually we really want to know as a global community because we want to know what the supply looks like. We want to know how soon it is that, you know, sort of collectively all of these different contracts add up to a world that is vaccinated and so on when the immense public interest in this stuff and we’re not seeing and we’re not seeing it, I think maybe partially because some pharmaceutical companies don’t want to talk about profits they’re going to make.

Advertisement
Advertisement
Advertisement

S3: But I think it’s also that a whole bunch of governments have signed contracts basically saying me first, and they’re rightly a little embarrassed about that. But, you know, their embarrassment is nothing compared to the advantage of the planet as a whole to know the outcomes of it. So I would love it for the G7 or the G20 or somebody to get together and basically say, hey, look, we’re all going to publish all the contracts. Maybe there are some annexes that don’t get published because they’ve got some commercially sensitive information. And I don’t care. But, you know, at least around the sort of the central bits of information that we all really need to know and want to know around, you know, delivery, pricing, licensing and so on. And that needs to happen tomorrow.

S4: Yeah. And the private companies should feel obligated to be as transparent as possible since this is, you know, an international public health crisis and also because they wouldn’t have had the power to solve it so quickly without the public support to the pharmaceutical companies. I guess my cynical response is just like this is their M.O., like they charge different prices to different countries. That’s how drugs usually work.

S1: I’m in the situation of being a bit more sympathetic to them. Perhaps surprisingly, I think that they made a big mistake with AIDS drugs and kind of realize it, that they told what could have been a bit of a public relations win, which is they, you know, created these drugs that massively increase the life expectancy and quality of people with HIV and then kind of blew it by being so fussy about their IP and so on. And, you know, this this time they’ve somewhat learned their lesson. Certainly they they always start conversations around this area saying we learn from what happened with the HIV drugs. And I think there’s some truth to that. And I honestly think that, you know, right now they were part of something wonderful. I absolutely agree with you. You know, a lot of the basic research was government. Nearly all of the financing was government, massive role for government, but they were part of what is a successful story. And yet they are getting hammered. And I think they are partially getting hammered because governments don’t want to release this information partially. Maybe I’m being naive.

Advertisement
Advertisement
Advertisement

S4: Yeah, that was that’s really surprising to hear that it’s the governments that they wouldn’t want to release the information because it’s embarrassing that they wanted their country to go first. But I expect nothing less from the US. I mean, who would be upset in the US at the US wanting us to be first? I mean. GIBBERS So that’s kind of surprising to me.

S2: I feel I want to do a sleepless segment on the question of vaccine patents, because this is something which Charles is awesome about. But before we get to that, I want to go back to this idea of communication and how the pandemic basically just stopped people and goods moving around the world, not entirely, but massively. And how that movement of people and goods around the world is central and incredibly vital part of the global economy. And I want to know, Charles, a little bit about how long do you think it’s going to take to like, will we ever come back? I feel like we’re in this kind of a. globalised swing right now. The neo liberal globalist agenda seems to be in place absolutely nowhere anymore. And once you lose a bunch of trade ties, we could take a long time for them to come back. And, you know, what does the. For trade, what does this mean for migration and and you have this whole theory that we are we actually are already in a huge migration crisis, that there just isn’t enough migration from poor countries to rich countries. And that doesn’t seem like it’s going to get solved anytime soon.

S1: There’s a lot to unpack that I hope you are wrong that we’re at the sort of the turning point that the peak of globalization, because I think it has been such a massive force for good just to take the sort of issue of trade. One of the things that the Biden administration has done that really upsets me is said that it’s going to sort of carry forward this thing that started under under Trump of thinking about how we shorten our supply chains and bring all the manufacturing of medical goods back home. I mean, I think that’s sort of bad because we’ll be paying more for them. But in some ways, that’s the minor part. It’s bad from a purely selfish point of view, because what makes you at risk is concentrated supply chains. So if you get all of your supply from one source and that source goes down, you’re in trouble all the way to be protected, just like in finance. The way to be protected is to have a diversified portfolio of suppliers. Now, you don’t have a diversified portfolio of suppliers if all your suppliers are in one country and it doesn’t matter if that country is China or the United States.

Advertisement
Advertisement
Advertisement

S3: So I really think this is a bad move from the point of view of health security in the United States. It’s clearly a sort of a bad move. More broadly, there’s this idea of, you know, not just vaccine nationalism, but ppy nationalism and you name any part of the medical system. We’ve got to try and keep it all at home. And that’s partially because if you look around the world, the vast majority of countries don’t produce any PPE. They don’t produce any pharmaceutical products, or at least, you know, very few and none of the molecules that underlie them. And so if you get rid of sort of trade in medical supplies, you’re basically throwing a whole bunch of countries back to the situation of the hundreds in terms of health outcomes. You know, you’re getting rid of their supply of antibiotics, you’re getting rid of their supply of vaccines. So it’s just sort of a ridiculous and selfish and counterproductive approach to global health to think we’re going to produce all our health supplies at home and we’re going to keep them, keep them for us, it’s the wrong direction to go selfishly. It’s certainly the wrong direction to go for sort of moral reasons. And we need to move away from that. And the same is true with migration. My colleague Michael Clemens has produced a fantastic paper that basically looks at how fast previous pandemics spread around the world. We got good data on this going back for the last 120 years ish. And as there’s lots in the paper, but there’s a fantastic graph basically says, you know, here’s how fast it went from one country to 120 countries. And you look at the 1918 flu pandemic, I think it was maybe a week. It took a week longer to get to 120 countries and covid-19 did. The difference is teeny in sort of the grand scheme of things, and that’s not surprising. It doesn’t take very much movement of people at all to spread diseases around. Columbus managed to bring syphilis back from the new world with a couple of caravel. And then, you know, Vaska DeGarmo took it to India with a couple more. I mean, you know, it’s a really tiny amount of international connectivity. You need to spread infection. And nobody really plausibly is suggesting we go back that far in terms of international connectivity. So it’s just limiting migration on the grounds of global health is just. Stupidity in the extreme, to your point, I think the problem we face is in fact the opposite, that even without limits on migration, we’re not going to see enough of it now. Migration was hugely important part of the story of our response to covid-19 in that if you look at, for example, the Pfizer vaccine, there is a US company run by a Greek that has a bunch of Turkish refugees living in Germany to develop a vaccine. This is a story of the power of international migration as a force for innovation. We’re probably going to start seeing less of that just at the time we need more. If you look at the US and the United States, for example, populations are aging. They’re aging even faster in Japan. I think the figure is that between now and 2050, high income countries will lose three hundred and eighty million workers of working age. So just to sort of keep dependency ratios, what they are now in the economy, we need 380 million people to turn up from somewhere they’re not going to. We’re going to see an aging population. We’re going to see rising dependency ratios. We’re going to see all of that mean what that means in terms of Social Security under pressure, rising health care costs, so on and so forth. We’re not going to see nearly 300, 80 million, even if we just open borders tomorrow. Because the other thing that Michael Clemens work shows is as countries get richer and sort of pass a peak of about ten thousand dollars per capita, number of people who want to move goes down. And so, you know, the sort of global stock of immigrants is falling just at the time when we want a larger stock of global immigrants. Well, that can’t work. You know, you need one immigrant for each immigrant. And so I think by 2050, everybody will accept. The migration crisis we face is that there aren’t enough migrants.

Advertisement
Advertisement
Advertisement

S2: We have a very interesting natural experiment now with the U.K. opening up its borders to three million Hong Kong who were born before 1997. I think that’s how it works. And they say they expect like basically one in 10 of those 300000 to actually take them up on that offer and move to the UK because Hong Kong is becoming a human rights catastrophe. I’m taking the under on that one. What about what about you? I think it won’t be anywhere near 300000.

S3: I hope it is 300000 for the sake of the UK at least. Well, actually, for the sake of the planet, I mean, it’s it’s good to have these connections. I also think that that’s probably optimistic, partly because if you look at the experience of the European Union now, to be fair, nowhere in the European Union has seen the kind of slide in human rights that we’ve seen in Hong Kong. On the other hand, there are huge income disparities between the poorest parts of Europe and the richest parts of Europe. And yet people don’t move. I mean, Greek people are all still in Greece. Spanish people are also in Spain. The Bulgarians anyway, you know, I could go on. It’s sort of like three percent, I think, of the European population over the last 20 years where it’s been easy to move, have moved somewhere else. People just tend to stay where they are. They like being near their family. They like their culture. They like the house they live in, whatever it is. So it’s really hard to get people to move. And so I’d be surprised. That said, I have expressed that surprise on Twitter before now about the numbers they’re expecting to arrive. And I gather there is data from when Canada a while ago did a similar experiment with Hong Kong and actually a whole bunch of people from Hong Kong did move to Canada. So it may be that in the case of Hong Kong, because it’s such an international city with a whole load of people already really connected worldwide, you know, both you and I will be surprised by the scale of the migration that follows about the the coming maybe migrant crisis and how covid could make that worse, because fewer people are going to want to trade or move or deal with foreigners.

Advertisement
Advertisement
Advertisement

S4: There’s this overall tension in the book in the response to these pandemics, which is like becoming more connected, becoming more global, I guess, increases the risk of infectious disease and also increases the like nativism of the response. And like in the response, you can either improve the health of everyone and come up with, like besides the vaccine, like relatively simple technological solutions, like masks and hand washing and, you know, put a mosquito net up and then, like, carry on with being connected and globalized. Or you can sort of freak out and be like, we got to have the PPE method right next door to us and we can have anyone coming here any more and we can have immigrants any more. And that tension just repeats every time there is a crisis to the point where it’s almost like you, it’s part of the package of it. And the challenge going forward is going to be this tension between the actual solutions that make sense and work and then the kind of solutions that people come to out of fear. And in the United States right now, it really seems like we’re right on the edge of that because we have people getting vaccinated. But then we have like Governor Abbott and Texas telling people to put their masks away. And it’s really crazy, you know, Pfizer charging all this money for these vaccines. And you can have like a bunch of cheap mask solutions and people fighting that, too. It really tests. The logical capability is of of the citizens of the world.

S2: Charles, can I can I ask you that question directly as a historian of disease? Do you see this in history, this kind of thing, like put your masks away way, this kind of rhetoric from people? And do you understand where it comes from?

Advertisement
Advertisement
Advertisement

S1: I think Emily put it really well. It is about sort of instinct. And there’s a good reason. It’s about instinct, right? I mean, apes, when a new age wants to join the troop, they tend to throw rocks at the ape for a couple of weeks to keep the eight out of their immediate circle, but sort of close enough that they can monitor them. And it’s it sort of way to make you know, it’s a quarantine system, if you will keep them out until we’re sure he’s safe.

S3: And there is sort of good instinct of good instinctual reasons why people react to infection by becoming less welcoming to strangers. By the way, there’s now all been rafts of different tests around this. You you show people pictures of infected wounds and measles, and then you ask people about their attitudes towards immigration. You know, the ones you’ve seen, the pictures of infection become more anti-immigrant as a as a result. Lots of tests like that. So this is something very deep down in us is an instinctual reaction. It just doesn’t work with the modern world and becomes really counterproductive in the modern world. And, you know, straightforwardly evil. You know, in San Francisco during the plague in the late 19th century, we applied quarantines and lockdowns purely to the Chinese population in a way that made absolutely no sense. We then forced vaccination on them, a vaccination that almost certainly didn’t work and was experimental at the San Francisco Medical Board forced Chinese Americans to take it. So our reactions can be really bad. Instinctual reactions can be really bad and completely counterproductive. And we just need to sort of listen to our better angels, if you will, or listen to logic and reason around this, which is always easy to say in order quite often for politicians to manage.

Advertisement
Advertisement
Advertisement

S2: But they all of those examples are, you know, going along with our instinct to which is a natural instinct, which is grown up through thousands of years of dealing with plagues and infectious disease to do things that naturally protect us from plague and infectious disease like, you know, coming into contact with people. What is the natural instinct behind Governor Abbott, Abbott saying throw your masks away? Like, why is that a popular thing for certain politicians to do?

S1: It’s the trade off, I guess, between liberty and safety. Right. I mean, one of the Abbott’s lines that really upset me was this idea that he was doing it on the grounds of freeing people. I mean, there has always been this this trade off. If you go back through history, quarantines, for example, the public health people want to quarantine against yellow fever and the east coast of the United States, for example, and the businesses also. No, you are going to stop our ships coming in and our trade happening. And, you know, fair enough. It’s their livelihoods on the line. You can you can see their point of view. So it’s a long standing issue. And we’ve gone wrong on both sides. We have imposed excessively harsh quarantines, for example, the original cordon sanitaire that went along the Austrian Hungarian border with the Ottomans to keep out plague. Basically, you had to wait there. And if you showed any signs of plague in the 30 days you were waiting, they’d shoot you, which is a bit of an extreme response. Yeah, but also, you know, we’ve gone too far the other way, you know, getting rid of mass mandates too early, for example, you know, we can make mistakes on both sides and regularly do through history. I think, you know, nobody perhaps apart from Governor Abbott, can argue that it can’t purely be about liberty, that there is a trade off here. And the right position is somewhere between shooting people at the border who have the plague and no restrictions at all.

Advertisement
Advertisement
Advertisement

S2: Let’s have a numbers round, I think we should move away maybe. Well, we’ll see what the numbers are. Emily, do you have a number?

S4: I have a number. My number is thirty nine billion dollars. That is.

S2: How much money? Yes. I have a guess here whether these are plague related numbers or not. That’s billion that I’m going to guess that it’s not related.

S4: It’s like kind of plague is so. So. Thirty nine billion dollars is the amount of money in the one point nine trillion dollar stimulus package that the Senate is supposed to vote on this week. And the thirty nine billion is for essentially a bailout of the child care sector, which I think I’ve made us talk about before. And it’s a huge amount of money. Like I know it can be very negative on the show, but this is a really good thing. The the child care sector, as I’ve talked about, has been hit really hard by the pandemic because it’s not really a sector in the loosest terms, because it’s basically a bunch of small businesses all around the country that take care of kids before they go to kindergarten, mostly run by women, usually women of color. A lot of them had to shut down. They’re facing declines in enrollment, but like a massive increase in costs, they really, really, really need the money. Congress usually kind of ignores child care. They are not publicly funded and K through five. And last year, advocates were asking for 50 billion for a bailout. And the fact that they put thirty nine billion in this bill is like a sign that maybe the country actually cares about people taking care of little children in America. What you think they care about all along but didn’t really. So I’m excited about it and hopefully it’ll pass. It’s not even that controversial as far as I could tell.

Advertisement
Advertisement
Advertisement

S1: That’s fantastic. I mention this work that I’m doing. Meghan O’Donnell, she says pretty much one of the global messages coming out from the last 18 months regarding the general impact of covid is support for child care needs to be central to any package of response. And I mean, I have to say, if only there was 39 billion spent by the whole global aid community on child care, I would guess that’s a factor of 10 over what is spent globally on child care. But you should check with make it.

S4: Yeah, it’s pretty exciting.

S2: Charles, you have a number.

S1: So my number was going to be 11 million. But it is something we’ve already talked about pretty much. If it’s worth talking about, once it’s worth looking at, I don’t know what it is. It is the number of vaccines delivered this week to developing countries by Kovács. This international body and 11 million is great. You know, it is compared to six billion people in developing countries. So that’s not exactly one vaccine each.

S2: But if you multiply 11 billion by one hundred eleven million, a hundred, you get to one point one billion and one point one billion is the number of doses of vaccine being produced by the Serum Institute of India. And nearly all of those are going to developing countries, mostly India, but other countries do.

S1: So that thereby lies the rub. It is interesting how much of the vaccines that are going to developing countries aren’t going through Kovács. It’s the new world in which we live in a lot of is being supplied by China. A lot of it’s being supplied by Russia. And so hopefully the total number is going to be a lot larger than that. And again, it’s back to, by golly, we’re rolling this vaccine out rapidly in developing countries compared to ever before, but I wish it could be faster.

Advertisement
Advertisement
Advertisement

S2: So I also have an 11 million. Number one, I feel like my number should also be 11 million just because this number was 11 million. But Chelsea’s number was 11 million doses. My number is eleven million dollars. And it’s my favorite number from the past week. And it is well, taking the eleven point five million dollars, it is the amount of money that was spent at Christie’s in London on a kind of crappy painting by Winston Churchill, which is a view of Marrakesh that he painted in nineteen forty three. And I just love this story so much. In the short version is basically that Churchill finds himself in North Africa with FDR in the middle of the war, as you do. And he kind of turns to to Franklin and says, you know what, we’re not that far from cash. You should totally see America. It’s one of my favorite places. And FDR says, well, I mean, it’s not like there’s a global war on or anything. Sure. Let’s go to America. And so they take the five hour drive to Marrakesh and Winston Churchill close look at the beautiful Atlas Mountains. Isn’t it lovely? And FDR goes, yeah, lovely. And then goes back to fight the war. Churchill decides he’s going to stay on for a few days and do some watercolors because he’s Churchill and one of those paintings actually in oil he winds up giving to FDR. Who presumably, if FDR has any taste in art, takes one look at it and goes, yikes, and puts it in the closet somewhere, it then gets passed down through various bits of people and closets and stuff for a few decades until it turns up in an antique shop in New Orleans priced at three million dollars when who should walk into the antique shop? Brad Pitt, who has just finished filming Inglourious Basterds, and he’s got World War Two on the mind that goes. This would make a perfect present for my girlfriend, Angelina Jolie. So he buys it, gives it to Angelina Jolie, who presumably also goes, what on earth is this thing? When she breaks up with Brad Pitt? She says, OK, I have no need for this painting anymore. She consigns it to Christie’s. But at that point, the chain of celebrities who have touched this object goes from Churchill to Roosevelt to Brad Pitt, Angelina Jolie. And it is such a sort of resonating meme of celebrity that it sells for 11 and a half million dollars. There’s no, like, artistic merit to it, but it’s still 11 and a half million dollars worth of art.

Advertisement
Advertisement
Advertisement

S1: Yes. As you say, the painting is worth zero. Churchill and Roosevelt touching it at three million. Angelina and Brad certainly adds another eight point five. Well, that’s exactly.

S4: Actually, that does make sense.

S2: And that’s true. But we don’t know who bought it. But if you look at the estimate that Christie’s put on it, they basically had an estimate that assumed that the Brad Pitt Angelina Jolie premium would zero. They estimated it to sell about three million, which just goes to show how out of touch Christie’s is.

S4: Now, someone’s going to make it into an NFTE or something and it’s going to sell for millions.

S2: This is my theory is it’s basically it is a celebrity NFTE, like we just saw Liow sell, I think, eleven point six million dollars worth of NFTE. We saw Grymes sell like five years in case. And Elisenda does allow non fungible tokens to basically digital artworks, digital art. Grymes sold five and a half million dollars of these things and they’re worth that much money just because of that celebrity association. Right. But it doesn’t need to be digital. It works in the in the realm of art.

S4: And this is not new. Right? People always want to have famous people have had made new ish.

S2: It’s definitely a sort of small subset of the collector universe who loves, you know, I mean, it goes back to I guess, you know, like here’s a piece of the true cross or something like that that you get in religion. But I think it’s getting bigger and bigger, that kind of like celebrity memorabilia. And I apologized for offending anyone who thinks that. I just said a piece of the true cross was a piece of celebrity memorabilia.

Advertisement
Advertisement
Advertisement

S1: It’s almost certainly not a piece of a true cross.

S2: So I think that’s it for us this week. Thanks, Charles, for coming on. It was amazing to have you. We will have a sleepless segment about patent’s with you. Thanks so much to Jasmine Molly for producing. Thanks to all of you folks for sending in your questions and comments to sleep money at FT.com.

S6: We will be back on Tuesday with Josh Brown talking about Wall Street, the great Oliver Stone movie from 1987, which does hold up. Tune in for that. And then after that for another normal sleep money next Saturday. So thanks for listening.

S2: Charles, yes, we mentioned in the numbers round very briefly the Serum Institute of India producing one point one billion doses of the I don’t know whether we’re calling it the AstraZeneca vaccine or the Oxford vaccine, but in that one, which was a deal done not interestingly with after Savannakhet, but with Oxford. So in Slate plus, I want to talk a little bit more about this, because Oxford had all of the IP for this vaccine. And Oxford is a public university. It’s not a for profit pharmaceutical company like Pfizer or Madona or Johnson Johnson. So it doesn’t have that profit motive. It doesn’t have a fiduciary duty to its shareholders or anything like that. And its first instinct was to open up the IP and to make the IP available to anyone in the world who want to do it. Second instinct, which it wound up going with, was to basically transfer all of the IP to AstraZeneca in return for some kind of promise from AstraZeneca that they wouldn’t try and make lots of money off it and also with a side deal with the Serum Institute. So the Serum Institute has that deal, which was done at the same time as the AstraZeneca deal.

Advertisement
Advertisement
Advertisement

S5: But with the exception of that serum institute deal, it’s basically we don’t have what we’ve seen, for instance, with AIDS drugs for a long time, which is countries producing their own versions of the vaccine just because, you know, under international IP law, this thing called trips, they’re allowed to the countries are very much trying to license the IP and the vaccines and the deals directly from the IP holders.

S1: So what’s your view on the degree to which this is suboptimal into all of this? IP should be public? I am about to channel probably not very well, my colleague on the other side. There’s a lot more about this than I do. I think if it turns out that IP restrictions are slowing down to global production of vaccines against covid-19, we should get rid of the IP restrictions. So compulsory licensing ought to happen sort of tomorrow. I am told by Prashanth, amongst others, that the problem is a little bit different than it was with AIDS drugs. Where. Where? Pretty much the. Once you have the IP, once you had all the information in the patent, it was very easy to produce at scale the drugs. And with these vaccines, it’s not. And so sort of the limiting factor at the moment, at least, is actually the sort of knowledge and capacity to ramp up production at scale in a new facility. Now, that’s true at the moment. I don’t know if it’ll be true in five or 10 months and if in five or 10 months previously more magnanimous, if that’s the right word. Drugs companies start ramping up their prices for these drugs, I think they’ll be yet more reason to think about compulsory licensing. But at the moment, I am told for at least many of these new vaccines that the problem really is one of capacity. And that doesn’t just mean physical capacity, it means it’s knowledge.

Advertisement
Advertisement
Advertisement

S2: New house of the know how and and what everyone agrees to. And I’ve done a bunch of reporting on this question. And what everyone agrees is that certainly with the Amarone vaccines, you need a lot of know how to go along with the patent and which opens up this sort of like the uncomfortable question of you go along to these companies like Pfizer and, you know, the people who are defending the patent regime. And you basically say to them, are you saying that if the patent was freed up, then unless you were paid for it, you wouldn’t share your Know-How? And then they’re not saying that explicitly, but there is that kind of implication there. As part of licensing a patent, you also promised to use your best efforts to help in terms of sharing the know how. And if you don’t have that kind of paper to deal, then to know how will spread less effectively. I think that’s that’s a. Reasonable assumption, but I think the most important point that you didn’t make is just that. Yes, well, it’s true that the manufacturer but we’re basically at capacity right now in terms of manufacturing. We are going to be needing these vaccines for the foreseeable future. That covid isn’t going away anytime soon. And so we need to be building more capacity. And there’s no incentive for anyone to build capacity right now unless they have some kind of an IP license. And those IP licenses are taking a huge amount of time to put together and are not cheap. And my feeling is that if the IP was freed up, that would. Cause a lot of people to start investing in capacity who aren’t investing in capacity right now.

Advertisement
Advertisement
Advertisement

S4: Yeah, I mean, there’s no question that I mean, from a moral ethical perspective, panting these vaccines and keeping tight control over them on the part of the pharmaceutical companies doesn’t make any sense. Like I’m not a big believer in patents for drugs, big picture. But in this case, don’t do that. Make it as easy as possible to ramp up vaccine production and get more drug companies involved and make the incentives widely shared when the public interest is this high and certainly for next time.

S1: So Africa now produces flu vaccines partially thanks to a collaboration between, I think, the African CDC and maybe even the US government. And I can’t remember who else anyway. They built a factory and now have capacity to manufacture flu vaccines on the African continent. The same ought to be happening with RNA vaccines. And, you know, surely one of the things we’ve learned out of the last 12 months is we need more spare capacity sitting around in the vaccine production system globally. And surely a lot of that capacity should be in developing countries and that should be a priority for African developing countries and for donors to to support that. You know, again, I also worry about patent protections as a way to generate good health outcomes. I don’t think it seems to be working terribly well. But anyway, definitely there ought to be, you know, trips allows for compulsory licensing. And I think if ever there was a case for compulsory licensing, if it would help now seems a good one.

S2: And yet and yet, like this is one of the interesting things, right, is that TRIPS does allow for compulsory licensing and all of the governments who might be tempted to pull that trigger have avoided doing so largely, it seems, because they fear retaliation. The people will say, look, you’re allowed to do it, but we don’t like doing it and we’re going to retaliate in other ways.

Advertisement
Advertisement
Advertisement

S4: Felix, what was there? Was the deal was it this week where Merck said it would help produce vaccine JNJ, right? Yeah. So how does that work? Seems like a good thing.

S2: That is a good thing. And one of the fascinating things about covid is that the three largest. Vaccine producers in the world. Are Merck, if Merck, Sanofi and GSK, I think, and none of them have a successful vaccine. Yeah, so we have this kind of weird asymmetry where the people who develop successful vaccines are not the people who are good at producing vaccines. And the people who are good at producing vaccines are not the people who develop successful vaccines. And so you need to do these deals between people like JMJ and Merck, where you get the people who who invented it, doing deals with the people who can produce it so that you can get the vaccines out the door. And the fact that they finally did that deal is great. But honestly, like they could have done that deal before, you know, they could have done that deal a year ago. Really, in principle, these deals can be done. But, you know, everyone was wanting to wait to see whether their own vaccine would work before agreeing to produce someone else’s and that kind of thing.

S1: Yeah, we didn’t certainly we didn’t act in a kind of maximizing way when it came to producing as many vaccines as fast as possible. I don’t know how much of that was. You know, we really all still surprised we’re in the situation. We are in with actually rather a lot of vaccines that were I mean, remember, only six months ago, we were thinking maybe one of two of these will work and maybe they’ll work at 60 percent or whatever, and then. Wow.

S2: So I don’t know whether the strategy that looks terrible today look more sensible than I think even then, even if we thought that only one or two would work, that’s even more reason back then for everyone to come along and say, listen, we’re just going to do a global deal saying like whoever among us manages to be lucky enough to come up with the one that works. We’re all going to come together to produce as much of it as possible.

S1: Felix, a lot of your solutions seem to involve strong global government, which I’m not against, but we don’t have.

S2: Well, I won’t mention my my paid up membership of the global Zionist conspiracy. And that’s the AP situation for vaccines. Thanks, Slate. Plus members for being members.