The shortage of vaccines

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By GILBERTO LOPES*

Vaccine race scenarios

President Joe Biden had reiterated his desire for the United States to take the lead in the fight against Covid-19. In February, he pledged $4 billion to COVAX, an international initiative to buy Covid-19 vaccines and distribute them to countries with fewer resources. One of its first international initiatives – the Quad conference, a coalition with three of its main Asian allies: India, Japan and Australia – had as one of its objectives to promote the production of vaccines in India. In a virtual conference, the president met with the leaders of the three countries on March 12 to reactivate an initiative that was not new, but which took on renewed importance in the context of the confrontation with China and the challenges of the pandemic.

White House spokeswoman Jen Psaki had announced on the eve of the meeting that a series of issues of concern to the international community would be discussed, from the threat of Covid-19 to economic cooperation and the climate crisis. The Quad meeting was intended to announce a deal to fund vaccine production in India, "something New Delhi insisted on, to counter the vast vaccine diplomacy deployed by China," US diplomats told reporters.

But it was not just about China, but about Asia, in the opinion of former Secretary General of Defense General James Mattis and experts Michael Auslin and Joseph Felter, for whom the dialogue on security within the framework of the Quad is the main task. of Biden at the beginning of his administration. In an article published in the magazine Foreign Policy last March, they pointed out that this dialogue offers the best opportunities to face the Chinese challenge.

That the challenge in Asia is huge is evident from the announcement that, at the end of last week, India was registering more cases than any other country, with more than 125.000 a day, surpassing Brazil, which had been occupying the first place. In Bangladesh, daily cases were few – less than eight thousand – but they were also breaking records, as in Pakistan, where the president, prime minister and defense minister were among those infected. With testing virtually non-existent in rural areas, it is likely that in all three countries the numbers poorly reflect the actual number of cases. If the trend continues, the magazine said The Economist,, Southeast Asia, home to a quarter of Earth's humans, will soon overtake the European Union as the center of the pandemic. Having suffered more than 200.000 deaths, "the region could be on the verge of an even greater tragedy".

The vaccine war

Last week, The Economist, dedicated its edition to the pandemic and its effects. He recalled that on April 7, both Britain and the European Union acknowledged that there was strong evidence that the AstraZeneca vaccine could be linked to a rare type of blood clot in the brain or abdomen.

The English newspaper The Guardian reported last Saturday that emergency services in British hospitals were full of patients with mild side effects of the vaccine. There was a lot of fear in the face of the possibility of more serious consequences. But after 20 million doses applied in the country, the truth is that only 79 people had suffered such reactions and 19 had died. Numbers that, according to experts, are normal, or even lower than the side effects of any other vaccine, none of which, despite its enormous effectiveness, will eventually cease to present them. The United States was also adopting measures to reinforce production in its own territory, promoting an alliance between two major rivals – Merck and Johnson & Johnson –, in an ambitious plan to make the country a global vaccine supplier.

This was the subject of a long article in the magazine Vanity Fair, in which journalist Katherine Eban analyzed the difficulties the United States faces in achieving this goal. The international scene looks gray for her. On the one hand, although several vaccines are ready, a new and deadly strain of the virus, known as P.1, is ravaging Brazil, causing the collapse of the country's health system and its spread around the world. On the other hand, the AstraZeneca vaccine, which promised to be ideal for developing countries due to its low price and ease of handling, aroused distrust after announcements that it caused dangerous clots, which put people's lives at risk. Although the risk was minimal, it triggered a crisis that forced several governments to suspend its application while the complaint was evaluated, which was finally rejected, but without completely dissipating the fear among some sectors of the world's population.

a scandalous case

Eban ended his article with a reference to another problem. Last week, she said, there was a complaint about problems in the production of Johnson & Johnson vaccines at a plant of the biotechnology company Emergent BioSolutions, in Maryland, which forced the disposal of 15 million doses (enough to inoculate the entire population of a small country, like almost all of Central America or the Caribbean).

 

The case had already been discussed in detail in another article, published in New York Times on April 6th. “More than eight years ago, the federal government had been betting on security measures to avoid vaccine shortages during a pandemic,” states the article. The company was then responsible for producing about half of the anthrax vaccines part of the National Strategic Reserves, a project that cost $500 million a year.

Emergent also received a $163 million federal contract to upgrade its facilities to be ready for large-scale production when needed, the report said. When the pandemic began, the factory was the most important in the United States for the manufacture of vaccines, such as those previously developed by Johnson & Johnson and AstraZeneca. They managed to produce 150 million doses until a few weeks ago. But none of these doses could be used as the factory was not properly certified. Another 15 million doses had to be destroyed because Johnson & Johnson doses were contaminated by AstraZeneca doses. Between October and January, the company had discarded five more batches of the AstraZeneca vaccine, each containing two to three million doses.

The company, according to data published by the The New York Times, did not meet the deadlines required by the government for the manufacture of other vaccines. “Several audits showed how ill-prepared the company was for the enormous task it had undertaken,” they say. Government officials privately admitted that they were committed to an unhappy marriage to Emergent, and that Johnson & Johnson, whose manufacturing expertise is largely overseas, was in no position to replace it to weather the crisis. challenge.

In any case, the Biden administration also faces another problem. The agreements signed by his predecessor with the producing companies do not allow the export of vaccines, or even their donation, to avoid possible legal problems, which makes it more difficult to lead the fight against the pandemic, as proposed by Biden.

A healthier world

“We must make testing of Covid-19 vaccines available to everyone. It is time to build a healthier and fairer world for all”, we can read on the page of the World Health Organization (WHO), the same institution that Trump accused of being subject to Chinese interests and from which he withdrew. Biden rushed to return to the organization as soon as he took office.

Unlike the United States, China has prioritized vaccine exports. It had exported 115 million doses, more than double that of India and the European Union combined. But in the opinion of James Palmer, editor of Foreign Policy, the program was not as successful as expected because the Sinovac and Sinopharm vaccines “did not inspire confidence”. Its level of effectiveness is disputed, which, according to Palmer, the WHO would have estimated at around 70%, compared to more than 90% for Western vaccines. A calculation whose precision requires some weighting, as experts warn, due to the very different conditions in which each vaccine was tested. Only 39% of Hong Kong citizens would be willing to take Chinese vaccines, says Palmer, referring precisely to a scenario in which the United States and part of Europe are putting heavy pressure on Chinese interests.

The other scenario of this confrontation is the autonomous region of Xijiang, where, according to Secretary of State Antony Blinken, a genocide against the Uighur ethnic group is taking place. Consequently, the United States, European Union, Canada and England imposed sanctions on Chinese officials, a move that Beijing responded with even greater sanctions on officials in each country.

An exchange that will not facilitate the approval of the recent trade agreement with the European Union, signed by Beijing after seven years of negotiations, but which requires ratification by the European Parliament, dominated by very conservative forces. However, President Xi Jinping and German Chancellor Angela Merkel spoke by phone last Wednesday. China has been Germany's biggest trading partner for the past five years, which has not facilitated Washington's efforts to confront the two countries.

Xi Jiping expressed his opposition to the politicization of vaccines and proposed the cooperation of the international community to ensure fair and reasonable distribution. Shortly afterwards, the German Minister of Health, Jens Spahn, announced his interest in talking with Moscow to obtain the Sputnik V vaccine, rejecting the position of the EU, which refuses to negotiate with Russian vaccine manufacturers.

With the escalation of tensions with Russia, especially in the face of the conflict in Ukraine and the increase in US pressure, the German position breaks with EU policy. The Governor of Bavaria, Conservative Markus Söder, also announced the signing of a pre-contract with Russian vaccine producers. Once the necessary safety checks are carried out, the Bavarian company R-Pharm could produce 2,5 million doses ready for July.

The other scenario for this race for vaccines is the one that is developing in Cuba, with five varieties currently, in different degrees of experimentation. Two of these varieties are already in the last phase of trials, which, if they prove favorable, could allow the vaccination of the entire population of Havana – around 1,7 million people – by May. And, in August, almost the entire population could be vaccinated. It would be the first case of a country to obtain such results. But Cuban vaccines will also make it possible to meet demand from countries blocked by Washington, particularly Venezuela and Iran, where they would also be tested. The success of the tests would allow the joint production of up to 40 million doses.

The war for vaccines introduces a new factor into the world political scenario, which overlaps with the growing tensions between Washington, Moscow and Beijing, without it being possible to predict whether the WHO's call to make vaccines available to all will help to eliminate certain asperities, or if these roughness will end up making it impossible for everyone to be vaccinated in order to control the pandemic.

*Gilberto Lopes is a journalist, PhD in Society and Cultural Studies from the Universidad de Costa Rica (UCR). author of Political crisis of the modern world (Uruk).

Translation: Fernando Lima das Neves.

 

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