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The Myth of Cooperation

From the series Vaccines and world contention

There are by now ten authorised vaccines already in use against SARSCoV-2, and there are 77 countries in which vaccinations are taking place. By mid-February, 173 million doses had been administered and the campaign is proceeding at an average rate of six million a day, calculated on the basis of last week’s figures. At this pace, it would take 5 years to vaccinate 75% of the world population with two doses [Bloomberg, February 15th].

More than half of the injections have been carried out in the United States, the UK, and the European Union which, together, account for 11% of the world population. In at least one third of the 77 surveyed countries, less than 1% of the population have received their first dose of the vaccine, and, in the rest of the world, vaccines have not yet arrived.

Imperialist globalisation

Individual states are pursuing autonomous solutions to a global problem. Epidemiologists believe that, while a vast proportion of the population is still susceptible to the virus in the next few months, the increase in the number of persons who have been vaccinated or who have acquired natural immunity thanks to infection will produce a selective pressure that will favour the spread of new variants. These new strains will be potentially more dangerous due to increased contagiousness and virulence [Financial Times, February 9th].

It is a question of timing and internatonal coordination. Richard Horton, the editor-in-chief of The Lancet, writes that the response of govemments to COVID-19 represents the greatest political failure of Western democracies since the Second World War [The COVID-19 Catastrophe, 2020]. In his book, written in the ‘first phase’ of the pandemic, he examines the shortcomings of both the scientific community and the world leaderships, and the lessons learnt. Here we report only one of them: COVID-19 […] has also exposed our inability to cooperate, to coordinate and to act together, since national interests and rivalries have prevailed.

The need for a coordinated global effort that involves, most of all, the richest parts of the world, is highlighted by many experts and commentators. Martin Wolf of the Financial Times, paying particular attention to the economic damage the pandemic has already caused, writes that no event since the second world war has better demonstrated the limits of national autonomy and that the costs of an inward-looking policy of health in one country are not just narrowly economic. In order to halt the virus and to allow the recovery of normal trade, world leaders must do ‘whatever it takes’ to finance accelerated production and distribution of vaccines — and, if necessary, reformulated vaccines — globally, regardless of the expense, which would be incomparably less than the $5,600 billion of extra fiscal expense borne by the advanced economies in order to respond to the pandemic [February 10th].

The appeals to international cooperation are justified, even if they betray the fear that the part of the world left to itself will also drag the richer economies into the abyss, We should observe, however, that the incapacity to organise a joint, unitary action on a global scale is not a ‘dysfunction’: competition and rivalry among the economic groups, and struggles among the imperialist states for the division of spheres of interest and areas of influence, are ‘physiological’ in the capitalist social system. Unification of the world market does not mean the humankind without frontiers and class divisions; globalism does not mean internationalism.

New arrivals

On January 25th, the European Medicines Agency (EMA) authorised a third vaccine, after those of BioNTech/Pfizer and Moderna. Created by the University of Oxford, it was developed in collaboration with AstraZeneca and is already accepted in 27 other countries. AstraZeneca arose in 1999 out of the merger between the British company Zeneca and the Swedish company Astra, and is among the top ten Big Pharma companies with a $24.4 billion turnover and 70,000 employees; at the end of 2019 it was operating with 25 production sites in 16 countries. Before the pandemic it had a marginal presence in the world vaccines market.

The two-dose Oxford/AstraZeneca vaccine uses the tried and tested ‘viral vector’ technique. This technology, we recall, utilises a genetically modified virus, which is incapable of replicating itself, to transmit the genetic instructions (a fraction of the viral DNA) to human cells for the production of coronavirus spike protein. This protein will become the target of the immune system. The ‘carrier’ virus is a chimpanzee adenovirus (which causes light infections in humans such as the common cold).

According to the results made known in the latest clinical tests, the Oxford/AstraZeneca vaccine proved to be 82% effective with two doses at a distance of 12 weeks, significantly higher than with the previously observed six-week-intervalresults [The New York Times, February 319.

Political wars and trade wars

The EMA has conditionally authorised the distribution of the Oxford/AstraZeneca vaccine (pending further data from the company) for those over 18 years old. The Agency has not placed other age limits, but it has specified that there are not yet sufficient results in participants who are more than 55 years old. While this ‘recommendation’ has been adopted by other European regulatory bodies in Italy, France and Germany, the limit has been set for people who are 65 or older.

This is not the only ’stumbling block’ for Oxford/AstraZeneca. After the initial blunder regarding dosages and the intervals between the two injections, difficulties arose over respecting the delivery times of the doses promised to the European Union: these difficulties led to a commercial contention and a political clash with Britain over respecting the Brexit agreements to keep open the Irish borders.

The European Commission, under pressure from Germany, introduced controls on exports of vaccines produced in the Union in order to understand — said the German Health Minister Jens Spahn — whether the Union’s contracts with producers were being equally respected [Süddeutsche Zeitung, January 25th). The Health Commissioner Stella Kyriakides specified that the EU wants to know exactly which doses have been produced by AstraZeneca and where exactly so far and if or to whom they have been delivered. [Financial Times, January 26th]. The EU’s ‘protectionism’ came under fire from other countries such as Canada and Japan, concerned about supplies from Europe.

The slowdown in supplies — not only on the part of AstraZeneca — led to accusations being levelled against the management of vaccine supplies on the part of the EU, which centralised their anticipated purchases on behalf of all of its member states. The European Commission, argues Gideon Rachman in the Financial Times, saw the pandemic as a great opportunity to expand EU powers, showing a degree of ‘incompetence’ in handling trade agreements (February 2nd).

Vaccines and vaccinations, slower in Europe than in Britain and the United States, are being brandished in the confrontation among the powers. The Economist is even blunter: if the European Union wants to find its competitive spirit, then a vaccination race is the perfect place. For a bloc with global pretensions […] there is more at stake than health. If a group including some of the world’s most successful societies cannot vaccinate their populations swiftly, then any pretensions that the EU is a potential superpower look ridiculous [January 23rd]. This argument could be extended to the USA, a scientific and technological superpower: this giant in the scientific field has not succeeded in exploiting its knowledge within national policies in order to respond to the pandemic, writes Horton [op. cit.].

Industrial battles

In any case, the Commission has taken a step forward in European integraton, towards the realisation of a Europe de la santé Europe of the healthcarel invoked by French President Emmanuel Macron as early as May of last year. The President of the European Commission, Ursula von der Leyen, defended the centralisation of purchases, adopted to protect the smaller states who have less negotiating power with vaccine companies, but she recognised she had underestimated production problems.

Productive capacity is the crucial point. Pfizer, Moderna and AstraZeneca promised overall production of six billion doses this year. To make a comparison, the annual European production of fu shots (including Britain) is estimated by the European Federation of Pharmaceutical Industries and Associations (EFPIA) to be 1.7 billion doses, made in 27 production sites across 11 countries.

We have already observed that the strategic risk of dependence on foreign supplies in the health sector has been denounced for some time in Europe (and also in the USA). The EFPLA warns of the risk of a trade war in the new European rules: Moreover, given the global nature of vaccine supply lines, the proposal from the Commission might […] risk retaliatory measures from other regions, putting the supply of manufacturing matrials needed to produce COVID-19 vaccines and consumables related to the provision of those vaccines at risk. Retaliation measures could also extend the scope of the disruption to medicines and other products. [EFPLA, January 29th].

Thierry Breton, the European Commissioner for the Internal Market, stresses that the pandemic has increased the vulnerability of certain supply chains, and that the EU must create its own capacity in such key sectors as the pharmaceutical industry [Financial Times, May 6th]. On September 17th 2020 the European Parliament approved a resolution in which it asked the Commission to use the upcoming pharmaceutical strategy to [restore] the EU’s health independence and to increase the production of medicines and the level of innovation within the EU. Currently, 40% of the medicines on the market in the EU come from third countries [i.e., non-EU countries], while 60-80% of their active pharmaceutical ingredients are produced in China and India.

Global cooperation or global competition? The nation states are choosing ‘every man for himself’, and the Big Pharma groups are fighting for the carve-up of the world market.

Lotta Comunista, February 2021