27 May What is the Pandemic Teaching? Vaccines in a changing economic and social context

From the history of pandemics, we inherit important lessons for today’s society struggling to cope with COVID-19. First, it confirms that global pandemics can have grave and potentially permanent unequal economic consequences. The local economic impact of a pandemic depends, not only on the quality of health institutions and the policies to contain the pandemic, but also on unpredictable epidemiological factors. Similarly, the demographic impact of pandemics strongly depends on a complex series of conditions that are very difficult to predict.

This blog post discusses the importance of vaccines within the rapidly changing socio-economic context, and their potential to reduce inequalities. It is important to economically support our socio-economic system, to be able to provide effective, and above all, easily accessible vaccines in every part of the world.

Within the COVINFORM project, the University of Sapienza provides an in-depth analysis of economic and social welfare responses to COVID-19, critically evaluating their benefits and effectiveness. This will allow to recognise the interventions with positive effects on populations, and promising improvement of governmental practices.

Vaccine inequality

The launch of the vaccination campaign around the world has highlighted evident inequalities in access to vaccines, on which depend our hopes for getting out of the pandemic. WHO and UNICEF have pointed out that, of the millions of vaccine doses administered so far, more than three-quarters of vaccinations have occurred in just 10 countries representing 60% of the world’s GDP. To date, in some of these 130 countries, no doses of the vaccine have been administered so far. WHO and UNICEF have denounced that this self-defeating strategy will cost lives and livelihoods and will give the virus further opportunity to mutate, evade vaccines and threaten global economic recovery. In this regard, world leaders should look beyond their borders and implement a global vaccination strategy that can truly end the pandemic.

According to Agathe Demarais, the director of global forecasts of the Economist Intelligence Unit (EIT), at this rate, most developing countries will have widespread access to the vaccine no earlier than 2023: “Some of these countries, especially those with poorer people and a young demographic profile, could lose the motivation to distribute vaccines, especially if the disease spreads widely or if the associated costs prove too high”.

The Economist calculated that the 54 richest countries represent only 18% of adults on Earth but have secured 40% of vaccine orders. These decisions by the richer countries are at the expense of the poorer ones. Some experts on global public health and inequalities have urged rich nations to address this situation, through a policy that risks finding little support from their public opinion: the donation of doses to countries that need them, after reaching a vaccination threshold based, for example, on age and groups of people at risk. Indeed, the goal of a vaccination strategy during such a pandemic should not be to vaccinate all citizens of a country, but to work to vaccinate the people most at risk around the world. So far, however, this proposal has met limited consensus.

Meanwhile, countries such as China, India and Russia are donating millions of doses to countries with fewer economic resources to procure vaccines or have signed advantageous contracts by providing low-cost Chinese, Russian and Indian vaccines with the hope of extending their political influence or recovering diplomatic relations.

Vaccines and patent rights

Delays and inequalities in the production and delivery of vaccines, due to the difficulty of manufacturers to respond to the great demand from countries around the world, has prompted non-governmental organizations and public health experts to ask for the suspension of patent rights of pharmaceutical companies to allow for a wider production.

This proposal, however, has been opposed by several rich countries such as United States, Great Britain and the EU due to fears that its approval would stifle innovation in pharmaceutical companies, depriving them of the incentive to make huge investments in research and development. The president of the US, Joe Biden, made a recent proposal to suspend the patents on COVID vaccines, giving the possibility to anyone capable to start producing approved vaccines with the aim of increasing the availability of doses around the world. However, even with this endorsement, it will take time for WTO to reach an agreement.

In the event that governments decide to use the patent without the consent of the person who registered it and produce the vaccine independently, there could be consequences that should not be underestimated in the medium and long term. It would set a precedent that could make pharmaceutical companies more reluctant to make large investments in the development of new vaccines or drugs, because the uncertainties related to the development and testing phases would be added to those at the risk of having the patent suspended. Some companies may also decide not to patent their solutions, with the risk that they will never be fully available in the public domain.

The new Italian vaccine

Currently, testing of two new vaccines is being undertaken in Italy. The aim of the work carried on by the Italian researchers and European institutions, is to develop a technology that could potentially prove useful not only against COVID-19, but also on a series of other therapeutic applications, starting with cancer vaccines.

Unlike other vaccines already approved by the European Medicines Agency (EMA) which are using mRNA and adenoviral vectors, the new Italian vaccine is based on a DNA fragment injected into the muscle that promotes the production of a specific portion of the “spike” of the virus, stimulating a strong immune reaction against the virus. The efficiency of the process is increased by the “electroporation” technique, which favours the passage of DNA inside the cells in a simple, rapid way and without side effects.

The vaccines developed in Italy add to the pool of available vaccines. As the total number of vaccines in production increase, more and more people will be able to access them, not only in Italy but also in the world, contributing to reach those in economic and social difficulties.

The importance of collaboration

As we remain unaware of the final gravity that the COVID-19 pandemic will have on each individual European state and their national economies, collective responses to the crisis, possibly coordinated by the EU, appear to be highly advisable. We have at least one important historical example of the benefits of international solidarity and cooperation after a large-scale catastrophe: the rapid economic growth of Western Europe after World War II. Hopefully, the progressive construction of the European Union, which historically has secured peace and prosperity on the continent, will allow to transform the pandemic into an opportunity for collective recovery, and perhaps even for a growth in the long term – for the benefit of all.

In this context, collective responses to the crisis, as we are trying to do in Europe, overcoming populisms and selfishness and reviving, where possible, the spirit of cooperation, seem highly advisable, as does that of having more vaccines available.

Author: Donatella Strangio

Interview with with Prof. Beatrice Vallone on the Italian vaccine development.

References

Acemoglu, D. e Robinson, J. (2013) Why Nations Fail? The Origins of Power, Prosperity, and Poverty. Londra.

Alfani, G. (2013) Plague in seventeenth-century Europe and the decline of Italy: an epidemiological hypothesis”, European Review of Economic History, 17, 3, pp. 408–430.

Alfani, G. (2015) ‘Economic inequality in Northwestern Italy: A long term view (dal XIV al XVIII secolo) ‘, Journal of Economic History, 75, 4, pagg. 1058–1096.

Alfani, G. (2021) ‘Economic inequality in preindustrial times: Europe and beyond ‘, Journal of Economic Literature,  59, issue 1, pp. 3-44.

Alfani, G. e Tullio, M. Di (2019) The Lion’s Share. The Lion’s Share: Inequality and the Rise of the Fiscal State in Preindustrial Europe, Cambridge: Cambridge University Press.

Borsch, S. J. (2005) The Black Death in Egypt and England: A Comparative Study, Austin, Tex.

Borsch, S. J. (2015) ‘Plague, Depopulation and Irrigation Decay in Medieval Egypt’, in: Green, MH (a cura di), Pandemic Disease in the Medieval World. Rethinking the Black Death, Amsterdam, pagg. 125–156.

Broadberry, S. (2013) “Accounting for the Great Divergence”, LSE Economic History Documenti di lavoro, n. 184.

Campbell, B. M. S. (2016) The Great Transition. Climate, Disease and Society in the Late-Medieval World, Cambridge.

Cipolla, C. M. (1981) Fighting the Plague in Seventeenth-Century Italy , Madison

Snowden F.M., Epidemics ans Society. From the Black Death to the Present, Yale University, Yale University Press, 2019.

Zitelli A., (february 2021) https://www.valigiablu.it/vaccini-disuguaglianze