Governments across the world are in a race against the clock to roll out COVID vaccines. But the profiteering of Big Pharma, the recklessness of bourgeois politicians, and the anarchy of the market are hindering efforts.
With vaccination programmes underway around the world, one would think we are approaching the end of this pandemic. Unfortunately, the pharmaceutical profiteers and political representatives of the ruling class are bungling the rollout in some of the worst-affected countries. And in their haste to return to ‘normal’ and get the economy moving again, politicians are ignoring the science, cutting corners and putting lives at risk.
Despite ordering enough doses to vaccinate their populations several times over, governments in Europe, the US and the UK have already fallen well behind their vaccination targets. In Britain, where a new, highly virulent strain of the coronavirus is running riot and nearly 100,000 have died, experts estimate that two million jabs a week are needed to start to bring the situation under control. In fact, about 3 million have been administered in total since efforts began last year. In the worst-hit country in the world, the USA, the government claimed 20 million people would be vaccinated in 2020. But the Centres for Disease Control (CDC) estimates just 4.2m shots were administered last year.
This is partly due to the irrationality of capitalist production, which has created gaps in the supply chain. Companies like Pfizer and Moderna have sold far more doses than they can currently supply, guaranteeing huge profits upfront. In order to meet their commitments, they have to strike deals with other companies for items ranging from DNA molecules to lipid nanoparticles: the tiny oily droplets that deliver their vaccine’s mRNA ingredient. This in part led Pfizer and BioNTech in December to halve their production forecast to 50 million doses by year-end.
All of these commodities are owned by the private sector, which expects to be reimbursed. In short, private interests and a lack of central coordination are holding things up. By contrast, under socialism, all the necessary materials could be sourced and distributed immediately, without having to worry about businesses’ bottom lines.
But despite British Prime Minister Boris Johnson pinning the slow start entirely on a shortage of supply, there are problems with distribution as well. Officially, there were 530,000 doses of the Oxford/AstraZeneca vaccine ready for use in Britain on Monday, with an additional 450,000 on Tuesday. A further 18 million are in various states of preparation and approval. On top of that, it is estimated that about 5m doses of the Pfizer vaccine are ready for use.
There is, however, a shortage of medics to administer them. The NHS (battered by years of underinvestment even before the coronavirus hit) is barely coping with the latest wave of infections. This resulted directly from the Tories’ hapless handling of the pandemic. Only this week, the government finally announced a national lockdown after weeks of prevarication, by which time the situation has spiralled well beyond their worst-case scenarios.
This put a huge strain on the health service, which was already forced to put out a call for trained volunteers to deal with the influx of patients around Christmas. GPs are warning of the need for an even-bigger recruitment drive in order to meet vaccination targets, possibly including military personnel, midwives, optometrists and even firefighters and lifeguards, in addition to retired medics. Then there is the issue of the special, ultra-cold fridges needed for the Pfizer and Moderna product, of which the British government has not sourced nearly enough. There is even a shortage of normal fridge space available for the Oxford/AstraZeneca vaccine. Or rather, there is plenty of fridge capacity: but it is in private hands (private hospitals, supermarkets, restaurants etc.), meaning the public purse will need to cover the costs.
Compared to other advanced capitalist countries, Britain is vaccinating its population relatively quickly: a point the Tories are keen to emphasise. But firstly, this isn’t saying much. Secondly, it’s still not enough. And finally, the Johnson clique’s callous mismanagement meant Britain faced an astronomical infection rate to begin with. Had the Tories enacted a serious lockdown at the beginning of the year, rather than prioritising the short-term interests of their big business cronies, we wouldn’t be in this position.
Off to a bad start
In Europe, a painfully slow rollout has seen all semblance of ‘unity’ against the common viral threat break down into bickering and recriminations within and between the EU member states. An agreement (spearheaded by Germany) saw responsibility for securing vaccine doses delegated to the European Commission. In theory, this should have allowed the entire continent to access 2bn doses: more than enough to vaccinate the entire EU population. But in practice, bureaucratic obstacles and incompetence in Brussels, combined with local variations in rollout speed, have resulted in a terribly inefficient and patchy inoculation campaign as each ruling class seeks to look out for its own interests first.
The EU has signed six vaccine contracts – with Moderna, AstraZeneca, Sanofi-GSK, Janssen Pharmaceutica NV, Pfizer-BioNTech and CureVac. But so far only the Pfizer/BioNTech and Modern vaccines have been approved for use. The attempt at ‘diversification’ meant the Commission paid for a lot of vaccines it can’t yet use, and doesn’t have enough of the ones it has actually approved to meet demand. Finland, for example, only received about 40,000 doses in December, instead of the 300,000 that were expected. This, combined with the fact that richer EU countries have been able to secure additional doses outside of the joint purchasing agreement, is causing huge frustration across the bloc.
Despite seeming to handle the pandemic better than other countries up to now, the situation in Germany has deteriorated. Health Minister Jens Spahn is under fire for failing to secure enough vaccine doses, and being slow to start inoculations. Despite the German government investing billions in BioNTech’s vaccine research, opening hundreds of emergency vaccination centres and having the infrastructure to administer up to 300,000 shots a day, only a fraction of this capacity is being utilised. In the first two weeks of its vaccination drive, Germany delivered 533,000 shots, two-fifths of the 1.3 million doses received, leading to tension between state-level and federal governments.
Chancellor Angela Merkel, once the golden child of sound governance in Europe, has come under fire after it turned out she personally intervened to block a purchase of more doses of the Pfizer/BioNTech drug. Even the most reliable bourgeois agent of the ‘European community’ has lost her lustre under this crisis.
In the Spanish state, the speed of vaccine distribution has varied wildly due to a lack of preparedness and administrative incompetence at the top, meaning as of last week, about 0.1 percent of the Spanish population was vaccinated. In Portugal and the Netherlands, patients are only just beginning to receive jabs. And in Italy, despite a relatively high vaccination rate (about 300,000 people so far), as in Britain, the number of deaths and infections were already dire to begin with. Moreover, there are big regional variations, with Lombardy (21 percent of available doses), Valle d’Aosta (18.07 percent), Sardinia (9.8 percent) and Calabria (6 percent) all seeing low completion rates. This has contributed to a crisis of the already shaky regime, as three ministers from Italia Viva party resigned from Conte’s government, leaving him scrambling to hold his coalition together. In short, all the big member states have been caught totally unprepared, once again, and a huge amount of public anger is accumulating.
The pressure of the coronavirus pandemic is continuing to accelerate the divisions eating away the foundations of the EU, exposing the rot at the heart of its political regimes as they struggle to cope. All of this is dragging out the pandemic and putting countless lives at risk. The situation is particularly acute in France, where the bourgeois Macron government planned to vaccinate 20 million in the first half of 2021. It has so far administered just 0.38 Covid-19 vaccines per hundred people, despite receiving 500,000 doses of the BioNTech vaccine.
Vaccine wariness is higher in France than anywhere else in Europe, partly due to lingering resentment over the failure of the H1N1 flu vaccination campaign in 2009, but mostly to a deep and profound distrust in the establishment and all its works following years of austerity, betrayals and repression. The Macron government tried to mitigate these concerns with a very tentative, ‘phased’ rollout – starting with elderly people in care homes, and relying mostly on family doctors. This backfired spectacularly.
“Going slowly doesn’t build confidence,” explained Philippe Juvin, head of the emergency department at the Georges Pompidou hospital in Paris. “On the contrary, it supports the idea that there is something to worry about.” Indeed, 40 percent of French people polled by Ipsos last week said they planned to be vaccinated, down from 54 per cent in October. A third of French people also believe vaccines are dangerous. In response, Macron performed one of his signature about-faces, promising in a televised New Year’s address to overhaul the country’s vaccination efforts, stating: “Every French person who wants to must be able to get vaccinated.” The government now says it will open mass public vaccination centres “before February”, but the damage has been done.
This hated regime of the rich has stumbled from one crisis to another ever since Macron was elected in 2017. His confidence and authority have been shattered, as these vacillating vaccination efforts attest. Had the French labour leaders given a lead to any of the mass movements of past years – from the gilets jaunes movement in 2018 to the massive strike wave a year ago – the Macron government could have been brought down, a workers’ government could have been established and this disaster averted.
Finally, in India – the country with the second-highest death and infection rate after the USA – a locally developed coronavirus vaccine (Covaxin) was approved for use despite Bharat Biotech not revealing its testing data. Malini Aisola, co-convener of the All India Drug Action Network, a health watchdog based in New Delhi, stated that she is “extremely alarmed and shocked because this is really signifying the grant of regulatory approval without efficacy data… The government has taken this accelerated process too far.” Between the lasting economic impact of the draconian lockdown in March, a rising peasants revolt, and skyrocketing COVID-19 casualties, Prime Minister Narendra Modi is clearly desperate to rush out a vaccine – even before it is confirmed to be safe – to maintain his authority and get business up and running.
Ignoring the science
This kind of recklessness is not limited to India. All over the world, political representatives of the ruling class are locked in a deadly race with a virus they have utterly failed to manage or contain. Faced with overrun hospitals and spiralling infection rates, and determined to get the economy going again at any cost, many of them are turning to so-called pragmatic measures. In plain English, this means cutting corners.
In Britain, the government is hoping to stretch its available vaccine supply by lengthening the recommended intervals between the two necessary doses from around three weeks to three months. It is also suggesting a ‘mix-and-match’ approach in emergencies: for example, where a second dose of the Pfizer vaccine is not available, administering a patient the Oxford/AstraZeneca product.
With the former, the rationale is that a lower-but-broader level of immunity might be preferable in the short term, and full immunity can still be achieved at a later date. But it is still not clear how long immunity is retained, especially after just one dose. The idea was justified by Britain’s chief medical officers, who pointed out that participants in Oxford’s UK study sometimes got their second dose between four and 12 weeks after the first.
However, a 21-day interval remains the recommended advice from Pfizer/BioNTech, and obviously it is not in their financial interests for these major products to fail. Data in their phase three trials were based on participants receiving their second dose only nine days after the first. A review in the New England Journal of Medicine found an efficacy rate of 52 percent after the first dose: higher than the protection level required for a COVID-19 vaccine by the US regulator, but far less than the 90+ percent for the full course.
There is an increased danger of new mutations if the virus is transmitted between millions of people with only partial immunity. It also raises the risk people might refuse, or simply forget, to take their second dose. Bearing in mind that between 70 and 80 percent of the population need to be immune for the virus to die out, this is clearly worrying.
Meanwhile, there is zero data behind Britain’s proposal to mix vaccines. The Pfizer and Oxford/AstraZeneca products are based on totally different technologies, and Stephen Evans, a professor in pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, told the Financial Times the approach was “not supported by randomised trial evidence”. Furthermore, CDC states categorically the coronavirus vaccines are not interchangeable. “None of this is being data-driven right now,” echoed Dr. Phyllis Tien, infectious disease physician at the University of California, “we’re kind of in this Wild West.”
And Britain is leading the rest of the world across this new frontier, with the US considering extending the period between doses, and Germany and Denmark ready to follow suit. In their desperation to get profits flowing again as quickly as possible, the political representatives of the ruling class are jeopardising their vaccination efforts, with billions of workers, poor and youth set to suffer the consequences if these drugs don’t have the expected effect. Given that public confidence in these vaccines is already low, it is incredibly irresponsible for governments to take risky shortcuts on a whim. This will only deter even more people from getting vaccinated, which will further hamper efforts to beat the virus.
Vaccine Apartheid
As we have written before, hoarding by the richest western countries is putting any vaccine out of reach for billions. Despite providing the bulk of cheap test subjects for Pfizer’s human trials, countries like South Africa, Argentina, Brazil and Turkey will not receive enough of the vaccine to inoculate their populations. As far as Big Pharma is concerned, poor people in these countries are fine as guinea pigs, but they aren’t worthy of a proper supply of vaccines.
Vaccine nationalism always favours countries that can afford to pay the Big Pharma profiteers. The WHO’s COVAX programme, which calls on international cooperation to bring vaccines to the poor world, faces “a very high risk of failure” due to underfunding and a lack of participation from the US and China. Meanwhile, the World Bank is providing aid for the delivery of vaccines in the form of loans, thus deepening Third World debt. “We’re facing a global vaccine apartheid,” said Zain Rizvi, law and policy researcher at Public Citizen.
In Israel, this term is especially apt. Despite inoculating a tenth of its population already (the highest proportion anywhere) and shipping out vaccines to settlers in the occupied territories, Palestinians living there might be waiting months for COVAX to provide them with vaccines. This means that, while Israelis could see a return to some normality in the near future, the Palestinians remain trapped with the virus.
Moreover, despite toothless regulations to prevent private interests dictating access to medicine in poor countries, Big Pharma is jealously protective of its intellectual property to avoid the production of cheaper derivatives. Even those like Moderna that agree not to enforce patents on COVID-19 vaccines refuse to share their research. These fatcats shouldn’t be allowed to get away with this, but you can’t control what you don’t own. A socialist society would simply expropriate the pharmaceutical pirates under workers’ control, and put their knowledge and technique in the service of society.
When will it end?
As the pandemic grinds on, the fight for socialism is ever-more urgent. The longer the virus runs amok, the greater risk of it mutating into a strain the existing vaccines can’t cope with. Already, Sir John Bell, regius professor of Medicine at the University of Oxford, has raised a “big question mark” over a mutant strain in South Africa. “The mutations associated with the South African form are really pretty substantial changes in the structure of the protein,” he said – specifically referring to the part of the virus that allows antibodies to stick to it. Cases of this strain have been found as far from South Africa as Great Britain. Another potentially vaccine-resistant strain has been observed in Brazil. Nothing is certain, but if Bell’s concerns are warranted, these are very worrying developments.
It is a tragedy that the essential task of manufacturing and distributing this vaccine has been left to a system wracked by crisis and decay. From the start of this pandemic, the Marxists have pointed out time and again that capitalism and the logic of the market are inhibiting our fight against the coronavirus. An academic interviewed in the Financial Times candidly explained how this applies to vaccine production:
“Given the huge costs, the best economic policy would be to mobilise and co-ordinate global resources to ramp up vaccine production as fast as possible. Capacity needs to be expanded, subcontracting to more companies if needed or even setting up new factories. If we were really ‘at war’ with the virus, governments would focus all their resources on this one task. Instead, there is a gulf between the rhetoric and reality of vaccine production.
“…Vaccine manufacturers have little interest in expanding production massively. In fact, they would be financially worse off if they did. If they ramped up production capacity so that the whole world was supplied within six months, the newly built facilities would stand empty immediately afterwards. Profits would then be much lower compared with current scenarios, where existing plants produce at capacity for years to come”. [Our emphasis]
There you have it! The system will not do what is needed to put an end to this public health calamity: because it is not profitable. Under socialism and a globally planned economy, anything and everything necessary would be done to fight the pandemic. It is the duty of the working class and youth worldwide to put an end to capitalism, rescue science from the straightjacket of the market, and chart a healthy, prosperous future for humanity.