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You recently wrote an article for the New York Times in which you stated that all the world agreed that we need a vaccine and i wonder if its really so subtle not the moan to governments who quad always under pressure to produce some sort of a solution some sort of a panacea but among scientists and they really are rather the consensus at that scene is the ultimate weapon against cobbett 90. d so sure are. I dont believe it will solve all the problems there are many problems about producing on a sufficient Scale Distribution of a sense that we need to jump over comments that there are people may think once of invention natured that all of the problems are going away and thats not true either at the societal level or at the individual level because its unlikely that a fuss about actually will be on the percentage of sectors that are speaking about this over confidence even on the bass of vaccines i mean this you mean the best possible scenario the vaccine will still have its limitations whats a realistic expectation at this point of time or whatever back you should be able to do ill be talking about i dont know seasonally protected high risk groups or is it all about eliminating 1000 and its to tally. Its certainly not about to limit or carrying the virus which is probably impossible in the early virus the terrible but not a minute or 2 just small theyve now been trying to relive in a rodeo for 40 years to its cost Something Like 10. 00 times the original estimate on which still not totally successful so it would be a disaster if people stopped saying we must try to eradicate the virus because it will prove it will prove impulsive 0 and far too costly its a question of control i heard you say before that historically vaccines have been prone to Mission Creep so to say the zapper expanding objectives and part of that may have something to do with the fact that the vaccines are one of the Fastest Growing markets for big pharma but speaking of these idea that we battled develop vaccines against everything to do you take it as more commercially driven or is it perhaps just a form of magical thinking the psychological demand for hawaiian more safety which i think is so characteristic of our times. Thats a very difficult question. I think the important thing to emphasize as that the kind of underlying dynamic of Vaccine Development the strange and in the 19 a is whereas previously vaccines have been seen as purely in the only launch of a true or a Public Health they increasingly in the 1980 s. Became seen as a commercially valuable commodity and there was a partial decoupling between the needs of the Health System and the approaches of fracturing development but under a recently a great deal of the dynamic behind Vaccine Development risk commercial now its more complicated with kofi not treating. Its very very much commercially driven not speaking about called 900 specifically i. Think you would probably agree with me that its not the data the s the fire says when it lands on the meter bullet only compromised calculations its dangerous and magnified many times over and this is unplanned major issue with the race to the accident praised because i think it ignores a vital part of what makes this virus. So dangerous and so deadly. Dont you think that in focusing so much on vaccines we are essentially taking a shortcut and ignoring structural issues which make so many people not all but so many people so susceptible and small vulnerable not only tickled at 19 but to many other viruses as well. Totally agree and i mean thats thats an interesting question for a historian because. In 1998 there was a very famous come from certain not key in kazakhstan which came up with the idea of healthful all on the idea was very much the vaccines or any specific disease focused acknowledged to be seen as a long weapon bugs used within a much broader Socio Economic approach to dealing with health the rejection by some place or as some by some experts of the idea that the Infectious Diseases had to be treated with a much broader array of that say equalizing technologies providing basic health care and decent Living Conditions for every party and that was the only way of protecting us ultimately and vaccines had to be seen as one instrument in that role in that broader approach but some people prefer to forget about that and say we must take it with a System Technology is a disease or time so. We launched the idea of focusing on those Socio Economic course interventions so and i think thats one of the tragedies are our present situation and why we become overreliant over we place too much faith in a back street you know as the the magic bullet that will slow up with limbs a lot of experts and voicing concerns about the speed of development and under investigated long term consequences but i would like to ask you about the vaccine design because most of the developers are currently in the face 3 trials of focusing on a single viral approaching the socalled spike protein as be immunised an active gents. Isnt that preaching dangerous isnt that putting most if not all that absent one busken well i dont know. Im not a viral edge of a store of banks and knowledge as. What struck me as the. 10 or so vaccines that are counter to vaccines now in trials indeed some of them im making to solve tech and platforms like that and some of them im making here so of recombinant d. N. A. Trigger knowledge is which are not yet been used in existing human licensed human bankruptcy so im glad i mean im not an expert on these these things but i wouldnt say id be morning trying to place my faith in a vaccine that uses an established platform an established way of making vaccines i mean its very complicated because most vaccines consists not only of. Thing the one who may protect but also an active and which will strengthen the reaction well what im struck by is that how little coordination and any there is on being a National Level it seems that everybody is just and rushing to bring a lot of whatever they had in Development Without really trying to 0 on you know how much their breaths and take on different areas of expertise is that in that example in a situation like this or do you think it would have been managed in an more effective way an assault by well now we get into questions of politics i mean thats something. About the present situation of course is that were now in a situation in which the the World Health Organization which tried our kind of monopoly of moral forestry in the field and stream progressively undermine. Its very difficult to say where and if consensus could be reached survey is. A structure kovacs riches been established by the World Health Organization and godfrey something called c. P. Which is basically all slow but to a number of launches countries have chosen not to participate in it it should be a way of kind of ensuring some drove or anxious to back streams even in poor countries but the big problem is that Vaccine Development in this band has become as been turned into a matter of global geopolitical strangeness and thats tragic we will definitely talk more about that but let me ask you a question about w. H. O. Its very hard to see you would just pass its policies in a balanced way partially because adults under doesnt immediately invokes all the. American political infighting but as color jeev being the w sure has lived up to the authority that it claims for in south aroud these prices we needed to have a new fish person to we have to restore it. Any of this this is so different a situation im from lets say the way in which smallpox was eradicated shipped in which the w. H. O. Presided over a very successful a reticulation campaign in which the major powers in the wont whatever their political differences ship them aside in order to collaborate under the auspices of w. H. O. In ridding the well look this terrible deceived we are all still look bad so no at the moment w. H. O. Khan to want to get them but the world we better if youd coach well that is no question about that i guess im trying to figure out the limits of the sort of chord a nation verses are in Decision Making because after the make a very interesting point that many governments are now failing themselves to be under pressure to conform to some sort of a Single Health policy regardless of the it in a logical situation on the ground there social taboos that cultural attitudes that budgets and i would argue that we have seen this play out vividly if theyre out of the commitment and then done it by there is a very strong push for strong quarantines even though that would have produced. Major problems and now theyre you know satyrs of upside to shows it really served us well i mean im not speaking about of course nation but this sort of single handed single policy approach to a Global Pandemic regardless of what the situation really is on the ground im not even sure what the parameters are whatever of some turturro policy would be. One of the issues of course at the moment is how to ensure. When theyre all is a vaccine away there are a number of vaccine they get to the places that then most needed that he wouldnt even agree he or the world wouldnt even agree as to what those places are i mean most people now saying. Since the beginning there wont be enough vaccine for everybody. Priority should be given to those those most urgently need of it like. Health care workers people in essential occupations but theres not likely to be much agreement as to who back tears. And what about the millions of people in refugee camps theyre not going to be at the top or anybodys list of priorities and yet they could easily turn into a hotbed of brutal infection its hard to say its hard to think youre going to instantly implementable solution because. The situation were in have such a deep roots going back lets say at least of the 98 years on top so we have a lot of issues to consider but for the time being our professor going to have to take a very short break well be back in just a few moments. Of the. Join me every thursday on the alex salmond show and ill be speaking to guest of the world of politics sports business im showbusiness ill see you then. Welcome back to world to fight this tour the globe Professor Emeritus of science and Technology Studies at the university of amsterdam where someone just before the break we touched upon the geopolitical aspect of Public Health and using valid that argument in new york New York Times piece where you rode that the race to develop a vaccine isnt just about saving lives its also about power profit and National Prestige is there anything wrong with that thats a very good history of. Where we like to think. Theres all about saving drives but in fact the very beginnings of Public Health in the 19th century the founder of Public Health hooterville called said dont Public Health his politics played by other means and will lead to think that all the fullest systems are dependent on the initiatives that are taken are in the interests of on health and in fact. Not true to me because that also happened 8 infused with those other considerations absolutely thats i mean there isnt the only thing you need to. Look at is the sort of Public Health problem profile at major countries in europe the bad you know peoples interest im not at the top of that enda now each talked a lot about the fact that it will act. To backwards and i wonder what equitable even means in these deniz isnt the governments 1st obligation to its own citizens yes i suppose it is inevitable and i suppose politically well politically inevitable for sure their governments will think 1st about their their own citizens well then we get into the vexed question of who or whos we whos obstacles and im british where im pretty sound dots ive been living in a country which is not the country of my birth for a long time and the deep blue pill asians now are very mobile. It because its more difficult than it might have been. 50 years ago even to say who people are so yes its inevitable i think collision communicable that got him elected politicians will give priority to their own citizens sons but there are times to be somehow downtrodden by. For those who are not overworked consider to be us who where do we draw from lunch now i want to ask you specifically about national mistys because. This name be a selfserving question before you remember that the russians were there 1st you register that youre in a vaccine and theyve received a lot of negative press in the west a lot of allegations that the problem is sacrificing our jacket as well shall or glory even though Russian Developers are going for the same stages as our western colleagues theyre publishing their results in the same medical journals like the labs and i want to be on such a politically and diplomatically charged issue how does one distinguish legitimate concerns from politically driven and actives well for most of us or to people because regionally go whats available in the public media ive seen the reaction mr beaty. The vague to the launch of the russian backseat no longer registration its not necessary in order to know it started these based try as i mean thats the baby how the russian process works where the one hand its true or right as far as i understand thought phase 3 trials of that fraction of not being completed on the other hand i have no doubt order of the negative publicity in the west is promptly motivated by both political and commercial interests. I mean. Russia one previously the soviet union had a long tradition of making that actually and on a very long scandal thats sure and i think the only thing we can probably agree on is of nobody really agree so knows where the 1st generally available and effective function will come from now there is 11 more important distinction between a russian and the west and approaches to your back since and. Part learned it from from your own writing because in the west as you write this states used to be involved in the production of saxons but its no longer the case in most countries its primarily a corporate down to prise in russia most bastions as film developed produced and overseen by the state and i wonder if there is any difference in how the scenes made how they are developed how they test the child and market it how they sell how theyve used depending on who runs the back of the business by the its the state or whether its at or prevent a price who as there are times im working with people from 9 country is on a book. There where the writing on exactly how this ship for a Public Private domain to place in each country its very complicated question id rather own id rather come back into yes when we finished our book. I think on the one hand it was true that many of the state in strict troops in many countries were. Underfunded perhaps insufficiently record like tears but also were denied access to the most Sophisticated Technology areas by commercial companies that are patent to them so on the on around. Those institutes absent deficiences without any doubt the people trusted what they produced because people knew that they were better to produce the jewels the Better National Health System required bot. There is no doubt that the o. In stripy own Public Sector institutes Richard Dieter most countries for of vanished all are in process of being dismantled. Were there was a deficiency is was seen as trustworthy as if it were true so the interests of the people to the british. They were not much if at all influenced by market so commercial considerations too weve lost something. For sure and thats the wrenching out of the book were working on im looking forward to reading it because here youre always very very interesting if fact in that book you also mentioned that. This attitude towards vaccines as these big bully grail of Public Health as the main to acknowledge ease of control and prevention was in part form because of their rivalry between the soviet union and the United States he alluded to that actually him in his earlier that the United States was pushing for vaccines and that is only if you any and was advocating abt rother Socio Economic approach. Following because of it 19 pandemic which really demonstrated i think this same deal says in fascism Metabolic Diseases i mean its really a hybrid disease at its core do you think that will change do you think there would be more are so her appreciation of how sick and commercial practices may. Jeopardize Public Health today extended then they may not be even able to deal with that because it even without calling it 1000 many states were already struggling with the rates of diabetes and heart Heart Disease etc that were primarily produced by you know runaway consumption of certain full. Well just one slight correction the the emphasis on a broader approach came suddenly from the from the from the server during and it also came from the w. H. O. And the director general of that every chair at that time now tamala who was from norway odonnell also said it has to be brought. Whether we can ever go back to that. Who knows i mean i mean i dont think the brutal system thats very quick to look what to be done from the financial crisis of 10 years ago what you really love from previous epidemics were not very good at learning because it seems so so interest trumps knowledge well you seem to be very pessimistic and i think theyre quite good fuel very inspiring examples of lets say sort of broader Human Interest in mind and one of them in my view is the polio vaccine after you mansion these facts and before as as an example of sort of geopolitical competition and this audience trumpeting its success at their successes in producing that backs and but behind it it is actually a story of collaboration because they saw good scientists god that their regional sample from that american colleague who had adopted time no chances of getting bad backs him into a production because it was based on an attenuated polio virus rather than in it and captivated by that the United States was favoring at that time so collaboration and pretty large scale collaboration it was possible even to hide of the cold war surely it should be possible now of course i would like to think that to expulsion from i would like to think that we can tackle the social and economic courses both towards the emergence of new viral diseases. Susceptibility to infection. Its hard to know who. Are we do i mean it would need it would require a transformation. Ways of living if we are if we are political leaders are really to facing seriously perhaps perhaps its possible i would like to think its possible. I dont see the seeds of it yet well maybe you got stuck being skeptical maybe my questions actually absence i want to finish with a very practical question based on in part on on your book ask about have accents became so controversial because you know that if you know them and master and yet you recognise the 2nd has a patient and suspicion at around the issue ringback of vaccines is not unwarranted because they were instances of a method call and commercially driven paddling of vaccines now how should parents go out about it should they research every single vaccine and theyre acting current its 1. 00 to 6. 00 recommended by the dollar and shown more than a 3rd seemed in to about men i mean how do you make an informed decision on such a complicated issue when youre sitting there by yourself in your living room and youre trying to decide whats best for your child well i think one thing wont one thing on their to say to the purpose of that book wester throw in a different light on vaccine hazards im sure youre going to show that the reasons that Something Like 50 percent of people in many countries in some countries are now saying they wouldnt take a back shouldnt against the code be 19 vaccines even when there is one so on the one hand theres the question of reestablishing people strong strain of banks because we need people to accept one if its going to have any benefit to compare any benefit the other questioner or so to choose sometimes a policy question to choose between. Which vaccines to introduce into the international or thats a nation scheme and how to choose an alternative i think one lesson we all ought to have learn. About probably havent as the vaccines have to be acceptable to the compilation before long they are rolled out in a in a society because if an office acceptable there is a real risk of undermining faith in the vaccination system as a whole and i think governments are under such pressure to introduce a vaccine rapidly that the willingness to consult and to ensure acceptability are somehow been eroded joint think. People have to trust the vaccine we have to think about how to reestablish trust both in vaccination generally and in a 19 vaccine for me out and that raises questions that go beyond beyond. What theyre about political systems and in our institutions stress of living we are out of time there really grateful for you joining us today thank you very much for being frank a very much an interesting discussion and they fearful western hope this year again next week and all the part of. Their. Problem drugs dont always come from unscrupulous dealers but from pharmacies too in every state in the United States we see me very sharp increase in the number of people seeking treatment for addiction to prescription opioids it invaded america under the banner of medicine persisted with the pain but instead of trying to wean him off though she did dose after dose after dose after dose and really became his drug dealer so whos to blame patients doctors manufacturers all the governments of. Thousands upon. Thousands take to the streets of protest against the president and. 250 people have reportedly been detained already. And in the stories that shapes the week purely agree to work with moscow on a probe into the alleged poisoning of opposition figurehead. As the issue fires up german lawmakers and why does not only need such a level of protection from most security services. Parts of the system why would the russian government be so stupid to even lead to germany instead of hiding him in russia. And a former u. K. Prime minister has condemned the governments plan to override the treaty with the e. U

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