Problems there are many problems about producing a sufficient Scale Distribution of a sense that we may become overcome the people may think one should be 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 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 it ill be talking about i dont know seasonally protecting high risk groups or is it all about eliminating 1000 in its totality. Its certainly not about to limit or carrying the virus which is probably impossible when the only virus or terrible but not a minute or 2 just small theyve now been trying to remain a rodeo for 40 years to its cost Something Like 20. 00 times the original estimate and its 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 these ever 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 a 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 ringback in the only way were launching a true upon the cattle thing 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 to recruit 51 tree about its very very much commercially driven not speaking about call it 900 specifically i. Think you would probably agree with me that its not the data the ester fire says but when it lands on the meter bullet only compromised calculations its dangerous magnified many times over and this is in line 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 comb from a certain amount of king 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 their own 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 thats a equalizing technology is 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 existing technology as a disease or time so. We launched the idea of focusing on those Socio Economic course of your factions and i think thats one of the tragedies are all present situation and why we become overreliant over we place too much faith in a back street you know its the the magic bullet that will slow up with them so a lot of experts have 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 accident. Isnt that preaching dangerous isnt that putting most if not all that absent one busken well i dont know. Im going to fire all edge of a store of banks and all of just. What struck me as the. 10 or so vaccines that are counter to vaccines now in trials indeed some of them im aching to solve taken 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 going to 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 facts of 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 had a kind of monopoly of moral foreign to you in the field and stream progressively undermining. Its very difficult to say where and if consensus could be reached surveys. A structure kovacs reaches 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 ensuring some drove or anxious to actually change 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 in which the w. H. O. Presided over a very successful a ready Commission Campaign in which the major paolos 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 get them but the world will be better if you 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 their social taboos that cultural attitudes that budgets and i would argue that we have seen this play out vividly if theyre out of the college mind and then damn it when there is a very strong push for strong quarantines even though that would have produced. Major problems and other you know satyrs of us aside to hasnt really served us well i mean im not speaking about of course nation but these sort of single handed single policy approaches you and i gloat condemning regardless of what the situation really is on the ground im not even sure what the parameters or whatever of sumter provo policy would be. For one of the issues of course at the moment is how to ensure that. When theyre all is a vaccine away there are a number of vaccine they get to the places that them 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 at 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 able to operate he formed his list of priorities and yet they could easily turn into a hotbed of global infection 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 1980 s. And cops are. A lot of issues to consider based on the time being at professor going to have to take a very short break well be back in just a few moments. To get the bill daly to snare those who really can show. That they can just be suitably. Left without us above on the job just as they are so that. You know none of us could be in a bowl episodes didnt go to see the secure cure the disease it think its near there in your force where you could being in my stubbornness today if not thoughts about spirit i didnt do it was more than a 6 but im intending no. Stadia cruel. Shows to stress a skinny schulmans for you to post their top up by some sort of move willow dress alone vulnerable couldnt go full story keep lists if they were bogus. Ringback. But Survival Guide book stacy goes to the store and simply Federal Reserve to. Be sure its still there you go to get it back. Oh heck no. Repatriations look at the rest of 70 years. Bill of this every year kaiser report. Welcome back to worlds apart this tour the globe Professor Emeritus of science and Technology Studies at the university of amsterdam or to someone just before the break we touched upon the political aspect of Public Health and you developed that argument in your New York Times piece where you rode out of 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. Well wed like to think. But its 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 is 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. That are not true to me because they also happen late 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 a major countries and you believe that you know peoples interest im not at the top of the bed and not each talked a lot about the fact that it will act. To backwards and i wonder what the book even means in these days isnt the governments 1st allegation 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 who is we who is obstinance and im british well im pretty sure im dots ive been living in a country which is not the country of my birth for a long time the deep relationships now are very mobile. It because its more difficult than it might have been. 50 years ago even to say who our own people are so yes its inevitable i think collision communicable that got him elected politicians will give priority to their own citizens some. There tends to be somehow downtime. For those who are not overworked consider to be our school whose are where do we draw from lunch now i want to ask you specifically about national mistys because. This may 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 if it was 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 air politically and to political charged issue how does one distinguish legitimate concerns from politically driven and actives well for most of us or to people because we can only go whats available in the public media ive seen the reactions to the. The vague to the launch of the russian backseat no longer registration its not necessary in order to know it started these base a try as i mean thats 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 moti very jaded by both political and commercial interests. I mean. Russia where 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 that 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 vaccines and. Partner and 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 price in russia most vaccines are still developed produced and overseen by the state and i wonder if there is any difference in how that seems 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 except for preventive price who as are times im working with people from 9 country is on a book. There twitter 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 patented on the on around. Those institutes absent deficiences without any doubt but people trusted what they produced because people knew that they were bad to produce the tools that their national Health System required bot. There is no doubt that the o. In st the own Public Sector institutes Richard Dieter most countries for of vanished. Are in process of being dismantled. Where there was a deficiency as was seen as trustworthy as it were so the interests of the health of the people to british. They were not much if at all influenced by markets all commercial considerations to usual something. For sure and thats the ration 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 the holy grail of Public Health as the main to acknowledge ease of control and prevention was in part foreign because of their rivalry between the soviet union and the United States the alluded to actually him and his earlier that the United States was pushing for back scenes and that is only if you any and was advocating abt rother Socio Economic approach. All waiting because of it 19 pandemic which really demonstrated i think this same deal says in fascism out of all of disease i mean its really a hybrid disease at its core do you think that will change do you think there would be in war are so her appreciation of how sick and commercial practices may. Jeopardize Public Health did extended then the state 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 people. Well just one slight correction the the emphasis on a broader approach came suddenly from the from the from the server during the it also came from the w. H. O. And the director general there were a 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 global 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 said to interest trumps knowledge well you seem to be very pessimistic and i think there were quiet if you will 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 activated 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 wont. Or 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 what makes me think youve got to stop being skeptical but maybe my questions actually absence i want to finish with a very practical question based on in part on on your book at about how back since became so controversial because you know that if you know them and baxter and yet you recognize the 2nd has a patient and suspicion at around the issue 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 into 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 and theyre presented the pope and sometimes both wester throw 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 protein 900 actually 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 us or so to choose to adopt 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 dont wanna listen we all want to have love. Bob probably havent as the vaccines have to be acceptable to the population 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 so i think. People have to trust the vaccine we have to think about how to reestablish trust both in vaccination generally and inappropriate 19 facts when we have and that raises questions that go beyond that beyond health care but there are about transfer political systems women are in structures im sure offensively and we are out of time there really grateful for you joining us today thank you very much for the be thank you very much for an interesting discussion and they fearful what you hope this year again next week and will the party. Are. There. Going to be used as a workable is the more fleecing of the police the more the maysan issue there. Are that some of the guy who. Was only as a name for almost any of the bills the most normal flow sound. Business with the appeal is still currency for the both of you so. The point was to use the book with those guys discovering that those that would use of these are the 1000000000 users but the other media of course is. The community. The rallies are held across the protests against the president and 2nd leading to hundreds of arrests our correspondent was that. Theres no drive to the president we should go to leave leave the presidency for a 2nd round of elections they want. Plus in the stories of the shakes the weak job many agrees to walk with moscow on a proof instead much of poisoning of opposition figure say no founding an issue thats why its up to your job and lawmakers. Why does the volume need such a level of protection from most of your political mud it is part of the putin system why would the russian government be so stupid and even lets not