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 in 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 it to the virus which is probably impossible when the only virus the terrible but not a minute or 2 just smokes theyve now been trying to remain a rodeo for 40 years to its cost Something Like 10. 00 times the original estimates 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 oh 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 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. Well 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 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 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 s the fire says but when it lands on the meter bullet only compromised calculations its dangerous magnified many times over and this is a line major issue with the race to vaccinate 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 by gene but to many other viruses as well are totally agree and i mean thats a thats an interesting question for a historian because. In 1998 there was a very famous come from a certain amount of king in kazakhstan which came up with the idea of helpful all on the idea was very much the vaccines or any specific disease focused acknowledged to be seen as long as the bugs used within a much broader Socio Economic approach to dealing with. 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 lets 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 of your friendships 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 its the the magic bullet that will slow up with them so a lot of experts of 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 being immunize an adjective and isnt that breaching dangerous isnt that putting most if not all that absent one busken well i dont know. Im going to fire all ages 4 of banks and all of just. What struck me as the. 10 or so vaccines there are counter to vaccines now in trials indeed some of them are making to solve tech and platforms like that and some of them are making here so of recombinant d. N. A. Trick knowledge is which are not yet been used in existing human licensed human back 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 very extreme i mean its very complicated because most vaccines consists not only of. Thing the one who. Protects but also the natural 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 emphatic way and its all that 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 is not our kind of monopoly of moral forestry in the field and stream progressive we 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 god create 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 deemed to double your share has leave doubts of the authority that it claims for in south or out 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 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 d get there 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 patterns 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 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 has it 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 are whatever of sumter Global Policy would be. 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 we wouldnt even agree here 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. Healthcare workers or people in essential capacious but thats not likely to be much agreement as to who that is. And what about the millions of people in refugee camps theyre not going to be at the top of anybodys list of priorities and yet they could easily turn into a hotbed of global infection its hard to say its hard to think of instantly implementable solution because the the situation were in have such a deep roots going back lets say at least of the 1980 s. And cup so we have a lot of issues to consider but for the time being at professor going to have to take a very short break well be back in just a few moments. Of the. World is driven by shaped by those. Who dares thinks. We dare to ask. Our. 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 geopolitical aspect of Public Health and you value that argument in your New York Times piece what are your road that they raise 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. 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. That are not true to me because they also happen late in future story those other considerations are 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 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 equitable even means in these dany 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 but then we get into the vexed question of who on whose we whose obstacles. Im british where im pretty sure im docs ive been living in a country which is not the country of my birth for a long time 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 some. There tends to be somehow down time by. Those who not over consider to be our school whose are where do we draw some 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 around in a vaccine and theyve received a lot of negative press in the west a lot of allegations that the crown land 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 bill laswell and i want it 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 regionally go whats available in the public media ive seen the reaction. The vague to the launch of the russian backseat no longer registration its not necessary in order to go a star these based b. Try as i mean thats how the russian process works when the one hand its true or 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 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 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 taxes 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 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 that its the state or whether its at or prevent a price who as are times im working with people from 9 country is on a book. There twitter writing on exactly how this shift from a public to 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 wretched like tears but also when denied access to the most Sophisticated Technology areas by commercial companies that are patent to you on the one hand. Those institutes absent deficiences without any doubt the people trusted what they produced the has people knew that they will have to produce the tools the national Health System requires about. There is no doubt that the o. In stripy own Public Sector institutes rich indeed in most countries of vanished all are in process of being dismantled. Were they deficiency as was seen as trustworthy as it were some of them so the interests of the health of the people to british and they were not much if at all influenced by the markets all commercial considerations weve lost something for sure and thats the rationale of the book while working on im looking forward to reading it because youre younger i was 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 he alluded to that actually him and 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. Fall we. Cobbett 19 pandemic which really demonstrated i think this same deal says infectious and 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 sort of appreciation of how sick and commercial practices may. Jeopardize Public Health did extend and then the state may not be even able to deal with that because it even without calling 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 to be the emphasis on a broader approach karim certainly from the from there from the soviet union it also came from the w. H. O. And the director general of that every parent there time now tamala who are from norway denmark also a trade 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 read. From previous epidemics were not very good at learning because it seems to say oh 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 a 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 that 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