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The ugly side of the coming vaccination

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Award-winning and multishortlisted novelist Steven Boykey Sidley has meandered through careers as an animator, chief technology officer for a Fortune 500 company, jazz musician, software developer, video game designer, private equity investor and hi-technology entrepreneur. He currently lives in Johannesburg with his wife and two children. Free Association is his fourth and latest novel.

If you think you have seen hot tempers flare as people cage-fight one another over the facts and fiction surrounding this virus, you ain’t seen nothing yet. Wait until a vaccine arrives. Then it will really get ugly.

There are about 90 vaccines under development, all at various stages of the process. Which is long, arduous, complicated and unpredictable. By way of illustration, when HIV showed its ugly face to the world in the early 80s, scientists and labs and health institutions swung into action, diverting funds and resources from all sorts of worthy projects, all in attempt to find the magic bullet that would stamp out the virus and its terrible progeny AIDS from the planet.

Then, in the 90s, a treatment was found which in an instant, changed it from a death sentence to a manageable, if chronic, condition. We had gone from terrified to somewhat concerned in an instant. After all, this wasn’t a concern for most of us anymore, right? If we were mildly cautious, we were going to be OK.

And now, 30 years later, still no HIV vaccination. The reason most frequently given is that the virology of HIV is madly complex. Vaccines are still a dark art, and when faced with this wily combatant, science couldn’t deliver. But one could also argue that as money drained from AIDS research and back into the system, urgency waned. Who knows whether the battle would have been resoundingly won with more money and more fear?

There are four basic approaches to the vaccine science, all above my pay grade, so I will list them if only to illustrate the diversity of means and mechanisms – virus (using a weakening Covid-19), viral vector (using another virus, like measles, to produce C19 proteins), nucleic acid (genetic instructions to produce C19 proteins) and protein-based (direct injection of C19 protein shells). Oh, and ‘other’. Suffice to say that they all seek the same goal – to get our bodies to attack, de-activate, weaken, trick or otherwise klap the virus so that it stops killing us.

Keep in mind that by some accounts, primitive vaccinations started in 250BCE. And certainly in China in the 15th Century, where they crushed up smallpox scabs into powder and blew it up people’s noses. It worked well enough.

So let’s assume, for the sake of much-needed optimism, that, unlike HIV, we get there (there are reasons for hope, this virus is not too unlike previous coronaviruses which have surrendered to vaccine science).

But now we have something entirely new. We are all at risk. We are all terrified. The Covid-19 trajectory in the body has been widely reported. It is not pretty. And for those who die, it is truly awful and often lonely, in an ICU without friends or family.

And so the muscle that has been applied to the race for a vaccine is astonishing. It is sucking in unimaginable amounts of public and private money and scientific skill and technical excellence. It is top of mind for governments, health fundis, doctors, civil society, pharmas. And us. It would be difficult to find a world event in history which has been so all-consuming for the average Joe(lle).

Right then, a zillion dollars and most of the world’s attention focused on this thing, the vaccine. And a race, with 90 contestants. And fabulous fame and wealth and great sex for the winner. Or, at the very least, the adulation of a grateful planet and a slew of Nobels on the mantelpiece.

This is where it gets ugly. I give you the following scenarios:

  1. PharmaCo in (choose your favourite free-market country here) gets there first. And says — $20K per pop. We spent the farm developing this thing, and now it’s time for payback for our efforts. Of course, this is how most of the world works, so this scenario is likely.
  2. PharmaCo in China gets there first. Free, but only if you are Chinese. The rest pay $20K per pop. Long live the Xi dynasty ( Trump’s America or Putin’s Russia work just as well).
  3. An academic institution gets there first (Oxford is leading the pack right now). Government steps in and says, first we immunise our own, then we share the recipe for free. Nationalism takes the stage.
  4. Nice country’s health department gets there first (insert your favourite country here — mine would be The Netherlands), and says — this is for everyone, here is the secret sauce. But not all countries can equally afford to produce, or distribute. Rich world gets healthy; poor world dies while waiting.
  5. Two vaccines come out at the same time. Misinformation about one competitor’s product mysteriously appears on social media.

I could go on, but the battleground is going to be ferocious. The stakes are ridiculously high. There are careers, positions, officials, appointments and patronage that will be riding on our health. Over which we, in desperation for a future we seem to have lost, will have limited control. And, of course, there are lives.

6 billion vaccines will have to be administered to achieve herd immunity. Someone will have to pay. Someone will get it before another. Someone will want to jump the queue.

It will break Twitter.

It will end national alliances.

It will reorder the world.

It will bring down governments.

And people will die, with their cure in sight just over there, where the money and politics bicker and play. DM

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