Sovereignty, in its most distilled form, is the power to decide who will live and who must die. Both U.S. and U.K. heads of state have increasingly invoked sovereignty as a dominant discourse in their economic and foreign policies. President Trump used the words “sovereign” or “sovereignty” 21 times in his inaugural address to the United Nations General Assembly in September 2017. More recently, Prime Minister Boris Johnson characterized Britain’s exit from the European Union as “recaptured sovereignty.”
These invocations of sovereign power reflect a form of American and British exceptionalism that are echoed in the University of Oxford’s exclusive deal with AstraZeneca to manufacture a potential Covid-19 vaccine developed by the university. The deal prioritizes British and American access to the vaccine following significant financial investments by both governments. While questions have been raised about why two of the wealthiest countries should receive priority access to the vaccine, little attention has been paid to the role of the university in reinforcing what I call “vaccine sovereignty.”
This form of sovereignty symbolizes the vaccine as an instrument of power deployed to exercise control over life and death. While vaccine sovereignty is centered on how access to vaccines is shaped through wealth and power, it is also about recognizing those who are the subject of that power — those who must die.
Nearly one-third of all new medicines and health technologies are developed in university labs supported through public funding. As authorized centers of knowledge production, universities can play a fundamental role in reimagining the profit-driven biomedical research model.
Oxford, ranked as the number one university in the world, is at the center of the authorized center. Its behavior and actions will invariably shape the vaccine research and development landscape.
Oxford may, of course, argue that it is ultimately a British institution and so it is eminently understandable that the U.K. should be the first to benefit from its research. Yet the extension of the university’s vaccine deal to the U.S. suggests that it is the highest bidder, rather than national interest, that determines who gets access to the vaccine.
The university’s collaboration with pharma also raises concerns about the price of the potential vaccine, which was developed with public funding. AstraZeneca indicated its commitment to distribute the vaccine at cost during the pandemic phase — though there is no clarity on how long that phase will last — and no details were provided on what the cost would actually be. While AstraZeneca may be perceived as acting altruistically, its share price increased to record highs following the announcement of the collaboration with Oxford. Profiting from the vaccine has therefore already begun.
Vaccine sovereignty is consequently not just focused on nationalistic impulses articulated by the state. It also captures how non-state actors, such as pharma companies and universities, reinforce systems of power that place profit before people. Consequently, the call for a “people’s vaccine” signed by a range of global leaders and supported by the Open Society Foundations, which I work for, serves as a form of counter-power to the vaccine sovereignty evident in the Oxford-AstraZeneca deal.
A people’s vaccine seeks to ensure mandatory worldwide sharing of all Covid-19-related knowledge, establish a global and equitable rapid manufacturing and distribution plan fully-funded by wealthy nations, and guarantees that Covid-19 tests, diagnostics, treatments, and vaccines are provided free to everyone, everywhere.
Momentum for a people’s vaccine is growing, reinforced by a number of initiatives such as the Free the Vaccine campaign that includes the involvement of university medical students led by Universities Allied for Essential Medicines. (Both the campaign and UAEM are supported by the Open Society Foundations.) In addition to being about ensuring access to a Covid-19 vaccine, these initiatives also seek to dismantle the biomedical system upon which the Oxford-AstraZeneca deal was built.
The Covid-19 pandemic has created a new vocabulary for talking about access and affordability related to vaccines. While the discourse emerging from the U.S. and the U.K. reinforces vaccine sovereignty, countries in the global South are committed to the idea of a people’s vaccine. This tension between North and South — which is less about geography and more about relationships of power — will be exacerbated once the full impact of Covid-19 is felt across Africa, Latin America, and Asia.
In a moment where the university — as the epicenter of knowledge production — should be playing a leading role in advancing the idea of a people’s vaccine, Oxford is instead contributing to a culture of vaccine sovereignty in which wealthy countries like England and the U.S. are dictating who will live and who must die.
Kayum Ahmed is the director of the Access and Accountability Division of the Open Society Foundations.