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.

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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.

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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.

  • “Vaccine sovereignty”? “People’s vaccine”? Complete rubbish.

    Let’s be clear what Mr Ahmed is really advocating: Nobody gets a vaccine until everyone can get the vaccine, all on the same day, because god forbid someone will be first. So to everyone world-wide, keep on dying until the “people’s vaccine” is equally available to ALL of the people.

    There’s no logic here, just emoting.

  • Remember Dr. Jonas Saulk that public health is a moral commitment and he did not profit from it or patent it. This is a chance from the pharma industry to show goodwill to the greater global
    community!!!

    • But during Dr. Saulk’s time we also did not have legions of attorneys looking for any harm that a drug or vaccine might do years or decades later. Given today’s litigious society, without some measure of profit why would any company invest in any vaccine or new drug?

  • The author mistakenly attributes nefarious intent to AstraZeneca due to their share price changing. Any rational human would recognize that “at cost” will include some level of overhead allocation. With an expectation of billions of doses, AZ could improve its profit substantially with even a small allocation.

  • NOT what the word ‘sovereignty’ means! Trump & Johnson were clearly referring to their nations ability or right to self-rule. The inability to use language carefully leads to all sorts of illogical thought patterns, and this article is an excellent example of this “language distortion”.

    The author plods ahead with more language abuse for the purpose of distortion; equating “sovereignty’ with “exceptionalism” is pure nonsense. Nothing about UK or US self-rule implies ‘exceptionalism’. Certainly Greeks and Malaysians consider their nations sovereign too.

    A vaccine (if it ever exists) is NOT “the power to decide who will live and who must die”, but only involves who may live. This is a primary logical flaw in the article.

    “The deal prioritizes British and American access to the [POTENTIAL] vaccine following significant financial investments by both governments. While questions have been raised about why two of the wealthiest countries should receive priority access”. No one sane ever raised that question. It’s pure nonsense rhetoric. Shall we question why Mr.Ahmed gets “priority access” to the home he pays for, or the auto he owns ? Rubbish thinking!

    “…little attention has been paid to the role of the university in reinforcing what I call “vaccine sovereignty.””. Worse yet, no one has paid attention to the “editorial sovereignty” exercised by authors incapable of presenting a coherent and logical case, who must instead rely on emotionally loaded & invented, distorted new meanings of common words.

  • Typical, left-wing liberal sniveling; “We want everything first and for free! Let the West spend all the money and time developing miracle drugs, but be sure to give it to the useless first so they can continue to propagate at the expense of the rest of us. Crap.

  • last month oxford themselves published 2 concerns: half trial patients had previous adenovirus exposure making vaccine potentially useless; and that using adenovirus vector is proven to increase risk of HIV. RNA vaccines (Moderno and Pfizer) dont have these problems

    • The Oxford research team did not publish the concerns you report. I think you are deliberately trying to spread misinformation.

      Oxford chose a chimpanzee adenovirus because very few humans will have been previously exposed to it.

      There is no evidence such a vaccine increases the risk of HIV.

    • The vaccine under development might increase the risk of HIV infection or it might not. It might cause recipients to grow additional toes 10 years after administration or it might not. It might make the moon turn purple or it might not.

      However, the Oxford vaccine research group has not published a statement or anything similar saying that they are concerned because the Covid-19 vaccine they are testing has been proven to increase the risk of HIV infection. This is probably because it hasn’t been proven to have any effect on the risk of HIV infection.

      A 2008 paper about an HIV vaccine trial is of very limited relevance.

  • This must be one of the absolute stupidest articles that I have ever read yet unfortunately it is now mainstream that everything is discriminatory and the wealthy must pay and subsidize everyone

  • Here’s a revelation for you. He who has the most money to buy water will be the last to die of thirst. Now say wow..

  • You have your facts wrong. Astrazeneca does not have exclusivity and Oxford signed with the Serum institute of India before Astrazeneca. Furthermore, Oxford rejected many pharma companies as the university stipulated that there should be no profit while the pandemic is going on. So please check your facts.

    • Oxford rejected approaches by several pharmaceutical companies specifically because those companies demanded exclusivity and Oxford said that was unacceptable because it’s important to make the vaccine as widely available as possible.

      The author is quite possibly fully aware of the facts, but unfortunately telling lies better supports his political thinking.

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