Ethics and Vaccines - Biotech Spain

Crises reveal the shortcomings we must face and pose a series of challenges that we must address from an ethical standpoint. The situation we are currently experiencing with COVID-19 is a clear example of this.

We are all sad witnesses to the tremendous impact COVID-19 is having on the economy, people's lives, and businesses as well as the significant stress healthcare personnel are experiencing. The urgent need to address all this is evident, as is the extremely high priority that efforts must have to bring the pandemic to an end as soon as possible.

Fortunately, effective vaccines have been developed in an extraordinarily short period of time: a process that can often last decades has been achieved in 12 months. This has been a tremendous achievement. Now the urgency is for the vaccine to be applied quickly, universally, and equitably.
What is the bottleneck preventing rapid vaccine production and distribution? At one time, the bottleneck seemed to be the organisational and logistical structure across various countries in terms of their ability to inoculate their citizens. However, we can now see that the production of these vaccines is the limiting factor. The delays by vaccine producers in releasing the vaccine when the system is already prepared for mass vaccination is proof of the situation.

The interest in increasing the production and distribution we need should be of the utmost importance so large groups of the population, or entire countries, do not remain unvaccinated. It is estimated that 85 countries will not have their population immunized until 2023! And we already know that the longer it takes to make the virus disappear, the more likely it is that various mutations will take place which can produce new strains or variants that current vaccines are not effective against. This would harm the economy even further, not to mention the enormous human cost brought about by the disease.

In technical terms, the production of these highly complex products is difficult and requires highly qualified facilities and personnel. But one may wonder: what actually hinders the mass production of vaccines? What prevents, for example, clones at vaccine-producing plants from doubling or even tripling production? We would like to point out two main reasons.

The first is the lack of decisive and agile investment for production to ensure universal immunity and reach all ends of the planet. Indeed, isn't this lack of decisive, coordinated, and rapid investment stunning, when the International Chamber of Commerce (ICC) has reported that the cost of vaccines not reaching the world's poorest people would be "between 1.24 and 7.6 trillion (yes, with a T) euros"?

It seems evident that public authorities at different levels and pharmaceutical companies must commit to strengthening their efforts as a service to society. After the effort to develop vaccines, production licenses should be facilitated and production must be increased at the most reasonable prices possible.

Second, going to the root issue, the origin of the shortfall in coordinated and consensual decision making regarding the pandemic could be because we lack a global perspective that sees humanity as a whole and we need a cooperative vision that is conscious not only of the responsibility to save lives and livelihoods, but also that we are all connected to one another.

However, we must be cautious and not forget that simply increasing the production of vaccines will not by itself guarantee their equitable and universal distribution to reach the poorest countries. An ethical and humanitarian commitment is required to redouble the effort not only in production, but also in universal distribution. Is the race between countries to get more and more vaccines for their own citizens or rich countries purchasing more vaccines than their population needs not reminiscent of a perspective that is now out-dated? Perhaps we should go back to a more global, fraternal, and long-term conscience with new models of global governance in matters of solidarity and health.

Finally, it is important to stress that the situation we are experiencing has also brought out the best in many people. For example, we can cite the tremendous contributions of healthcare personnel, people who care for the sick and the elderly, those who work in technological and scientific research, individuals who have collaborated with wonderful transparency, and the people responsible for making major decisions. This goes along the same lines that we have commented on and that are already underway, such as the COVAX initiative for the equitable global development of COVID-19 vaccines.

Perhaps these individuals can serve as a reminder that it is time to regain the value of a caring, broad, and people-centred vision in addition to courageous and dignified decision making? We hope COVID-19 helps us learn lessons that will serve us in the future, because its price has already been enormous.

Llorenç Puig, Cristina Fornaguera, Flavio Comim

Llorenç Puig: Department of Ethics and Christian Thought, IQS School of Engineering.
Cristina Fornaguera: Materials Engineering Group (GEMAT), IQS Department of Bioengineering
Flavio Comim: Department of Ethics and Christian Thought, IQS School of Management.