A volunteer in an Oxford/AstraZeneca vaccine trial in Soweto, South Africa, in July 2020 (Photo by Felix Dlangamandia/Beeld/Gallo Images via Getty Images)
As an American living 14 years in the United Kingdom, I tried to make sense of my adopted country by absorbing its culture: reading its literature, listening to its music, watching its movies and television, but I also studied its history and politics. I asked a friend, who was a solicitor, her opinion of the 18th-century political philosopher Thomas Paine.
“Who,” she asked.
The Englishman who wrote the pamphlet, Common Sense (1776), I prompted,
The American who rejected the concept of monarchy,
The thinker who roused sentiment for the American Revolution.
My friend’s blank reaction was a lesson in the vagaries of history and the power of those who write it. Later, I learned that Paine had been tried and convicted of seditious libel in absentia in 1792 when the English government worried that the French Revolution might spread to its island shores. The government began to suppress works that espoused so-called radical philosophies. No wonder my friend had not been taught Paine from primary school through university as I had been in the former colony that had overthrown the Crown.
The self-educated Paine wrote, arguably, America’s first bestseller. The Founding Father, John Adams, said that without Common Sense, “the sword of Washington would have been raised in vain”.
Paine wrote:
“Society is produced by our wants, and government by our wickedness; the former promotes our happiness positively by uniting our affections, the latter negatively by restraining our vices. The one encourages intercourse, the other creates distinction. The first is a patron, the last a punisher.
“Society in every state is a blessing, but government even in its best state is but a necessary evil; in its worst state an intolerable one; for when we suffer, or are exposed to the same miseries by a government, which we might expect in a country without government, our calamity is heightened by reflecting that we furnish the means by which we suffer.
“Government, like dress, is the badge of lost innocence; the palaces of kings are built on the ruins of the bowers of paradise. For were the impulses of conscience clear, uniform, and irresistibly obeyed, man would need no other lawgiver; but that not being the case, he finds it necessary to surrender up a part of his property to furnish means for the protection of the rest; and this he is induced to do so by the same prudence which in every other case advises him out of two evils to choose the least.”
Paine was political, but he did not play politics. Paine was consistent, drat the consequences.
“The man was characterized by irony, restlessness and, particularly, controversy. No one who knew him was neutral about him,” wrote the novelist, Diana Gabaldon, in her introduction to Common Sense (2004).
Paine wrote: “Society is produced by our wants, and government by our wickedness.”
Especially during a pandemic, we need strong national leaders and governments to act as a focal organizing and moral force. Federal governments must make decisions that may be unpopular because society would not do so on its own. It will be difficult for governments to retain power in future elections because of people’s dissatisfaction with lockdowns, vaccine rollouts, border closures, and travel requirements.
Although, in a sober move, the Portuguese re-elected President Marcelo Rebelo de Sousa on January 24.
At this juncture, the world is grappling with rising COVID-19 infections and deaths, and it is struggling with uneven vaccine rollouts. Variants of a virus are normal over time and in a populace without the antibodies to fight it. What we hope is that the vaccines still will be effective against the United Kingdom, South African, Brazilian, and other variants. The mRNA vaccines use technology that makes it somewhat easier to adapt to new variants.
“Moderna already is testing two booster-shot options -- one specifically aimed at the South African variant and another to broadly fight new mutations, reported Publico (January 25). “Laboratory research using blood from people and monkeys who had received the company’s vaccine found that the U.K. variant did not appear to reduce the production of neutralizing antibodies. But the South African variant showed a six-fold reduction.”
However, before the potential need for boosters, the world needs to move on and out of this present crisis. So, we are in a vaccination race against virulent variants.
I expect that Washington will become the strong actor it needs to be in the United States’ vaccination plan as the new Biden administration designs and enacts a program that was non-existent in the previous administration. U.S. President Joe Biden has said that “we need unified national response to COVID-19.” At present, 50 states and the District of Columbia receive vaccines and are directed to get on with it. This scattershot approach is chaotic.
It matters to everyone that all countries vaccinate at least 70 percent of their citizens.
“An outbreak anywhere can become an outbreak everywhere,” said Gavin Yamey, director of Duke University’s Center for Policy Impact in Global Health, on BBC World News (January 27).
Paine wrote: “For were the impulses of conscience clear, uniform, and irresistibly obeyed, man would need no other lawgiver . . .”
Self-survival also can be a powerful impulse. We will only be as well as everyone else in this pandemic.
COVAX, an international vaccine advocacy group, is on track to deliver at least 2 billion doses by the end of the year, including at least 1.3 million doses to 92 low-income economies.
“It is a major step forward for equitable access to vaccines, and an essential part of the global effort to beat this pandemic. We will only be safe anywhere if we are safe everywhere,” said Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases.
On January 22, it announced the signing of an advance purchase agreement for up to 40 million doses of the Pfizer-BioNTech vaccine. “Rollout to commence with successful execution of supply agreements.”
Additionally, COVAX said that, pending WHO emergency use authorization, nearly 150 million doses of the Oxford/AstraZeneca vaccine are anticipated to be available in the first quarter of 2021, via existing agreements with the Serum Institute of India and AstraZeneca.
“We have secured two billion doses from five producers with options of more than one billion more doses, and we aim to start deliveries in February,” said WHO Director-General Tedros Adhanom Ghebreyesus.
Launched for the COVID-19 pandemic, COVAX is an initiative of the World Health Organization, Gavi (the Vaccine Alliance) and the Coalition for Epidemic Preparedness Innovations (CEPI). Its aim is to create a powerful brokering bloc with pharmaceutical companies.
More than 180 countries have signed the COVAX initiative, according to BBC News (January 18). The United States, under the newly inaugurated President Joe Biden, committed $4 billion to the scheme, reported BBC News (January 26).
Paine wrote: “Society in every state is a blessing, but government even in its best state is but a necessary evil.”
Norway became one of the first countries to commit to donating vaccines to low-income countries at the same time as vaccinating its own citizens, according to The Telegraph (January 20).
Norway has access to three times as many vaccines as it needs for its 5 million citizens, if all the vaccines get approval. Interestingly, Oslo, Norway, is the base of the Coalition for Epidemic Preparedness Innovations (CEPI), which began in 2017 as a reaction to the Ebola virus and a commitment to make vaccines affordable for developing countries. CEPI funds and coordinates vaccine research projects.
Dag-Inge Ulstein, Minister of International Development, said donations would begin as soon as vaccinations suitable for developing countries get approval from the European Medicines Agency.
Ulstein may have been referring to the Oxford/AstraZeneca vaccine, which is 60 percent effective as compared with the Pfizer/BioNTech, which is 95 percent effective and the Moderna vaccine, which is 94.5 percent effective. Because of the low temperatures required for the latter two, the AstraZeneca vaccine is being touted as better for poor countries. Yet, it also must be kept at a refrigerated temperature.
One clear advantage of the AstraZeneca vaccine has nothing to do with health. The viral vector AstraZeneca vaccine (£3 or $4 per dose) is markedly cheaper than the newer technology mRNA Pfizer vaccine (£15 or $20) and the Moderna vaccine (£25 or $33).
From the start, the team at the University of Oxford wanted to create a vaccine that could help all countries, regardless of their economic situation. To vaccinate the world, researchers would need to produce billions of doses, something that only could be provided by industry, reported BBC News (December 14, 2020). Sir Mene Pangalos, of the Cambridge-based pharmaceutical giant, AstraZeneca, offered the company’s help.
The two parties struck an agreement in April 2020:
“The vaccine would be provided on a not-for-profit basis worldwide, for the duration of the pandemic, and always at cost to low- and middle-income countries. Most importantly of all, AstraZeneca agreed to take on financial risk, even if the vaccine turned out not to work,” reported BBC News.
“In May, in a huge vote of confidence, the U.K. government agreed to buy 100 million doses and provided £90 million in support.”
Presently, the European Union and AstraZeneca are in a row regarding the delivery of supplies. I am more interested in seeing more data from the vaccine company as is the U.S. Food and Drug Administration.
A U.S. vaccine expert characterized the data of the AstraZeneca vaccine trial as “odd,” adding that it had one “pretty serious error” in it, according to Business Insider (January 8).
AstraZeneca is now conducting a larger trial of nearly 30,000 people in the United States.
Germany’s disease control agency, the Robert Koch Institute, has recommended that the AstraZeneca vaccine should not be used on people aged 65 and older, citing a lack of data, reported The Guardian (January 28).
AstraZeneca and the vaccine developers have said that the vaccine is safe for older adults, and Public Health England said that the vaccine has elicited reassuring immune responses in older people even if data on the precise level of protection was patchy.
The Lancet (December 8) reported: “The limitations include that less than 4% of participants were older than 70 years of age, no participants older than 55 years of age received the mixed-dose regimen, and those with comorbidities were a minority, with results for that subgroup not yet available. The heterogeneity in vaccine dosage was fortuitous in uncovering a potentially highly efficacious formulation but was unplanned, and needs further evaluation in older adults and to confirm the unexpected results.” The European Medicines Agency is expected to make a decision on the AstraZeneca vaccine as soon as January 29.
The United Kingdom gave the AstraZeneca vaccine emergency authorization and began inoculating its populace with it on January 4.
India also has approved the Oxford/AstraZeneca vaccine, which is produced by its Serum Institute, and Covaxin, produced by local firm, Bharat Biotech. Foreign Minister S. Jaishankar said on Twitter that the “Pharmacy of the World will deliver to overcome the COVID challenge”, according to France 24 (January 20).
India exported its first batch of locally produced vaccines on January 20, officials said. The Maldives was scheduled to receive a free supply of 100,000 doses of the AstraZenaca vaccine and 150,000 to Bhutan as a gift. India’s South Asian neighbors, and countries in Latin America, including Brazil, Africa, including South Africa, and central Asia, including Bangladesh, Nepal, Myanmar and Seychelles, are next in line.
India’s efforts are seen as a push with rival China, which is also supplying vaccines to other countries. So, the vaccine rollout is a political game.
Thomas Paine did not play that game.
Paine became notorious because of his pamphlets and writing. He is believed to have written the first prominent piece against slavery in the colonies in March 1775. In the Rights of Man (1791), he defended the French Revolution. In The Age of Reason (1793-1794), he promoted reason, free thought and argued against institutionalized religion, in general, and Christian doctrine, in particular. In Agrarian Justice (1797), he discussed the origins of property and introduced the concept of a guaranteed minimum income through a one-time inheritance tax on landowners.
“Through this new language, he communicated a new vision – a utopian image of an egalitarian, republican society,” said biographer Eric Foner.
Certainly, Paine would have helped rouse the spirit of global egalitarianism in the COVID-19 challenge.
Comments