It has now become a kind of mantra that vaccines belong to everyone. Indeed, they are health essentials, necessary in many cases for even survival itself. But as Pope Francis often reminds us, vaccinations also affect the common good and justice: “If a pharmaceutical can cure a disease, it should be available to everyone, otherwise injustice will result…there is no place for ‘medical marginalization’.” Pope Francis continues: “Globalized social and economic differences risk controlling the way anti-Covid vaccines are distributed, with the poor always coming last and the right to universal health care, which everyone accepts in principle, being emptied of any real value.”
In addition, vaccines should be available to everyone and everywhere, without restrictions based on economics, even in “low-income” countries. But since vaccines are produced by human genius—and are not an environmental resource spontaneously present in nature (such as air or the oceans) and are not discovered through research (such as the human genome)—to make them available to everyone, specific choices and actions are called for. We need a commitment from all those taking part in vaccine research, especially since vaccines are delicate and complicated, both from the point of view of the technological resources they require and by reason of the symbolic power that they have. In particular, the anti-Covid19 vaccines are very sophisticated products that make use of advanced knowledge coming from different fields of pharmacological research, e.g., oncology. This makes it more difficult to overcome the problems of technology transfer and patent management. We must recognize the significance of these patents, but not absolutize them. The Holy See’s Permanent Observer to the United Nations and Specialized Organizations in Geneva, Archbishop Ivan Jurkovič, made it clear in the context of the World Trade Organization (WTO), and the Trade Related Intellectual Property Rights (TRIPs) Council, that there is a need to strike a balance between the private rights of inventors (and investors) and the needs of society as a whole. Supporting the universal availability of vaccines means entering into a complex set of problems, which have aspects that are scientific-technological, economic-commercial and geopolitical (e.g., “vaccine nationalism”’).
What I would like to point out in particular are the cultural aspects of vaccines in different societies. Clearly, “vaccination hesitancy,” referred to in our Statement, is a varied phenomenon that has different motivations in different areas of the world. We must be careful not to impose a unitary Western vision on the question. In this regard, I would like to highlight two issues that arise in the globalized world, which I do not think are sufficiently considered.
1. First of all, it must be understood that biological and medical considerations are not the only ones that come into play, that seem objective and immutable. In fact, vaccines have a history that is marked by injustice and oppression. It is difficult to ask for trust from people who have had to deal with systemic victimization by the countries that are generally the ones that produce vaccines. Lots of chickens are coming home to roost in these countries. A one-time effort is not enough. To build real confidence we need policies that include a comprehensive vision of development and fairer international relations.
2. Second, it is not necessarily true that the priorities of the West coincide with those of countries of the Global South (in particular Africa). What seems to us to be a priority is not necessarily a priority for others. We must prevent the Covid-19 pandemic from drawing all attention to itself to a point that it appears, albeit with valid reasons, as the most urgent. We must not forget, for example, that malaria and tuberculosis claim far more victims in Africa than covid-19. But even more important, the lack of basic sanitation and drinking water is a serious threat to health and survival. This suggests to us that we reexamine our research and investment agenda with respect to vaccine production and distribution. It is important that the initiatives now undertaken in response to the Covid-19 emergency take future needs and structural concerns into account as before and not limit themselves to the short term. In the future, for example, the WHO Immunization Agenda 2030 reminds us, campaigns for vaccinations against other widespread diseases will have to be strengthened, since the current pandemic is tending to neglect this point.
The undertaking facing us is complex and will require a lot of work. That is why it is important for us to join forces with all those who share our objectives, even if we have different beliefs from them about other subjects. This framework of synergy on specific objectives that are of great current importance is what the collaboration between the World Medical Association and the Pontifical Academy for Life is based on.
In fact, as I said, it was—before the pandemic broke out—already our intention to have a conference on vaccines in general. Having clearly grasped the importance of the issue back then, we had already started planning. But the difficulties that arose forced us to reduce the size of the meeting, to narrow down the theme and to conduct the conference as the on-line Webinar that we streamed yesterday. It can still be accessed online. The follow-on Declaration we are presenting today takes the same approach, and in any case our original project—a conference that addresses the issue of vaccines in its entirety – has been only postponed, not abandoned—quod differtur non aufertur.