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Transcript of Sin Límites Podcast titled “La Política De La Vacuna” published on July 28 2020. Introduction and greetings omitted. To this day, we have no vaccine in sight that we can visualize as the vaccine that will stop the Novel Coronavirus pandemic. Even though there is a good amount of comments and claims that a vaccine has been developed, there is no vaccine to prevent the infection of the virus that generates the disease COVID-19, however, there are a good number of companies and several countries competing to create one. Whatever the case may be, at least the following major countries are on the run and closing deals with pharmaceutical companies for the development and production of vaccines to cover their own populations. We have the United States, China, France, Germany and Italy. The World Health Organization says there are 25 possible coronavirus vaccines in clinical trials internationally. The rest of the world, that is, countries with small economies and without the technology and knowledge to embark on this race, thinking that they will be excluded from the market, are concerned. Unfortunately, this will be the ugly flip side of the pandemic. The World Health Organization is the leader in a coalition of global health organizations to ensure what is known as a "popular vaccine" for poor and middle-income countries. Right now, WHO is struggling to get sufficient funds of wealthy donors, who are reluctant to invest billions of dollars in developing vaccine candidates that may never be successful. There are at least two major branches defining this topic. The first are purely technical, so to speak, refers to the particularities in the process of producing a vaccine. I will mention some in a moment. The other branch is around public health, unfortunately participating or explicitly defined by the national policy of each of the countries, and it is here where we are going to see a very ugly face of this pandemic. From the technical branch that I mentioned, I can tell you that the research and experience in the production of a vaccine manifested at least three main challenges to be overcome. It's worth a quick pass on these. First, ensure the safety of the vaccine. It is about a vaccine that improves the survival of those who receive the vaccine and prevent infection. The vaccine should also avoid causing complications, such as lung damage. A Novel Coronavirus vaccine will need to be thoroughly tested to make sure it is safe for all of us. Second, provide long-term protection. After coronavirus infection, reinfection with the same virus, we hope to be possible after a period of many months or years. An effective vaccine against the Novel Coronavirus should provide all of us with protection against long-term infections. And third, protect older people. As we have been learning, people over the age of 50 generally have a higher risk of developing a serious state of COVID- 19. But older people generally do not respond to vaccines as well as younger people. An ideal Novel Coronavirus vaccine will work well for this age group. Well, this is the part belonging to the technical field and sometime sooner or later, we will see the emergence of various vaccines. The next step is fraught with decisions made by organizations or individuals with the power to decide on the lives of many people around the world. The economic aspect very possibly determines the behavior of countries and manufacturers. In other words, money. See that we are relatively far from having a thoroughly tested and authorized vaccine and China already offers the Latin American countries CREDITS for enormous amounts of dollars, billions of dollars in vaccines. In other words, China is trying to secure a market of several million people, how many? You ask yourself, well we are a total of 651,243,682 people in Latin America. The Chinese want good money, imagine an average of between $30 to $50 per vaccine, and for now let us say vaccination about once a year. The Price of Underdevelopment! This news I was talking about was an announcement by Beijing that it produced at the end of a virtual meeting between the members of the Community of Latin American and Caribbean States (CELAC) and China, in which multilateral cooperation in time of pandemic was analyzed. At this moment and after the antagonistic and offensive current of Mr. Trump, I would not be surprised if Latin America is aligned with China in this case. Furthermore, the United States, which during previous pandemics used its influence to drive international responses, has largely abdicated its role in the fight against Ebola, HIV / AIDS and malaria. Not only that, Mr. Trump has announced plans to withdraw from the WHO, even large European countries are blocking future vaccines first for them. What do you think? I think we need to ask some basic questions to exemplify how complex and how ugly the war between governments and vaccine manufacturers is going to be. Assuming the first vaccine is developed here in the United States, one of the first questions is: who should be the first vaccinated? If our opinion is that the citizens of this country have preference, well ... Who in the United States should be the first to receive the vaccine? Let us look to this day, people covering jobs labeled ‘required’ are the first victims of the Novel Coronavirus, Hispanics and African Americans have been the targets of COVID-19 in complete disproportion to other ethnic segments. Should we list these groups as the first to receive the vaccine? Or are them the last of the list? We could ask the same question for each of the Latin American countries, who in Mexico, or in Argentina, or in Peru should be the first to receive vaccination? Will it be those who have gone out and are going out to work every day at the high risk of contracting the Novel Coronavirus and developing COVID-19? Wherever you listen to me right now, friend, one of the central questions about all this is what will be a fair price per vaccination? Last week, the United States government established an agreement with the companies Pfizer and BioNTech for almost $ 2 billion for the development and production of a candidate vaccine against the Novel Coronavirus. Listen to this, according to the agreement the companies detailed on Wednesday, the US government will receive 100 million doses of a candidate vaccine against the Novel Coronavirus after its manufacture if it receives approval / authorization from the Food Administration and Medications. The FDA. The idea is that Americans get this vaccine for free. The agreement includes the option that "the government can also purchase up to 500 million additional doses." Now, let us consider the prevailing model for drug pricing in the United States. If you need to buy, for example, Janumet and do not have insurance that covers this medicine, you will end up paying around $ 470.00 to $ 490.00 depending on which pharmacy you buy it from. If you buy the exact same drug in Mexico, you will pay around $ 60.00. With respect to Mexican citizens, you are paying more or less $ 410 more here in the US for the same medicine. Examples of this we can offer for hours and hours. We must visualize that drug development is one of the most lucrative businesses out there. Pharmaceutical companies are engaged in real wars, from information to legal. These companies are willing to spare no money in legal expenses when it comes to patent disputes. Authentic monopolies with the power to set exorbitant prices. In this environment, a new cancer treatment can cost half a million dollars, and staples like insulin have risen to thousands of dollars a year. The government has neither the capacity nor the intention to defend this situation 100% against the country's population. Pharmaceutical companies have immeasurable power in all branches of the federal and state governments. If you ask yourself, how and why did Mr. Sanders was not the Democratic Party nomination? Look for the answer this way. I tell you that for recent vaccines targeting more limited populations, such as the meningitis B vaccine for college students and the herpes zoster vaccine for older adults, they have a retail cost of $ 300 to $ 400. If the greed driving the pharmaceutical companies does not get out of control, we could think that the vaccine against the Novel Coronavirus may be in the $50 per vaccination. This would generate a company of more than $ 150 billion, almost all of it will be profit. Amazing! If you, my friend, live in the United States, it is not worth seeing what and how other developed countries are doing it. Here, trade calculations (to call them somehow) have been allowed to drive up drug prices, forcing (us) to accept and absorb ever-higher costs. As the case of the Janumet price from $ 480.00 to $ 60.00, outside the United States! It really would not surprise us if the actual cost of the vaccine was about $ 4 to $ 6 no more. The US government has agreed to purchase 100 million doses of the Pfizer / BioNTech vaccine at a price of $39 for what is likely to be a two-dose treatment, or $ 19.50 per dose. As a comment, we are more than 320 million US citizens. Other companies will supply other similar quantities perhaps, but here, we will see arguments about the technology implemented in the development of each of the vaccines. These arguments are, of course, part of the marketing of each of the vaccines, inviting us to select or to choose one over the other. Will we have the freedom to select the one we want? If you have health insurance, how will your insurance companies will react and respond? We do not know at the moment. Are they going to absorb the price of the vaccine by establishing a co-pay of a few dollars, or will we have to pay a substantial amount? Until today we understand that some citizens will receive the vaccine free of charge. The first and second dose only? We will see. About the comment that I offered related to mutations that the Novel Coronavirus was published on July 22 by Professor Nick Loman of the University of Birmingham that is part of the Covid-19 Genomics Consortium, he said that the mutation, known as D614G, has an observable impact in human cases. While the new form of the virus is not believed to cause an increased risk of death or prolonged hospital stays, it is helping outbreaks to spread more quickly around the world. Mutations that may somehow alter the structure of the Novel Coronavirus will require a vaccine that is designed for such changes. The practical result for you and me is the need for constant vaccination, as we do against another Coronavirus, the Influenza virus or as we colloquially call it, flu. Now, there is another aspect of interest in all of this around vaccination against the Novel Coronavirus. Currently if you are in the US or Mexico, among other countries in the Americas, we cannot travel to Europe. This restriction is in place and it will not be until the Novel Coronavirus is properly controlled and the situation under control that the restrictions that the various countries have imposed are loosening their grip. Practically at least here in the US we ask ourselves the question whether we will ever need to demonstrate whether we have been vaccinated. An idea that sounds extreme but perhaps not so much. Time ago, passengers originating from some of the Latin American countries had to go to embassies or consulates of European countries to be vaccinated before their trip. A document was issued to them certifying that the passenger had received the necessary vaccine and this document was requested before boarding a plane to the country in question. In how many situations could we be required to show that we have been vaccinated? Well, maybe to get a new job, or during the renewal of licenses and passports, or as a requirement for admission to a sports club or gym, or as a requirement to be admitted to a school or university. At the extreme side of this new normal, perhaps restaurants, clubs, bars, cruises, markets, stadiums, and even churches, mosques, and other worship centers, will advertise to be places where only properly vaccinated people have been accepted. Do not be surprised, friend, if you see advertisements in front of restaurants and other centers that say: "Vaccinated Only", so do not forget to request your vaccination certificate.

July 29 2020

F. Chaparro

The Politics of the Vaccines The Fight For The Global Market

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