Fair Doses: Lessons from the Frontlines of Vaccine Equity
Author: Seth Berkley
ISBN-13: 978-0520413160
Publisher: University of California Press
Guideline Price: £25
This is the story of the life-or-death race to develop and equitably distribute vaccines during the Covid-19 pandemic – as told by the former CEO of Gavi, the Vaccine Alliance, a key public-private global body.
The account is part memoir, part wider history, and written in a style reflecting the urgency of the time. The author, as head of an organisation that has vaccinated more than half the world’s children, saving some 14 million lives, is well placed to tell the tale.
There are some policy prescriptions offered, based on hard lessons learned. In advance of the next ‘big one’, we can only hope governments around the world are taking note.
To his credit, the author doesn’t assume readers’ scientific knowledge and explains basic vaccine science for non-experts.
Aside from Covid-19, the book covers episodes of vaccine success such as the elimination of smallpox – officially declared eradicated in 1980 – to the ongoing failure to routinely immunise in the Global South.
The political, social and ethical challenges for organisations and people involved in global vaccine interventions are illuminated by personal anecdotes from war zones, clinics and boardrooms, with readers brought into moments of triumph and frustration.
Developing new vaccines is never easy. It can cost anywhere between €200 million to €2 billion, and takes, on average, 15 years. In some cases, like HIV AIDS, there is still no fully effective vaccine despite decades of effort.
The formation of COVAX, or the Covid-19 Vaccines Global Access, was essential to defeating the virus, but, despite this, its efforts were resisted by intense ‘vaccine nationalism’ among rich countries keen to see their citizens jump the vaccine queue.
The author’s passion for vaccine equity is clear, and he gives a compelling account of all the factors at play that ensured poorer countries were last in line when it came to an all-out scramble for life-saving medicines in the midst of pandemic panic.
Those factors include the profit motivation of pharmaceutical companies, the short-termism of wealthy governments and the complex logistics of delivering doses to far-flung areas.
This book’s central message is that while vaccines can save millions of lives, without political courage and global cooperation, they can never reach their full potential to help humanity.
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