The state of the world from the elite point of view.

Blair Fix

A few days ago, I received the attached essay, sent to me in error by a Dr. Tom Riddle. It offers a fascinating glimpse into the elite worldview. (Cover image: Elodie Tihange, altered)

 There is no good and evil. There is only power and those too weak to seek it.

— Lord Voldemort For centuries, philosophers have sought to understand concepts such as ‘equity’, ‘fairness’, and ‘justice’. The result has been widespread confusion.

The Voldemort Index

I crunch the numbers on COVID vaccines. No surprises … they’re going overwhelmingly to rich countries.

Around the world, rich countries are celebrating as their COVID numbers
fall. Their success is no mystery --- it's because of a massive rollout
of COVID vaccines. While we should celebrate the
[development](https://economicsfromthetopdown.com/2020/12/28/as-2020-ends-lets-celebrate-science/){target="_blank"
rel="noopener"} of these vaccines, their *deployment* highlights the
tyrannies of capitalism.

Most of the basic research for COVID vaccines was [funded by the
public](https://www.scientificamerican.com/article/for-billion-dollar-covid-vaccines-basic-government-funded-science-laid-the-groundwork/){target="_blank"
rel="noopener"}. Yet their manufacture is controlled by Big Pharma. The
predictable result is that vaccines flow to the highest bidder and Big
Pharma reaps the profit. Thus, the world is now 'blessed' with [9 new
pharma
billionaires](https://www.cnn.com/2021/05/21/business/covid-vaccine-billionaires/index.html){target="_blank"
rel="noopener"}.

Since we're stuck with COVID for the long haul, we need to end the
privatized vaccine model. The alternative is surprisingly simple. Let
governments continue to fund basic science. And let private companies
continue to manufacture vaccines. Just don't let these companies have a
monopoly on property rights. Instead, put vaccines in the Creative
Commons. The result will be cheap vaccines, available to all.

To make the case for open-access vaccines, it helps to run the numbers.
To date, the vast majority of COVID vaccines have gone to rich nations.
It's plutocratic healthcare in action: more money = more vaccines.

Let the data speak.

### The global distribution of COVID cases

We'll start by looking at how the global distribution of COVID cases has
played out since the beginning of the pandemic. Figure
[1](#fig-continent-case) shows the global share of cases by continent
since February 2020.

[]{#fig-continent-case}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/continent_case.png?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 1: Share of world’s COVID cases by
continent. [<a href="#sources-and-methods" target="_blank"
rel="noopener">Sources and methods</a>].</figcaption>
</figure>

When the pandemic started in late 2019, Asia had 100% of all COVID cases
--- obviously because the virus arose in China. In March 2020, Donald
Trump bemoaned the spread of the ['Chinese
virus'](https://www.msn.com/en-us/news/politics/trump-reference-to-covid-19-as-chinese-virus-prompted-increase-in-anti-asian-hashtags-study/ar-BB1eKSw7){target="_blank"
rel="noopener"}. But by then the vast majority of cases were in Europe,
which had refused to lock down until it was too late.

After the early European (and then American) debacle, the spread of the
virus slowed in these regions, but sped up in Asia and South America. By
September 2020, the majority of cases were in the 'Global South'. Then
in the fall of 2020, the US and Europe brashly reopened and cases there
skyrocketed. And so at the start of 2021, most COVID cases were again in
the 'Global North'.

Figure [2](#fig-north-case) shows this 'North-South' dynamic. I've
plotted here the Global North's share of world COVID cases since
February 2020. (Remember that 'North' is code for 'rich countries'. Here
it consists of North America, Europe and Oceania.)

[]{#fig-north-case}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/north_case.png?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 2: Share of world’s COVID cases in the
‘Global North’. [<a href="#sources-and-methods" target="_blank"
rel="noopener">Sources and methods</a>].</figcaption>
</figure>

I've marked in Figure [2](#fig-north-case) the approval dates of the 4
major COVID vaccines. Shortly after these vaccines went on the market,
COVID numbers in the Global North plummeted. Today, COVID is
overwhelmingly a disease of the Global South. In other words, the
pandemic is now a poor-country problem.

### The global distribution of COVID vaccines

Let's switch gears now and look at the global rollout of COVID vaccines.
The most ethical way to distribute vaccines would be to send them where
they are needed most. If we followed this principle, regions with the
most cases would get the most vaccines. In other words, the vaccine
rollout would mirror the COVID case load.

That's not how things have played out.

COVID vaccines haven't chased cases ... they've chased *dollars*. As
Figure [3](#fig-continent-vac) shows, vaccines have gone overwhelmingly
to rich buyers in Europe and North America.

[]{#fig-continent-vac}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/continent_vaccines.png?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 3: Share of the world’s fully vaccinated
people by continent. [<a href="#sources-and-methods"
target="_blank" rel="noopener">Sources and methods</a>].</figcaption>
</figure>

Figure [4](#fig-north-vac) simplifies things by looking at the vaccine
rollout in terms of a North-South dynamic. I've plotted here the share
of fully vaccinated people who live in the Global North. In January
2021, when vaccines first rolled out in the UK and the US, this share
was 100%. Thankfully, it declined thereafter, meaning some vaccines did
make it to the Global South. But outside rich countries, the pace of
vaccine distribution has been slow. As of June 4, 2021, 65% of all fully
vaccinated people live in the Global North.

[]{#fig-north-vac}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/north_vaccines.png?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 4: Share of the world’s fully vaccinated
people who live in the Global North. [<a
href="#sources-and-methods" target="_blank" rel="noopener">Sources and
methods</a>].</figcaption>
</figure>

The truth is that the rollout of COVID vaccines has followed a simple
plutocratic formula:

::: {style="text-align:center;"}
more money = more vaccines
:::

My guess is that you can see this formula at many different scales. For
instance, in Toronto (where I live) the vaccine rollout has been [slower
in low income
neighbourhoods](https://www.cbc.ca/news/canada/toronto/toronto-covid-19-vaccines-1.5978107){target="_blank"
rel="noopener"}. And as we've seen above, at the global level vaccines
have gone overwhelmingly to rich regions.

The same formula also holds at the national level, as shown in Figure
[5](#fig-north-gdp) and [6](#fig-vac-anim). Across countries, the
portion of people who are fully vaccinated is proportional to GDP per
capita. In other words, the greater your income, the more vaccines you
get.

[]{#fig-north-gdp}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/vac_gdp.png?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 5: COVID vaccination rates vs. GDP per
capita. Each point shows the most recent data for vaccination
rates by country, plotted against GDP per capita in 2019. [<a
href="#sources-and-methods" target="_blank" rel="noopener">Sources and
methods</a>].</figcaption>
</figure>

[]{#fig-vac-anim}

<figure class="wp-block-image size-large">
<img
src="https://i0.wp.com/economicsfromthetopdown.com/wp-content/uploads/2021/06/vac.gif?w=723&amp;ssl=1"
decoding="async" data-recalc-dims="1" />
<figcaption>Figure 6: COVID vaccination rates vs. GDP per
capita, January 2021 to June 2021. [<a
href="#sources-and-methods" target="_blank" rel="noopener">Sources and
methods</a>].</figcaption>
</figure>

If you're familiar with global health statistics, the above trend won't
surprise you. Pick any health indicator (including [other vaccination
rates](https://economicsfromthetopdown.com/2020/12/28/as-2020-ends-lets-celebrate-science/){target="_blank"
rel="noopener"}) and you'll find that it gets better as per capita
income grows. That's because we live in a plutocratic world where money
buys healthcare.

### The truth about intellectual property

The unequal rollout of COVID vaccines brings me back to intellectual
property. When drug patents expire, the drugs tend to [become
cheaper](https://pubmed.ncbi.nlm.nih.gov/30019138/){target="_blank"
rel="noopener"}. Why? According to
[drugs.com](https://www.drugs.com/article/generic_drugs.html){target="_blank"
rel="noopener"}, it's because generic manufacturers have lower costs:

> Generics are less expensive because the drug manufacturer does not
> have to duplicate the original clinical trials for effectiveness and
> safety, which lowers the cost to bring the drug to market.

Of course, it is true that generic manufacturers don't do drug trials.
But that's not why drugs get cheaper when patents expire. The reality is
that patented drugs are expensive *precisely because they are patented*.
Drug patents are a government-sanctioned monopoly that gives the power
to set prices. That's the secret to Big Pharma's thick profit margins
(which tend to [exceed the
margins](https://jamanetwork.com/journals/jama/fullarticle/2762308){target="_blank"
rel="noopener"} of most other companies on the S&P 500). Let the public
fund the dirty work. Then get a monopoly on the final product.

Speaking of thick profit margins earned through intellectual property,
perhaps the only firms that can compete with Big Pharma's margins are
academic publishers. In 2018, for instance, the publisher Elsevier
reaped a [profit margin of
37%](https://library.ust.hk/sc/academic-publishing-amazing-profit/){target="_blank"
rel="noopener"}. The reason academic publishers can compete with Big
Pharma is because they've adopted the same business model:

1. Let the public sector do the expensive basic science;
2. In the last mile, put IP around the final product;
3. Earn monopoly profits.

The key to these profits is intellectual property. It is the
institutional fence that sanctions monopoly power. Without IP, Big
Pharma's hefty profits would vanish. That is the dirty truth that pharma
execs dare not speak publicly. Instead, they'll call their IP an
'intangible asset' that 'generates value'. But inside the boardroom,
[Cory Doctorow
notes](https://pluralistic.net/2021/04/13/public-interest-pharma/#ip){target="_blank"
rel="noopener"}, the doublespeak gets dropped. In the halls of power,
'IP' has a crisp meaning:

> When you attune yourself to how businesses use "IP," it has a very
> crisp meaning: "IP is anything that lets me control the conduct of my
> competitors, customers and critics."

In other words, intellectual property is all about power. IP grants Big
Pharma the power to *restrict* access to drugs. It's no wonder that this
power leads to unjust results. That's what it's designed to do.

Back to COVID vaccines. Big Pharma has been wielding IP for a long time,
so there's nothing new or surprising about the inequities of the COVID
vaccine rollout. It's just that the brutality of the pandemic makes
these inequities more visceral. As a result, skepticism of drug IP is
probably at an all-time high. A [recent
poll](https://www.filesforprogress.org/memos/voters-support-a-peoples-vaccine-and-coronavirus-relief.pdf){target="_blank"
rel="noopener"} found that 85% of Americans oppose letting private
companies have monopoly rights to vaccines.

Let's put that skepticism to good use and end IP on all COVID vaccines.
And when we're done, let's do the same for every other life-saving drug.

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### Sources and methods

Data for COVID cases and vaccines is from [Our World in
Data](https://ourworldindata.org){target="_blank" rel="noopener"}. You
can download the whole dataset
[here](https://github.com/owid/covid-19-data/tree/master/public/data/){target="_blank"
rel="noopener"}. I define the 'Global North' as Europe, North American
and Oceania. Everything else is the 'Global South'.

GDP per capita data is from the World Bank, series
[`NY.GDP.PCAP.CD`](https://data.worldbank.org/indicator/NY.GDP.PCAP.CD){target="_blank"
rel="noopener"}.

### Further reading

Here's a collection of articles about the public funding behind COVID
vaccines and Big Pharma's monopolization of the end product.

**Public funding of vaccine science:**

- [For Billion-Dollar COVID Vaccines, Basic Government-Funded Science
 Laid the
 Groundwork](https://www.scientificamerican.com/article/for-billion-dollar-covid-vaccines-basic-government-funded-science-laid-the-groundwork/){target="_blank"
 rel="noopener"}
- [It Was The Government That Produced COVID-19 Vaccine
 Success](https://www.healthaffairs.org/do/10.1377/hblog20210512.191448/full/){target="_blank"
 rel="noopener"}
- ['Government Money That's Gone Into Vaccine Development Is Being
 Privatized by a Handful of
 Companies'](https://fair.org/home/government-money-thats-gone-into-vaccine-development-is-being-privatized-by-a-handful-of-companies/){target="_blank"
 rel="noopener"}

**mRNA researcher Dr. Katalin Karikó persists despite academic
rejection:**

- [Philly scientist behind COVID vaccine tech was demoted by UPenn, yet
 she
 persisted](https://billypenn.com/2020/12/29/university-pennsylvania-covid-vaccine-mrna-kariko-demoted-biontech-pfizer/){target="_blank"
 rel="noopener"}

**Hacking the mRNA vaccine:**

- [Stanford Scientists Post Entire mRNA Sequence for Moderna Vaccine on
 Github](https://www.msn.com/en-us/news/technology/stanford-scientists-post-entire-mrna-sequence-for-moderna-vaccine-on-github/ar-BB1f5Yan){target="_blank"
 rel="noopener"}

**Vaccine IP:**

- [Bill Gates will kill us
 all](https://pluralistic.net/2021/04/13/public-interest-pharma/#gates-foundation){target="_blank"
 rel="noopener"}
- [How Bill Gates Impeded Global Access to Covid
 Vaccines](https://newrepublic.com/article/162000/bill-gates-impeded-global-access-covid-vaccines){target="_blank"
 rel="noopener"}
- [Novelist Cory Doctorow on the Problem With Intellectual
 Property](https://jacobinmag.com/2021/05/cory-doctorow-interview-bill-gates-intellectual-property){target="_blank"
 rel="noopener"}
- [The World Loses Under Bill Gates' Vaccine
 Colonialism](https://www.wired.com/story/opinion-the-world-loses-under-bill-gates-vaccine-colonialism/){target="_blank"
 rel="noopener"}
- [Why Big Pharma's Arguments Against Patent Waivers Don't Add
 Up](https://www.counterpunch.org/2021/05/20/why-big-pharmas-arguments-against-patent-waivers-dont-add-up/){target="_blank"
 rel="noopener"}

Around the world, rich countries are celebrating as their COVID numbers fall. Their success is no mystery — it’s because of a massive rollout of COVID vaccines. While we should celebrate the development of these vaccines, their

 deployment

highlights the tyrannies of capitalism. Most of the basic research for COVID vaccines was funded by the public. Yet their manufacture is controlled by Big Pharma.

Messaggi di Rogue Scholar

The Voldemort Index

The Quant Case for Open-Access COVID Vaccines