[Plura-list] The Cuban vaccines

[Cory Doctorow]

Read today's issue online at: https://pluralistic.net/2021/11/28/somos-cuba/

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Are you going to San Diego Comic-Con? Me too!

* I'll be signing at the Mysterious Galaxy Booth (#1325) today from 12-12:45PM

* And I'll be on a panel, The Kids Are (Kinda) All Right, today from 1:30-230PM

https://www.eventeny.com/events/comiccon-special-edition-1800/?action=schedule-item&action_ops[item_id]=9591



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Today's links

* The Cuban vaccines: Omicron, vaccine apartheid, WTO TRIPS waivers and the false hope of viruses "gentling" themselves.

* This day in history: 2001, 2006, 2011, 2016

* Colophon: Recent publications, upcoming/recent appearances, current writing projects, current reading

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🐦 The Cuban vaccines

Are you low-key freaking out about omicron? Yeah, me too. Can't we catch a break?

Maybe.

Step one to preventing new, scarier mutant strains is to reduce the number of infected people, which require a mix of ventilation, masking, distancing, and, of course, vaccinations.

These days, the "vaccine controversy" is primarily about vaccine-hesitancy and vaccine denial - that is, about people who can get the vaccine but choose not to. But if you cast your mind way, way, *way* back to last spring, you'll remember that the big issue was vaccine equity - the maneuvering by the rich world to keep vaccines from the Global South until we'd all gotten our jabs.

This was and is a scandal. As a humanitarian matter, it's a frank admission that the lives of people in poor countries are less important than the lives of people in rich countries. But even if you have the kind of howling void in your ethics that can wave that away, it's also an epidemiological disaster.

Because vaccines don't offer perfect protection, even vaccinated people are at risk of breakthrough infection. The more exposure, the higher the risk. Leaving the 125 poorest countries in the world - 2.5 billion people - unvaccinated until 2023 or 2024 creates a huge pool of infected people who might infect you.

Dividing the world into vaccine haves and have-nots is like dividing a swimming pool so it has a "pissing end" and a "no pissing" end. We're still all in the same pool. Humanity has a shared epidemiological destiny.

But vaccinated people who get infected generally experience milder symptoms. I have a double-vaxed relative who got a breakthrough infection whose only symptom was loss of smell, and four days later he got his smell back and was testing negative on lateral-flow tests again.

So maybe if all you care about is your own skin, it's okay to deprive the Global South of vaccines? Not so fast. Remember omicron? At the root of a viral infection is a flurry of reproductive activity, in which a virus hijacks your own cells to make copies of itself. Some of those copies will be imperfect, leading to mutations. Most of those mutations are inconsequential. Some make the virus less dangerous. Some make it more dangerous - better at spreading, better at bypassing vaccine protection, better at making us sicker.

The decision to impose Vaccine Apartheid on the Global South is a decision to turn 2.5 billion of our fellow humans into potential incubators for mutant strains, as their undefended bodies are colonized by covid and hijacked to produce trillions of copies of the covid virus. Even if the chances of a harmful mutation are small, these infections present an incomprehensibly vast number of lottery tickets that the virus gets for free, and eventually, it will win a jackpot.

Last spring, a talking point about why we didn't need to worry about this started to circulate: we don't need to worry about harmful mutations because viruses tend to "gentle" themselves over time. A strain that kills its host too quickly, or immobilizes them with severe symptoms, will lose out to less harmful strains that get more reproductive opportunities because their hosts can spread them farther and wider.

This is certainly true of some pathogens, but it's by no means a universal law, not even over very long timescales: rabies hasn't gotten gentler through the millennia. And it's even less true over short timescales: HIV is just as dangerous today as it was in the 1980s.

What's more, the story of self-gentling viruses omits a key detail about how more deadly strains die off: by killing everyone who contracts them so quickly and decisively that the sick can't drag themselves to a new population before expiring. Other pathogens like the Black Death "gentled" themselves by wiping out significant pluralities of the populations of whole nations, over and over again, for *centuries*.

Despite this, the story that blocking vaccine access to 2.5 billion poor people didn't pose a risk to vaccinated people was repeated. Sometimes, this was clearly motivated reasoning ("I'd rather believe in self-gentling vaccines than public goods"). Sometimes it was plain old wishful thinking.

Not everyone who told this tale was talking out of their hat - I heard from a molecular biologist with lots of experience in tracking viral mutation who thought that the specific characteristics of the covid molecule made harmful mutation very, very unlikely.

Maybe he was right. But very, very unlikely outcomes to processes that we allow to unfold trillions and trillions of times are still a real risk (hi, omicron!).

The public subsidized the covid vaccines at many junctures through their development. But the rapacious pharma giants who produced them spun a narrative that attributed vaccine development to the miracle of private enterprise. This let them defend the idea of blocking global access to vaccine-making patents and associated materials.

https://pluralistic.net/2021/05/16/entrepreneurial-state/#patient-zero-money

This story was bolstered by more lies, including the claim that it would simply take too long to build new mRNA vaccine factories (privately, Moderna admitted that new factories could be scratch-built in 3-4 months):

https://apnews.com/article/drug-companies-called-share-vaccine-info-22d92afbc3ea9ed519be007f8887bcf6

Even more important to the narrative were the racist lies about the incompetence of brown people in poor countries and their inability to make vaccines of their own (the world's largest vaccine factories are in the poor world).

Big Pharma was absolutely shameless here, using New Cold War rhetoric about China "stealing American IP" to stampede the White House and Congress into backing its move to keep the Global South from making its own vaccines:

https://pluralistic.net/2021/05/15/how-to-rob-a-bank/#roll-the-dice

The belief that poor people are incapable of making vaccines goes hand-in-hand with a doctrinal worship of "market forces" as the only way to resolve hard policy questions. This is Bill Gates's bread-and-butter, and his Gates Foundation led the charge to keep vaccine production in private, for-profit hands.

https://pluralistic.net/2021/04/13/public-interest-pharma/#gates-foundation

Gates's work started with convincing the Oxford team to renege on its promise to put its publicly funded vaccine in the public domain. Instead, they gave exclusive rights to Astrazeneca:

https://khn.org/news/rather-than-give-away-its-covid-vaccine-oxford-makes-a-deal-with-drugmaker/

Then Gates and the Gates Foundation lobbied hard against a WTO TRIPS Waiver that would let poor countries seize the means of (vaccine) production and make their own jabs. This wasn't the Foundation's first rodeo: they were also on the vanguard of the campaign to keep generic AIDS drugs out of South Africa at the peak of the country's health emergency.

https://newrepublic.com/article/162000/bill-gates-impeded-global-access-covid-vaccines

Pharma has deep pockets and can buy some pretty impressive spokevillains. Howard Dean (once a lion of progressive politics and now on Big Pharma's payroll) pushed the racist brown-people-too-stupid-to-make-vaccines lie, too:

https://pluralistic.net/2021/04/08/howard-dino/#the-scream

Despite all this, the Biden administration - to its everlasting credit - backed the idea of a WTO waiver:

https://pluralistic.net/2021/05/10/comrade-ustr/#vaccine-diplomacy

But even without the US trade rep's help, Big Pharma managed to stall the WTO waiver, and now we have omicron.

https://twitter.com/WallachLori/status/1464344665851899906

But the Global South has not sat idly by while the north prioritized pharma shareholders' dividends over the continuation of our species. Cuba has one of the world's most advanced biotech industries, and it went into high gear as soon as covid emerged, producing *five* viable vaccine candidates:

https://pluralistic.net/2021/03/31/vaccine-for-the-global-south/#Soberana-Abdala

Today, the Cuba vaccine program - publicly owned, cooperative, and managed for the public good - is paying off handsomely. 100% of Cubans have had at least one dose, and 78% are fully vaccinated. Only 2.8% of the population of the world's other low-income countries are vaccinated.

https://jacobinmag.com/2021/11/cuban-covid-vaccine-pandemic-biotech-research

The country has "reopened its borders on November 15 to tourism, roughly a tenth of its economy, and has reopened schools."

Cuba is also scaling up its vaccine production and getting ready to vaccinate the rest of the world in a south-south technnology transfer. Vietnam (39% vaccinated) is getting 5m doses - 1m of them a donation from the people of Cuba to the people of Vietnam. Iran and Nigeria have inked deals to build their own vaccine factories to make Cuban vaccines.

Two of Cuba's five vaccines are now in production. The other three are still in trials. One, a nasal spray, is in Phase II trials.

The Cuban vaccines aren't mRNA-based; rather, they're conventional protein vaccines, which has many advantages. They don't need elaborate cold-chains, and we know a lot more about how safe they are for kids to take.

As Branko Marcetic writes in Jacobin, Cuba's decision to build out a domestic biotech industry started when Reagan announced cruel new sanctions while the country was undergoing a brutal dengue fever outbreak. It was a good call: today, 70% of the medicine Cubans take are made on the island and the country exports hundreds of millions of vaccine doses every year.

The country's biotech sector has received recognition from the rich world, including, incredibly, from WIPO, a UN agency that is entirely beholden to multinational corporate interests. WIPO has given Cuba *ten* gold medals for its biotech products, including the world's first meningitis B vaccine. The country was the first to eliminate mother-to-child HIV and syphilis transmission.

Cuba's vaccine miracle almost didn't happen, though: the ongoing blockade created a massive syringe shortage (solidarity donations from individuals abroad, including the US, saved its butt).

We don't know yet how the vaccines - both Big Pharma's and Cuba's - will perform against omicron. But until we get the whole world - including poor people in poor countries - vaccinated, we will remain at risk from new strains.

Remember, the path to a "gentler" covid runs through mountains of dead people who are immobilized or killed so quickly that they never get the chance to spread the less-gentle strains. We can't afford that, and we don't have to.

Pass a WTO waiver now!

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🐦 This day in history

#20yrsago Cybiko PDA looks like a scientific calculator designed by HR Giger https://web.archive.org/web/20011204212308/http://www.kcgeek.com/content/features/1006840309.Lev.review/feature.html
#20yrago Footage of the real Christopher Robin in a Pooh suit http://news.bbc.co.uk/2/hi/entertainment/1677945.stm

#15yrsago Russia saves to US Trade Rep's brutal conditions for WTO membership https://web.archive.org/web/20061205073809/https://ustr.gov/assets/Document_Library/Fact_Sheets/2006/asset_upload_file151_9980.pdf

#10yrsago Alan Moore talks V for Vendetta Guy Fawkes masks https://www.theguardian.com/books/2011/nov/27/alan-moore-v-vendetta-mask-protest

#10yrsago How the tax code works for billionaires https://www.nytimes.com/2011/11/27/business/estee-lauder-heirs-tax-strategies-typify-advantages-for-wealthy.html

#10yrsago One percenter asks: “Have You Ever Heard of Anybody Great That’s Come Out of the 99 Percent?” https://web.archive.org/web/20111130232652/http://blogs.villagevoice.com/runninscared/2011/11/proud_one_perce.php

#10yrsago Secret records of US bank bailout released, over howls of protest https://www.bloomberg.com/news/articles/2011-11-28/secret-fed-loans-undisclosed-to-congress-gave-banks-13-billion-in-income

#5yrsago The Snoopers Charter gives these 48 organisations unlimited, secret access to all UK browsing history https://web.archive.org/web/20161127150339/https://www.zerohedge.com/news/2016-11-26/these-are-48-organizations-now-have-access-every-brits-browsing-history

#5yrsago Donald Trump didn’t kill the TPP – activism did https://www.theguardian.com/commentisfree/2016/nov/28/tpp-protests-mass-opposition-worked-trump-presidency

#5yrsago Ransomware creep accidentally hijacks San Francisco Muni, won’t give it back https://www.sfgate.com/bayarea/article/Free-rides-for-Muni-customers-after-apparent-10637873.php

#5yrsago Amid a media blackout of the Standing Rock protests, law enforcement targets the rare journalists on the scene https://theintercept.com/2016/11/27/arrests-of-journalists-at-standing-rock-test-the-boundaries-of-the-first-amendment/

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🐦 Colophon

Today's top sources: Naked Capitalism (https://www.nakedcapitalism.com/).

Currently writing:

* Picks and Shovels, a Martin Hench noir thriller about the heroic era of the PC. Yesterday's progress: 528 words (43060 words total).

* A short story for MIT Tech Review's 12 Tomorrows PLANNING

* A Little Brother short story about remote invigilation.  PLANNING

* A Little Brother short story about DIU insulin PLANNING

* Spill, a Little Brother short story about pipeline protests. Yesterday's progress: 621 words (32894 words total) FIRST DRAFT COMPLETE

* A nonfiction book about excessive buyer-power in the arts, co-written with Rebecca Giblin, "The Shakedown."  FINAL EDITS

* A post-GND utopian novel, "The Lost Cause."  FINISHED

* A cyberpunk noir thriller novel, "Red Team Blues."  FINISHED

Currently reading: Analogia by George Dyson.

Latest podcast: Jam To-Day (https://craphound.com/news/2021/11/21/jam-to-day/)

Upcoming appearances:

* The Kids Are (Kinda) All Right (San Diego Comic-Con), Nov 28
https://www.eventeny.com/events/comiccon-special-edition-1800/?action=schedule-item&action_ops[item_id]=9591

* Redistribute the Internet (NGI Summit), Nov 30
https://summit.ngi.eu/programme#day2

* Internet Governance Forum (Warsaw), Dec 10
https://www.intgovforum.org/en/schedule/20211210

* Competition and Regulation in Disrupted Times, Dec 16
https://www.cra-brusselsconference.com/

Recent appearances:

* NFTs (Upstream)
https://soundcloud.com/upstreampodcast/nfts

* Policy, Profit, Privacy, and Privilege: The Post-Pandemic Future of Remote Testing Technology (ACM-USTPC):
https://www.acm.org/public-policy/ustpc/hottopics/remote-testing

* Alternative recommender systems in the DSA:
https://www.youtube.com/watch?v=ZPuB4JRRhw0

Latest book:

* "Attack Surface": The third Little Brother novel, a standalone technothriller for adults. The *Washington Post* called it "a political cyberthriller, vigorous, bold and savvy about the limits of revolution and resistance." Order signed, personalized copies from Dark Delicacies https://www.darkdel.com/store/p1840/Available_Now%3A_Attack_Surface.html

* "How to Destroy Surveillance Capitalism": an anti-monopoly pamphlet analyzing the true harms of surveillance capitalism and proposing a solution. https://onezero.medium.com/how-to-destroy-surveillance-capitalism-8135e6744d59 (print edition: https://bookshop.org/books/how-to-destroy-surveillance-capitalism/9781736205907) (signed copies: https://www.darkdel.com/store/p2024/Available_Now%3A__How_to_Destroy_Surveillance_Capitalism.html)

* "Little Brother/Homeland": A reissue omnibus edition with a new introduction by Edward Snowden: https://us.macmillan.com/books/9781250774583; personalized/signed copies here: https://www.darkdel.com/store/p1750/July%3A__Little_Brother_%26_Homeland.html

* "Poesy the Monster Slayer" a picture book about monsters, bedtime, gender, and kicking ass. Order here: https://us.macmillan.com/books/9781626723627. Get a personalized, signed copy here: https://www.darkdel.com/store/p1562/_Poesy_the_Monster_Slayer.html.

Upcoming books:

* The Shakedown, with Rebecca Giblin, nonfiction/business/politics, Beacon Press 2022

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