immunization how vaccines became controversial professor bloom and such an honor such a pleasure talking to you thank you very much for your time many thanks for the invitation now you recently wrote an article for the new york times and ricci stated that old world agrees that we need a vaccine and i'm glad if it's really so subtle not a moan to governments who while he's under pressure to produce some sort of a solution some sort of a panacea but among scientists have they really arrived at the consensus that a vaccine is the ultimate weapon against cobbett 90. it's an essential weapon so sure. i don't believe it will solve all the problems there are many problems about producing a sufficient scale distribution of a sense that we may become overcome to the people may think once of invention natured that all of the problems are going away and that's not true either at the

societal level or at the individual level because it's unlikely that a fuss about actually will be on the percentage of sectors that are speaking about this over confidence even in the bass of vaccines i mean this you mean the best possible scenario the vaccine will still have its limitations what's a realistic expectation at this point of time or whatever back you should be able to do i'll be talking about i don't know seasonally protected high risk groups or is it all about eliminating 1000 and it's to tally. it's certainly not about to limit it to the virus which is probably impossible when the only virus the terrible but not a minute or 2 just smokes they've now been trying to remain a rodeo for 40 years to its cost something like $10.00 times the original estimates and it's still not totally successful so it would be

a disaster if people stopped saying we must try to eradicate the virus because it will prove it will prove impulsive oh and far too costly it's a question of control i heard you say before that historically vaccines have been prone to mission creep so to say the ever expanding objectives and part of that may have something to do with the fact that the vaccines are one of the fastest growing markets for big pharma but speaking of these idea that we battled develop vaccines against everything to do you take it as more commercially driven or is it perhaps just a form of magical thinking the psychological demand for hawaiian more safety which i think is a characteristic of our times. well that's a very difficult question. i think the important thing to emphasize as that the kind of underlying dynamic of vaccine development the strange and in the

19 a is whereas previously vaccines have been seen as purely ringback in the only launch of a true or a public health they increasingly in the 1980 s. became seen as a commercially valuable commodity and there was a partial decoupling between the needs of the health system and the approaches of fracturing development but under a recently a great deal of the dynamic behind vaccine development risk commercial now it's more complicated to recruit 51 tree about it's very very much commercially driven not speaking about call it 900 specifically i. think you would probably agree with me that it's not the data the s the fire says but when it lands on the meter bullet only compromised calculations it's dangerous magnified many times over and this is

a line major issue with the race to vaccinate praised because i think it ignores a vital part of what makes this virus. so dangerous and so deadly. don't you think that in focusing so much on vaccines we are essentially taking a shortcut and ignoring structural issues which make so many people not all but so many people so susceptible and small vulnerable not only tickled by gene but to many other viruses as well are totally agree and i mean that's a that's an interesting question for a historian because. in 1998 there was a very famous come from a certain amount of king in kazakhstan which came up with the idea of helpful all on the idea was very much the vaccines or any specific disease focused acknowledged to be seen as long as the bugs used within

a much broader socio economic approach to dealing with. the rejection by some place or as some by some experts of the idea that the infectious diseases had to be treated with a much broader array of let's say equalizing technologies providing basic health care and decent living conditions for every party and that was the only way of protecting us ultimately and vaccines had to be seen as one instrument in that role in that broader approach but some people prefer to forget about that and say we must take it with a system technology is a disease or time so. we launched the idea of focusing on those socio economic course of your friendships and i think that's one of the tragedies are our present situation and why we become overreliant over we place too

much faith in a back street you know it's the the magic bullet that will slow up with them so a lot of experts of voicing concerns about the speed of development and under investigated long term consequences but i would like to ask you about the vaccine design because most of the developers are currently in the face 3 trials of focusing on a single viral approaching the so-called spike protein as being immunize an adjective and isn't that breaching dangerous isn't that putting most if not all that absent one busken well i don't know. i'm going to fire all ages 4 of banks and all of just. what struck me as the. 10 or so vaccines there are counter to vaccines now in trials indeed some of them are making to solve tech and platforms like that and some of them are making here so of

recombinant d.n.a. trick knowledge is which are not yet been used in existing human licensed human back so i'm glad i mean i'm not an expert on these these things but i wouldn't say i'd be morning trying to place my faith. in a vaccine that uses an established platform an established way of making very extreme i mean it's very complicated because most vaccines consists not only of. thing the one who. protects but also the natural and which will strengthen the reaction well what i'm struck by is that how little coordination and any there is on being a national level it seems that everybody is just and rushing to bring a lot of whatever they had in development without really trying to 0 on you know how much their breaths and take on different areas of expertise is that in that

example in a situation like this or do you think it would have been managed in an more emphatic way and it's all that well now we get into questions of politics i mean that's something. about the present situation of course is that we're now in a situation in which the the world health organization which is not our kind of monopoly of moral forestry in the field and stream progressive we undermine. it's very difficult to say where and if consensus could be reached survey is. a structure kovacs riches been established by the world health organization and god create something called c.p. which is basically all slow but to a number of launches countries have chosen not to participate in it it should be a way of ensuring some drove or anxious to actually change even in poor countries

but the big problem is that vaccine development in this band has become as been turned into a matter of global geopolitical strangeness and that's tragic we will definitely talk more about that but let me ask you a question about w.h.o. it's very hard to see you would just pass its policies in a balanced way partially because adults under doesn't immediately invokes all the. american political infighting but as color deemed to double your share has leave doubts of the authority that it claims for in south or out these prices we needed to have a new fish person to we have to restore it. any of this this is so different a situation i'm from let's say the way in which smallpox was eradicated in which the w.h.o.

. presided over a very successful a ready commission campaign in which the major powers in the wont whatever their political differences ship them aside in order to collaborate under the auspices of w.h.o. in ridding the well look this terrible deceived we are all still look bad so no at the moment w.h.o. khan to 'd get there but the world will be better if you coach well that is no question about that i guess i'm trying to figure out the limits of the sort of chord a nation verses are in decision making because after the make a very interesting point that many governments are now failing themselves to be under pressure to conform to some sort of a single health policy regardless of the it in a logical situation on the ground their social patterns that cultural attitudes that budgets and i would argue that we have seen this play out vividly if they're

out of the commitment and then done it when there is a very strong push for strong quarantines even though that would have produced. major problems and other you know satyrs of us aside to has it really served us well i mean i'm not speaking about of course nation but these sort of single handed single policy approaches you and i gloat condemning regardless of what the situation really is on the ground i'm not even sure what the parameters are whatever of sumter global policy would be. one of the issues of course at the moment is how to ensure that. when they're all is a vaccine away there are a number of vaccine they get to the places that them most needed that we wouldn't even agree here or the world wouldn't even agree as to what those places are i mean most people now saying. since the beginning there won't be enough vaccine for

everybody. priority should be given to those those most urgently need of it like. healthcare workers or people in essential capacious but that's not likely to be much agreement as to who that is. and what about the millions of people in refugee camps they're not going to be at the top of anybody's list of priorities and yet they could easily turn into a hotbed of global infection it's hard to say it's hard to think of instantly implementable solution because the the situation we're in have such a deep roots going back let's say at least of the 1980 s. and cup so we have a lot of issues to consider but for the time being at professor going to have to take a very short break we'll be back in just a few moments. of

the. world is driven by shaped by those.

who dares thinks. we dare to ask. our. welcome back to worlds apart this tour the globe professor emeritus of science and technology studies at the university of amsterdam or to someone just before the break we touched upon the geopolitical aspect of public health and you value that argument in your new york times piece what are your road that they raise to develop a vaccine isn't just about saving lives it's also about power profit and national

prestige is there anything wrong with that that's a very good. well we'd like to think. there's all about saving drives but in fact the very beginnings of public health in the 19th century the founder of public health hooterville called said don't public health his politics played by other means and will lead to think that all the fullest systems are dependent on the initiatives that are taken are in the interests of on health and in fact. that are not true to me because they also happen late in future story those other considerations are absolutely that's i mean there isn't the only thing you need to. look at is the sort of public health problem profile at major countries and you believe that you know people's interest i'm not

at the top of the bed and not each talked a lot about the fact that it will act. to backwards and i wonder what equitable even means in these dany isn't the government's 1st allegation to its own citizens yes i suppose it is inevitable and i suppose politically well politically inevitable for sure their governments will think 1st about their their own citizens but then we get into the vexed question of who on whose we whose obstacles. i'm british where i'm pretty sure i'm docs i've been living in a country which is not the country of my birth for a long time the deep blue pill asians now are very mobile. it because it's more difficult than it might have been. 50 years ago even to say who people are so yes it's inevitable i think collision communicable that got him

elected politicians will give priority to their own citizens some. there tends to be somehow down time by. those who not over consider to be our school whose are where do we draw some lunch now i want to ask you specifically about national misty's because. this name be a self-serving question before you remember that the russians were there 1st you register that around in a vaccine and they've received a lot of negative press in the west a lot of allegations that the crown land is sacrificing our jacket as if it was shall or glory even though russian developers are going for the same stages as our western colleagues they're publishing their results in the same medical journals like bill laswell and i want it on such air politically and to political charged issue how does one distinguish legitimate concerns from politically driven and

actives well for most of us or to people because regionally go what's available in the public media i've seen the reaction. the vague to the launch of the russian backseat no longer registration it's not necessary in order to go a star these based b. try as i mean that's how the russian process works when the one hand it's true or as far as i understand thought phase 3 trials of that fraction of not being completed on the other hand i have no doubt order of the negative publicity in the west is promptly moti very jaded by both political and commercial interests. i mean . russia one previously the soviet union had a long tradition of making that actually and on a very long scandal that's sure and i think the only thing we can probably agree on

is that nobody really agree so knows where the 1st generally available and effective function will come from now there is 11 more important distinction between a russian and the west and approaches to your taxes and. partner and it from from your own writing because in the west as you write this states used to be involved in the production of saxons but it's no longer the case in most countries it's primarily a corporate down to price in russia most vaccines are still developed produced and overseen by the state and i wonder if there is any difference in how the scenes made how they are developed how they test the child and market it how they sell how they've used depending on who runs the back of the business by that it's the state or whether it's at or prevent a price who as are times i'm working with people from 9 country is

on a book. there twitter writing on exactly how this shift from a public to private domain to place in each country it's very complicated question i'd rather own i'd rather come back into yes when we finished our book. i think on the one hand it was true that many of the state in strict troops in many countries were. underfunded perhaps insufficiently wretched like tears but also when denied access to the most sophisticated technology areas by commercial companies that are patent to you on the one hand. those institute's absent deficiences without any doubt the people trusted what they produced the has people knew that they will have to produce the tools the national

health system requires about. there is no doubt that the o. in stripy own public sector institutes rich indeed in most countries of vanished all are in process of being dismantled. were they deficiency as was seen as trustworthy as it were some of them so the interests of the health of the people to british and they were not much if at all influenced by the markets all commercial considerations we've lost something for sure and that's the rationale of the book while working on i'm looking forward to reading it because you're younger i was very very interesting if fact in that book you also mentioned that. this attitude towards vaccines as these the holy grail of public health as the main to acknowledge ease of control and prevention was in part

foreign because of their rivalry between the soviet union and the united states he alluded to that actually him and his. earlier that the united states was pushing for vaccines and that is only if you any and was advocating abt rother socio economic approach. fall we. cobbett 19 pandemic which really demonstrated i think this same deal says infectious and metabolic diseases i mean it's really a hybrid disease at its core do you think that will change do you think there would be more are sort of appreciation of how sick and commercial practices may. jeopardize public health did extend and then the state may not be even able to deal with that because it even without calling 1000 many states were already struggling with the rates of diabetes and heart heart disease etc that were primarily produced by you know runaway consumption of certain full.

well just one slight correction to be the emphasis on a broader approach karim certainly from the from there from the soviet union it also came from the w.h.o. . and the director general of that every parent there time now tamala who are from norway denmark also a trade it has to be brought. whether we can ever go back to that. who knows i mean i mean i don't think the global system that's very quick to look what to be done from the financial crisis of 10 years ago what you read. from previous epidemics we're not very good at learning because it seems to say oh interest trumps knowledge well you seem to be very pessimistic and i think they're quite good fuel very inspiring examples of let's say sort of broader human interest in mind and one of them in my view is

a polio vaccine after you mansion these facts and before as as an example of sort of geopolitical competition and this audience trumpeting its success at their successes in producing that backs and but behind it it is actually a story of collaboration because they saw that scientists god that their regional sample from that american colleague who had adopted time no chances of getting bad backs him into a production because it was based on an attenuated polio virus rather than in it and activated by that the united states was favoring at that time so collaboration and pretty large scale collaboration it was possible even to hide of the cold war surely it should be possible now of course i would like to think that to expulsion from i would like to think that we can tackle the social and economic courses both towards the emergence of new viral diseases. susceptibility to infection.

it's hard to know who won't. or we do i mean it would need it would require a transformation. ways of living if we are if we are political leaders are really true facing seriously perhaps perhaps it's possible i would like to think it's possible. i don't see the seeds of it yet. what makes me think you got stuck being skeptical when maybe my questions actually absence i want to finish with a very practical question based on in part on on your book asked about have accents became so controversial because you know that if you know them and baxter and yet you recognize the 2nd has a patient and suspicion at around the issue ringback of vaccines is not unwarranted because they were instances of a method call and commercially driven handling of vaccines now how should parents

go out about it should they research every single vaccine and they're acting current it's $1.00 to $6.00 recommended by the dollar and shown more than a 3rd seemed into about men i mean how do you make an informed decision on such a complicated issue when you're sitting there by yourself in your living room and you're trying to decide what's best for your child well i think one thing won't one thing on their to say to the pope and sometimes both wester throw a different light on vaccine hazards i'm sure you're going to show that the reasons that something like 50 percent of people in many countries in some countries are now saying they wouldn't take a back shouldn't against the code be 19 vaccines even when there is one so on the one hand there's the question of reestablishing people strong strain of banks because we need people to accept one if it's going to have any benefit to compare any benefit the other questioner or so to choose to adopt a policy question to choose between. which vaccines to introduce into the

international or that's the nation scheme and how to choose an alternative i don't want to listen we all want to have lunch. bob probably haven't as the vaccines have to be acceptable to the population before long they are rolled out in a in a society because if the nauts acceptable there is a real risk of undermining faith in the vaccination system as a whole and i think governments are under such pressure to introduce a vaccine rapidly that the willingness to consult and to ensure acceptability are somehow been eroded joint think. people have to trust the vaccine we have to think about how to reestablish trust both in vaccination generally. facts remain out and that raises questions that go beyond beyond. there are

about political systems from in our institution resolutely out of time there really grateful for you joining us today thank you very much for being very much an interesting discussion and they fearful what you hope to syria again next week on the world's apart. problem drugs don't always come from unscrupulous dealers but from pharmacies to in every state in the united states we've seen very sharp increase in the number of

people seeking treatment for addiction to prescription opioids and invited to america under the banner of medicine persisted with the pain but instead of trying to wean him off though she just goes after dose after dose after dose and really became his drug dealer who's to blame patients doctors manufacturers all the government. that we've been talking about saslow for you know a number of weeks few months because it is a phenomenon and the point i've been making from day one is that if they mean they mean that as a market valuation at one point over $400000000000.00. and it taps into people to trade me on these are generations in the millennia old song the robert of apps and other forms. of no fundamental value there's nothing there it's just

it's a murmur ation like starlings in the sky they congregate and then they disperse. yellow vast antigovernment activists to recruit from paris for the past time since the town meeting to a brutal standoff with police on hundreds. correspondent was. starting to get a look up but not clear. see here gas as people and i'm trying to move away from that. russia excuses ukraine of disregarding free speech after it all stops will to remove all russian media content from the country up stole. on britain for path to nima gatherings of molten 6 p. .