how high is the risk of an eventual instant pete well to discuss that i'm now joined by stuart bloom professor emeritus of science and technology status at the university of amsterdam and author of immunization how vaccines became controversial the present moment 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 in which she stated that old world agrees that we need a vaccine and i'm glad if it's really so subtle not the moment the government's 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 a consensus that at baskin is the ultimate weapon against cobbett 19. it's an essential weapon so sure. i don't believe it was sold 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 protecting high risk groups or is it all about eliminating 1000 in its totality. it's certainly not about to limit it to the virus which is probably impossible when the only virus the terrible been eliminated to smoke will they've now been trying to

relive in a rodeo for 40 years it's cost something like 10 times the original estimate 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 phone to call street it's a question of control i heard you say before that historically vaccines have been prone serial mission creep so to say the zapper 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 batted 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 time and. that's

a very difficult question. i think the important thing to emphasise 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 an only launch of a true or a public cattle thing 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 to fracturing development but under a recently a great deal of the dynamic behind vaccine development risk commercial now it's more complicated to with kofi not. it's very very much commercially driven not speaking about 19 specifically i. think you would probably agree with me that

it's not the data the ester fire says when it lands on the miserable achille compromised calculations it's dangerous magnified many times over and this is online major issue with the race to vaccinate approach 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 to cope with my team but to many other viruses as well are currently agree that there's an interesting question for a historian because. in 1998 there was a very famous come from circuit in not keep in kazakhstan which came up with the idea of healthful all on the idea was very much the vaccines or any specific

disease focused acknowledged to be seen as a long weapon 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 have 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 lost the idea of focusing on

those socio economic course of your conscience and i think that's one of the tragedies are all 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 show up with limbs a lot of experience 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 who are currently in the face 3 trials of focusing on a single viral approaching the salt spike protein as being immunize an adjective and isn't that preaching dangerous isn't that putting most if not all that absent one busken well i know. i'm not a viral edge of a store of banks and all just. what struck me as the.

10 or so back seems they were counted eventually and now in trials indeed some of them are making to solve tekken of platforms like that and some of them i'm making here so of recombinant d.n.a. technology is which are not yet been used in existing human license human bankruptcy so i'm going to 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 an active 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 aspects he is that in that had to bill in a situation like this or do you think it would have been managed in an more effective way and if so by 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 tried 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 which has been established by the world health organization and godfrey

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 kind of ensuring some drove or anxious to backstreet and 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 geo political statement. 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 jeev being the w sure has lived up to the authority that it claims for itself they're 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 palos 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 con to watch it get there but the world really better if you'd coach well there 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 there social taboos that cultural attitudes that budgets and i would argue that we have seen this play out vividly if they're out of the college 19th endemic when there is a very strong push for strong quarantines even though that would have produced. major problems and now they're you know satyrs of upside to hasn't 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 all condemning regardless of what the situation really is on the ground i'm not even sure what the parameters or whatever of some turturro policy would be. for one of the issues of course at the moment is how to ensure. 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 on the road 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. health care workers people in essential occupations but there's not likely to be much agreement as to who back tears. 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 brutal infection it's hard to say it's hard to think of instantly implementable solution because. the situation we're in have such a deep roots going back let's say at least of the 98 years and perhaps earlier 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. nobody

was there's a workable if there were policemen of the police who would go through maze and sure there. were the sounds the guy. was only isn't there a need for a list of details coming through from. the field so. don't go to the q so. the point was to use the book with the ghost discovering that those that would use up these are the 1000000000 users but the media of course you. are. welcome back to worlds apart this tour the globe professor emeritus of science and

technology studies at the university of amsterdam and to someone just before the break we touched upon the geopolitical aspect of public health and you should value that argument in your new york times piece where you rode that their race 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 christian. well we'd like to think. there's it's all about saving lives 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

a infused with those other considerations how to live it as i mean there isn't the only thing you need to. look at is the sort of public health problem profile at a major countries in europe the that you know people insist on not at the top of benda not each talked a lot about the fact that it will act. to backwards and i wonder what equitable even means in these days isn't the government's 1st obligation 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 dot's 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 sons but there are times to be somehow downtrodden by. for those who are not overworked consider to be us who where do we draw from lunch now i want to ask you specifically about national mysterious because. this name be a self-serving question before you remember that the russians were there 1st you register that you're in a vaccine and they've received a lot of negative press in the west a lot of allegations that the problem 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 the labs and i want to be on such a politically and diplomatically charged issue how does one distinguish legitimate concerns from politically driven and actives. well for most of us are to because regionally go what's available in the public media i've seen the reactions to the. the vague to the launch of the russian backseat no longer registration it's not necessary in order to go and start the peace based he try as i mean that's the baby how the russian process works where the one hand it's true or right 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 motivated 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 agrees oh 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 back since and. pointed learned 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 the 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 ship for a public 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 were denied access to the most sophisticated technology areas by commercial

companies that are patent to them so on the on hand. those institutes have certain deficiences without any doubt but people trusted what they produced because people knew that they were better to produce the tools that their national health system required box. there is no doubt that the o. in stripy own public sector institute's richard dieter most countries for of vanished. are in process of being dismantled. were they deficiency is was seen as trustworthy as it were so the interests of the health of the people to british and they were not much if at all influenced by markets all commercial considerations to usual something. for sure and that's the wrenching out of the book we're working on i'm looking forward to reading it

because here you're always very very interesting if fact in that book you also mentioned that. this attitude towards vaccines as these people the grail of public health as the main to acknowledge ease of control and prevention was in part form because of their rivalry between the soviet union and the united states you know alluded to actually a minister earlier that the united states was pushing for vaccines and that is i mean if you any and was advocating at draw their socio economic approach. fall waiting. cobbett 19 pandemic which really demonstrated i think this same deal says in fact just a matter ball of disease 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 so her appreciation of how sick and commercial practices may. jeopardize public health did extended then the state may not be even able to

deliver 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 people. yeah. well just one slight correction to be the emphasis on a broader approach came suddenly from the from the from the server during the it also came from a dollar a share and the director general of that every chair at that time now tamala who was from norway o'donnell also said it has to be the roll out. 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 academics 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 quiet if you will very inspiring examples of let's say sort of broader human interest in mind and one of them in my view is the polio vaccine after you masha and 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 captivated 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 for the emergence of new farm to caesar's. susceptibility to infection. it's hard to know who. are we do care about i mean it would need it would require a transformation. ways of living if we are if we are political leaders are really to facing seriously perhaps perhaps it's possible i would like to think it's possible. i don't see the seeds of it yet well maybe you got stuck being skeptical but maybe my questions actually absence i want to finish with a very practical question based on in part on on your book ask about have accents

became so controversial because you know that if you know them and baxter and yet you recognise the 2nd has a patient and suspicion at around the issue of vaccines is not unwarranted because they were instances of a method call and commercially driven paddling of vaccines now how should parents go out about it should they research every single vaccine and they're acting currently trying to 6 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 sometimes a policy question to choose between. which vaccines to introduce into the international or that's a nation scheme and how to choose an alternative i didn't want to listen we all want to have lunch. bob probably haven't as the vaccines have to be acceptable to the compilation 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 and in a crew feeding 19 vaccine when we have and that raises questions that go beyond beyond . there are about political systems and in our institution stress of living we are 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 this year again next week and will that part of. their.

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 invaded 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 governments. join me every thursday on the alex salmond show and i'll be speaking to us of the world of politics small business i'm show business i'll see that.

in the top stories of the last 7 days from us germany agrees to cooperate with moscow and of probe into the alleged poisoning of the opposition figure. is the issue. of the stories the big guns of the british political scene split in the middle over prime minister. and thousands of women rally in the capital calling on the president to resign over contested elections. high profile opposition leader is arrested.