Who cares?

The Corona pandemic caught humanity unprepared and mercilessly exposed its weaknesses.

‘We passed the science test. But we are getting an F in Ethics.’ These are the strong words used by UN Secretary General António Guterres during the 76th Session of the UN General Assembly in September 2021 to describe the fight against the coronavirus pandemic. ‘Yet instead of humility in the face of these epic challenges, we see hubris. Instead of the path of solidarity, we are on a dead end to destruction.’

Guterres’ urgent appeal: ‘We are on the edge of an abyss – and moving in the wrong direction. Our world has never been more threatened. Or more divided.’ ‘Even if we factor out the immediate medical emergency, the coronavirus still represents an unprecedented global political crisis,’ explains Prof. Dr. Andreas Frewer.

Structural violence against ethical principles

For Frewer, who is a doctor and Professor of Medical Ethics at FAU, the Covid-19 pandemic is a lesson in sustainability – a negative one, unfortunately. He believes that not enough attention is being paid to basic principles such as social justice and showing consideration for the needs of the poorest and weakest in society.

Science achieved great things after the pandemic began and developed several effective vaccines within a very short time, emphasises Frewer. However, long before the first emergency approvals were granted for Covid-19 vaccines, the much promised solidarity with the world’s weakest and poorest was suddenly forgotten. Developed nations flexed their elbows and secured hundreds of millions of doses of potential vaccines for themselves. Developing and emerging countries were left high and dry.

Rich developed nations push to the front of the queue

UN Secretary General Guterres also found strong words for this in his speech, describing the unequal distribution of coronavirus vaccines as an ‘obscenity’.

The World Health Organisation (WHO) launched the Covax initiative as early on as April 2020. Covax stands for ‘Covid-19 Vaccines Global Access’ and its objective is to provide the best possible access to vaccines for Covid-19 to nations regardless of their purchasing power.

The idea behind the initiative is that all states in the world should make contributions to a joint fund. This money is then to be used to purchase vaccines for all, so that richer nations contribute to the costs for poorer nations and the vaccines are distributed fairly according to priority. However, despite a large number of donations, from the USA and the EU among others, the distribution of vaccines is a long way from being fair.

Whereas a majority of the populations of developed nations have been vaccinated, people in poorer countries, where around two thirds of the world’s population lives, are still waiting. The vaccination rate in these nations is under five percent, and hundreds of thousands of people there have already died from the virus.

Global solutions are the only way out

That said, Andreas Frewer does not believe it is wise for people from developed countries to forgo their third vaccination out of solidarity with people from poorer nations. According to Frewer, creating infrastructure and resources for testing and vaccination is a task for politicians and thus a structural and ethical issue that can only be tackled on a national and global scale. There is little any one individual can achieve at this level.

The problem we are facing can only be solved on an international level, warns Frewer: ‘The United Nations must galvanise politicians to implement even more measures aimed at increasing recognition of the fact  that the pandemic is a global crisis and needs to be tackled as such – in the interests of global justice.’ And in the interests of medicine.

The fact remains that dangerous mutations can develop in places where there are little or no resources to tackle the pandemic, and these mutations can spread all over the entire globe as we have seen in the last few months.

The propaganda sideshow 

‘National strategies are therefore quite simply short-sighted,’ says Frewer. ‘Politicians must either invest in saving lives by dealing with the cause of the pandemic everywhere right now, or they will end up spending billions in the long term for the consequences without there being an end in sight.’

Thinking within national boundaries has also triggered a resurge in another phenomenon: nationalism. Examples include when former US president Donald Trump coined the phrase ‘Chinese virus’, thus fanning the flames of his own political agenda, while the Chinese government used its state media to lead many of its citizens to believe that the Covid-19 pandemic was inflicted on them by the USA.

Discriminatory, but unfortunately quite typical, says medical historian and ethicist Frewer. There are several examples of such nationalistic and racist terms in the long history of medical conditions and how they were named.

Even though it was certainly less deliberate, the choice of names given to virus variants at the beginning of the pandemic according to their supposed country of origin was no less discriminatory. This gave rise to discussions about an ‘Indian variant’ or initially also a ‘British variant’, damaging the image of countries already suffering from the devastating effects of the virus. This is the reason why mutations of the virus are no longer named after the country of origin, but with letters from the Greek alphabet. ‘We can only hope that we don’t need to use them all up too quickly,’ says Frewer.

Open access to knowledge

Politicians are still debating about how we can actually tackle the coronavirus pandemic on a global level. For some, it’s clear that a waiver of the patents for vaccines is an important step in dealing with the vaccine shortage. Open access to medical knowledge can help make cheaper generic medication available to poorer nations that cannot afford the more expensive original versions. For example, the deliberate violation of patents in Brazil and India was a significant step forward in the fight against the HIV pandemic in both countries.

In the case of Covid-19, a waiver of the patents is only part of the solution, says Frewer. Simply knowing the formula is not enough to produce the vaccine. Manufacturing coronavirus vaccines requires high quality standards during the manufacturing process in order to guarantee the efficacy of the vaccine.

Exporting know-how to emerging countries

Within the context of sustainable development, it is therefore necessary to develop expertise and capacity in countries where they are lacking, in other words by providing training for experts and building factories in countries such as Africa, South America and the poorer nations of Asia.

It’s now up to politicians to convince companies to pursue this strategy using both political and financial incentives. ‘Many companies advertise that they are making the world a better place. This is an opportunity for them to get involved for the benefit of all. It certainly won’t do them any harm.’

One thing is certain. ‘At some point, a new coronavirus mutation or another virus will come along that will pose new challenges for us,’ warns Andreas Frewer. ‘We need infrastructure all over the world to face these challenges and not just in developed nations.’ It is therefore vitally important for the future that we support initiatives such as Covax and invest more in general pandemic readiness.

The next pandemic is not far away

Although it’s important to keep a close eye on Covid-19 and its mutations, we should continue to be wary of several ‘familiar faces’ that are still lurking around. ‘We currently have to deal with some setbacks in the fight against tuberculosis. There are still too many deaths from HIV, despite the availability of effective drugs. And the Ebola epidemic is starting to flare up again,’ warns Professor Frewer.

‘In addition, more attention should finally be paid to humanitarian disasters.’ The decades of ongoing poverty and famine across the world seem to have been forgotten entirely, even though the situation has worsened considerably due to the pandemic and has provided fertile ground for disease to spread. International spending on humanitarian aid has been falling for several years now.

‘It’s finally time for a rethink,’ demands Frewer. Industrial nations must take responsibility, as they have the power and the means to change the status quo and bring about more justice and sustainability.

‘The gap between the rich and the poor is widening even further during this time of crisis. Those who were faced with difficult challenges before the pandemic are those who are being worst hit by it. We must help those who cannot help themselves.’

FAU research magazine friedrich

This article first appeared in our research magazine friedrich. You can order the print issue (only available in German) free of charge at presse@fau.de.