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"Our unique success in vaccine development and mass production — notably beating out our main rival, China"

I'd like to see a whole article (from Noah or anyone really) about how the US -- "can't do infrastructure", "bad at mass manufacturing", "no industrial base", etc -- seems to have beaten China soooooooo badly on this one. The R&D? Okay, sure, expected the US to do better there. Even if its own population is hesitant to get vaccinated ... why isn't China able to produce a billion shots and do REAL vaccine diplomacy? Instead I keep reading stories like how Thailand ordered 2 million shots of Sinovac and 90 million shots of AstraZeneca. Or the Philippines got a mere 500,000 shots of Sinovac for their population of 110,000,000, good for half of 1% of the country.

I mean, we're 5 months into 2021 at this point. I'm pretty sure that Chinese factories can build iPhones faster than this. I hear stories like "China is building one gigabattery factory a week" or how China directed state capitalism is good at quickly executing mega-projects. So what's the full story here?

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The Chinese vaccines are old-fashioned, meaning they have to be manufactured in an antiquated manner (I believe growing them in chicken eggs still). The mRNA vaccines can be made in huge vats. Evidently it’s a delicate production process but can be ramped up much more quickly.

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It took until December 2020 for Sinovac to secure the $500 million funding necessary to double production. Once funding was secured they had the new production line ready by early April. So less than four months to double production.

It takes 48 days from culture to packaging for a complete dose.

Why wasn't there a Chinese Operation Warpseed in July 2020 that gave them $1 or $2 billion so that production would be 8x what it is today?

I don't think chicken eggs are the limiting factor here. The government could just buy/requisition every egg in the country months ago.

I'm not saying I understand this at all... But what little I know makes it hard to piece together why their response has been so bad given the popular narrative of run by technocrats, centralised and decisive, large state capacity, less constrained by countervailing parties and interests, etc.

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I think it's partly the difficulty of overcoming the "gravitational field" generated by China's corrupt, authoritarian government. There was a great article a while ago about how China's autocratic system actually leads to a lot of inefficiency and stifles innovation. Because people are afraid to ask too many questions, afraid to report disappointing results or challenging truths, afraid to push back against authority figures, etc... Lack of transparency and accountability, plus fear and distrust, make huge new undertakings like the vaccine more difficult. It's why China has relied on stealing other country's technologies. 🙄🙄🙄

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I'm not exactly sympathetic to very strong IP rights, but I've heard that loosening (even temporarily) international IP protections for COVID vaccines wouldn't do much good for developing countries because:

- LMICs that have production capacity tend to be middle-income so they don't need the IP restrictions waived (idk about this, there are still a lot of very poor people in middle-income countries).

- LMICs that don't have production capacity wouldn't benefit from an IP waiver, at least not directly. (However, they could still benefit from lower vaccine prices coming from other countries.)

Another possible argument against waiving IP for developing countries (which I haven't heard but am making up on the spot) is that it's still an incentive for pharmas to develop vaccines that are well-suited to distribution in LMICs. For example, the Oxford-AstraZeneca vaccine ended up being a good fit for LMICs (although they've agreed to sell it to LMICs at cost, in perpetuity).

What do you think of these counterarguments?

Also, your Bloomberg link over the text "waive intellectual property rights for other countries" doesn't say anything about IP rights for vaccines. Is that the wrong link?

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Also, I don't agree with the framing of COVID as a special case, because I think we should be designing policies *around* unlikely global catastrophic risks instead of treating them as exceptions - even if that means we're gonna have a policy of waiving IP rights for LMICs every time there's a global pandemic.

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Clarification (since we can't edit comments): I don't necessarily think "waiving the IP in LMICs" for vaccines is a bad policy. Re-reading the article, it sounds like it would be implemented with either a prize system (essentially an auction where the gov't or WHO buys the developing world patent rights from the vaccine developer willing to sell at the lowest price) or eminent domain. I'm just saying that whatever we decide to do during the COVID-19 pandemic, we should be prepared to do during every future pandemic (adapting the policy to varying circumstances).

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"even if that means we're gonna have a policy of waiving IP rights for LMICs every time there's a global pandemic"

donaldtrumpsayingcorrect.gif

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From an economist's viewpoint, I'd think that a two-sided strategy of high-income countries subsidizing Pfizer/BioNTech/Moderna/etc. while loosening intellectual-monopoly protections is a pretty obvious one. Economists oppose monopolies (and so might, in principle, be expected to oppose the intellectual monopoly that is "IP") and like subsidizing things that have positive externalities.

In my view, such a strategy is robust in the face of the counterpoints mentioned above.

If LMICs with production capacity are, in fact, able and willing to pay Pfizer et al. for the right to make vaccines, why can't high-income governments be the ones to pay Pfizer et al., and just send the capacity-having LMICs a bill after the fact? If LMICs with capacity are able and willing to pay the bill, they'll pay whether it comes directly from foreign pharma companies or from foreign governments. (Of course, I would say: just waive the damn bill. But I recognize that others don't think like me.)

As for LMICs without production capacity, well, waiving intellectual-monopoly restrictions for those countries couldn't cost pharma companies anything, could it? If the restrictions aren't the binding constraint on those countries, waiving the restrictions won't make a difference to the bottom line; those countries won't be making vaccines either way.

So pharma companies can't be made worse off by waiving restrictions for those LMICs, and it wouldn't even be necessary to subsidize a waiver for them. High-income countries could just waive restrictions for those LMICs and that'd be virtually a Pareto improvement in its own right.

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Yes, vaccine diplomacy is an obvious way for the US to outcompete China and prove the superiority of the liberal democratic approach (we must never forget the way authoritarian China treated its own doctor who tried to warn people about COVID).

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hi I am from India. India has two Vaccines it currently manufactures 1. AZ- Covidshield, 2 Indigenous -VoVaxin, and there is no raw material shortage for the above two and we expect significant ramp up in production and vaccination in May. in addition Indian companies have started to manufacture Russian vaccine "Sputnik 5" so India can manage without US help... but the fact is US help... the raw material shortage is for the fourth vaccine "Covocax" which is licensed from Novavax an American company.. it is a mRNA based vaccine. the production for "Covocax" is towards India's contribution to "GAVI" a WHO initiative to provide vaccine's to Africa and South America. so in short US is blocking vaccines for poor countries ... Lastly you notice india has licensed all the vaccine it makes... and by manufacturing at a global scale... it can bring down the cost of vaccine for entire world... the waiver in IP is for other countries... the current cost estimate for vaccination of Indian population is 0.4% of GDP... which we can afford...

PS: India has provided free vaccine to USA's neighbor's in Caribbean, south America and Canada. ..also last year when there was HCQ and PPE shortage India provided it globally including USA...

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> Still, our failure to sell Canada doses early on probably damaged our relations with them a little

I think the damage is more than 'a little'. The idea that Canada has to import vaccines from Europe rather than from the largest-trading-partner United States rankles the entire political system. The right wing uses it as a club against the centre-left government ("if you had done a good job, we'd all be vaccinated by now"), and the left wing uses it to argue against free trade generally ("why did governments ever allow biotech companies to leave" / "nationalize biotech")

This isn't even a one-off; it comes on the heels of the Trump administration using frivolous 'national security' grounds to penalize Canadian steel and aluminum. The only lesson for the Canadian political elite to take from this is that on matters of national importance, the United States is a competitor rather than a partner.

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Welcome to Team Vax the Planet, Noah!

Citations Needed ran an episode earlier this year (https://citationsneeded.libsyn.com/episode-129-vaccine-apartheid-us-medias-uncritical-adoption-of-racist-intellectual-property-dogma) about the overrating of "intellectual property" and how it feeds into the deadly denial of vaccines and medicines to poorer countries.

Transcript available over at Substack 1.0 (https://citationsneeded.medium.com/episode-129-vaccine-apartheid-us-medias-uncritical-adoption-of-racist-intellectual-property-b7fed9e288e6) for people who prefer to just read.

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I would love to use the vaccines to help other countries in the Americas. It has the added benefit of helping the immigration crisis in the US that we have almost 0 willpower to tackle in a comprehensive way, and is one of the few areas that needs drastic improvement that wouldn't be helped by the expected "infrastructure" package. I'm mainly focused on Central America and South America, not so much about Mexico (though they should be part of it too).

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That link to Bloomberg about waiving IP is the wrong link.

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The problem with India and Mexico first is that they're so big - by the time we get enough vaccines to them, I'm sure Canada and Japan will be well on their way.

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India can manufacture plenty, but they are starved for raw materials due to export controls. This should be simple to solve, but we are being as "America first" as Trump was in this case.

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We sometimes forget that the US also shares a "border" of sorts with the islands of the Caribbean. The US has significant security and economic interests in the region, which is also highly dependent on Tourism and has therefore taken a greater economic battering than most. It therefore surprises me that in addition to Canada and Mexico, the US authorities have not extended their vaccine largesse to this region.

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China doesn’t need to manufacture the vaccines as they solved the COVID problem with lockdowns. India has ordered 100 mill doses of Sputnik, it we can help them but probably not more than Russia.

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