Europe and the politics of vaccination

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The EU joint vaccination acquisitions scheme has not prevented a scramble by individual member states to acquire their own separate stocks. Nor has it prevented politics from interfering with the supply of vaccines.

Jonathan EyalGlobal Affairs Correspondent

Europe and the politics of vaccination

A doctor inoculates 92-year-old Herri Rehfeld against Covid-19 in Berlin on Jan 18, 2021.

PublishedJan 19, 2021, 5:00 am SGT

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When the European Union agreed last June that it would purchase its stocks of Covid-19 vaccines on behalf of all its member states and distribute them proportionally to every nation, the move was hailed as a great example of ingenuity and European solidarity.

With around 450 million inhabitants, the EU’s purchasing power would be unbeatable. That would not only give the EU the necessary muscle to drive down vaccine prices, but it would also mean that the EU’s smallest and poorest nations would gain access to such vaccines at the same time as the mightiest European states.

Other countries may engage in ugly “vaccine wars” and scramble for advantages with pharmaceutical companies but not the EU, ran the official explanation.

Britain, which formally left the EU in January last year, was invited to join the scheme. And when the British rejected the idea, that was portrayed by many in Europe as yet another example of the irrationality of London’s politicians.

Today, however, matters look quite different. The EU joint vaccination acquisitions scheme has not prevented a scramble by individual EU states to acquire their own separate stocks. Nor has it prevented politics from interfering with the supply of vaccines.

And Britain – that country seized by an irrational hate for the EU – is now leading all Europe in vaccination rates. By the time you read these lines, up to 7 per cent of the British population would have had the first dose of a vaccine, five to six times more than the EU average. And at least for the moment, the gap between Britain and the rest of Europe is widening.

Health and politics

What accounts for this unexpected outcome? Wrong bureaucratic decisions, a lack of communication between the EU’s central organisation and its member states, and a fundamental error in assuming that politics can ever be kept out of the coronavirus pandemic.

Health decisions are now political decisions, and political choices invariably have health implications; the EU’s hope of disconnecting the two was simply wrong.

It is worth recalling that despite the growing integration between EU member states over the past few decades, health policies remain firmly in the hands of national governments.

Indeed, the EU treaties contain special provisions that allow member states to suspend even the most basic rules of the Union – such as open borders and the free movement of people and goods – in case of epidemics. And that is precisely what happened when the coronavirus struck early last year. For a while, it was Europe at its worst.

Seen from this perspective, the decision of member states to give the European Commission (EC), the EU’s executive body, powers to manage the acquisition of vaccines was, without doubt, a genuine effort to restore European solidarity. Countries consciously handed over their vaccine acquisition to the EC, for the good of the Union.

Whether they were shamed into doing so when their separate dealings with pharmaceutical companies were discovered is immaterial; the fact remains that the decision to join hands was a sacrifice for some, and particularly for Germany’s leaders who ultimately found themselves in the awkward position of telling their nation that they will have to wait their turn to be vaccinated, even though the first vaccine to be approved for general distribution was invented in Germany.

However, good intentions do not necessarily translate into excellent outcomes. It is still not clear whether the EC has a problem employing the experienced staff to conduct such a massive vaccine purchase programme. Yet it is evident that, while the British were undoubtedly at a disadvantage in negotiating fair prices, they had the nimbleness that the EU did not possess.

The particular team tasked with vaccine acquisition by the British government worked so tightly with the big pharmaceutical enterprises that it was often suspected of being too close for comfort. Meanwhile, the EC negotiators appeared to have been discomfortingly too distant from pharmaceutical suppliers.

The result is that, to date, the United Kingdom has grabbed what it could, and whenever it could: It has contracted total vaccine supplies that are three times the needs of its population. But although the EC made some tentative orders with Pfizer in August last year, it confirmed these only last November.

And the quantities were never sufficient. Pfizer initially offered the EC a total of 400 million doses of its vaccine. But the bloc’s executive chose to buy only 200 million, with an option for 100 million more.

Why? Perhaps it was lack of experience from EU officials.

Dr Ugur Sahin, who together with his wife Ozlem Tureci founded BioNTech, the German company that invented the vaccine manufactured by Pfizer, claimed to have been baffled by EC officials who were entirely uninterested in his offer of more doses, and told him that “they had the situation under control”.

But politics may be a more accurate explanation. An investigation by Der Spiegel news magazine, one of Germany’s most respected publications, claims that the real reason the EC declined to purchase the full quota of doses offered by Pfizer was that it came under pressure from France to reserve part of the total EU order for Sanofi, a French pharmaceutical manufacturer that once hoped to have its own vaccine. The French wanted to make sure that their leading pharma company would not lose out.

The snag is that Sanofi is unlikely to have a vaccine before the end of this year, EU supplies are inadequate and that the scramble everyone was hoping to avoid is now unfolding.

 

 

Side orders

After claiming that they would abide by the EU central purchasing agreement, the Germans subsequently revealed that they did place a separate – albeit smaller – order for their own vaccine supply stocks.

Always eager to humiliate the EC, Mr Viktor Orban, the Prime Minister of Hungary, has announced that he is now proposing to buy the vaccine produced by China’s Sinovac, which was not on the EU purchasing list. Meanwhile, the island state of Cyprus in the Mediterranean is appealing to Israel for extra supplies of vaccines.

It is possible that the EC will succeed in eliminating the current shortages. But nobody would be able to claim that this was a significant triumph of central EU action. And fewer still would be able to claim that Britain did badly by staying out of EU arrangements.

Yet all this pales into insignificance in comparison with the biggest current problem: the process of vaccinating Europe’s citizens. That was never the responsibility of the EC. However, it is possible that the EC’s involvement in procurement indirectly affected the vaccination plans of national governments.

Europe and the politics of vaccination

Vaccine approvals

When Britain became the first European country to authorise the Pfizer vaccine for general distribution, the EC was sniffy.

Although few EU officials said so publicly, in private many of them implied that Britain’s determination to be the first to introduce the vaccine was politically motivated by a desire to prove the alleged benefits of being outside the EU. The Europeans, the EC announced, would not be rushed into a decision to introduce vaccines until they were absolutely convinced that these were safe.

That European response was not only inappropriate but also dangerously so. For it ignored the real reason why the British were first in approving the vaccine. That was not because the British regulatory authority was cutting corners on safety or science but, instead, because the British government changed the legal regime: Instead of leaving it to the pharmaceutical companies to carry liability for any future mishaps of side effects with the vaccine, the British state took the liability on itself.

That meant not that safety provisions were ignored, but that some bureaucratic due-diligence procedures could be bypassed, and that gained precious time. The European Medicines Agency did nothing of the kind, and the result was a delay not on safety grounds, but on the theoretical problem of future liability.

Besides, having claimed that it would not be rushed into a decision, the agency ended up being bounced into granting approval to the vaccine earlier than anticipated, in response to pressure from individual EU governments that could no longer explain to their public why the British were vaccinating in droves, while the rest of the Europeans were not.

But what followed was largely a mess: With the notable exception of countries such as Denmark, most EU member states were unprepared for the vaccination campaign not only in logistical terms but also in terms of broad policy.

 

 

France’s decision to deliberately go slow on vaccinations – it administered only 500 jabs in the first two weeks, supposedly to persuade the public of the vaccines’ safety – was a disaster that was eminently predictable. So were the preparations of some EU member states that had not even decided on the priorities for vaccinating their people as the campaign began. Meanwhile, both Britain and the United States – the two nations that were usually dismissed as being awful at managing the pandemic – raced ahead in their vaccination campaigns.

What could be the explanation for this curious outcome?

Mr Bruno Macaes, a Portuguese former Cabinet minister and now a noted European commentator, claims that precisely because the American and British governments were so criticised for their handling of the health crisis, they did so well in rolling out their vaccine campaigns: They had an urgent need to redeem themselves.

Perhaps. But a much simpler explanation may be that the role which the EC had in purchasing vaccines meant that individual European governments were disconnected from planning the whole chain from procurement to vaccination and were therefore caught unprepared.

None of this should negate the hard and selfless work that thousands of EU officials have put into procuring vaccines. Nor should this episode suggest that, when the next health crisis comes, European nations may avoid cooperation.

Still, it is evident that the idea of taking politics or national considerations out of health decisions was always an illusion.

And regardless of how competent international institutions may be, there is no substitute for the good governance and logistical planning that each nation must safeguard for itself.

 

 

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