While the ongoing Covid-19 crisis has brought together researchers from across the globe to face a common challenge, it has also exposed existing inequalities among nations in their abilities to face the crisis. Looking beyond this pandemic, how does humanity tackle the epidemics that continue to ravage much of the developing world? Will nations pool their resources to produce and distribute – at low or no cost – vaccines that will save millions who die from treatable conditions?
These matters will be under discussion next week as the United Nations Commission on Science and Technology for Development (CSTD) meets for its twenty-fourth session in Geneva and online. Dr Shamika Sirimanne, director of the UN Conference on Trade and Development’s (UNCTAD) technology and logistics division, spoke with Geneva Solutions to share her expectations of the upcoming session.
She hopes that science, technology and innovation (STI) ministries around the world will build upon the solidarity shown in the context of Covid-19 to come together for what she calls the diseases of the poor.
One of the priority themes for next week’s session of the commission is Sustainable Development Goal 3 of UN’s 2030 Agenda, namely good health and well-being. Why was this chosen for discussion?
The Commission on Science and Technology for Development is the UN focal point for science, technology and innovation (STI) policy dialogue. It is a ministerial meeting mostly from the STI ministries and the information and computing technologies (ICT) ministries of the member states. Since we are living through a pandemic, the member states proposed that one of the discussions at the twenty-fourth session be on health.
What do you expect the discussions to be centred around?
The first discussion is going to be on Covid-19 and the inequalities that this pandemic has shown, in terms of access to personal protective equipment, access to vaccines, access to life-saving, low-tech tools like ventilators. There’s a whole gamut of technologies we can see bypassing developing countries. We cannot leave people behind because Covid-19 has shown that no-one is safe until we are all safe. And questions are going to be raised as to how some countries have been stockpiling vaccines while others have not even seen the vaccines.
At the beginning people started looking inwards, to protect their own populations. This is the business of politicians, otherwise they will not be able to run for office again. But I think all these countries who have been stockpiling these vaccines are in a place to lift the export bans, produce the vaccines en masse and start distributing them to developing countries at low or subsidised costs, subsidised by various parties such as international foundations, the G20 or big pharma itself. I can understand that pharmaceutical giants don’t want to make vaccines because there’s not much money in it: most vaccines are for very poor people out there.
A related issue has been around intellectual property (IP) of the vaccines. Will this be on the agenda for the session?
The issue of IP is something that I think the STI ministers of a lot of developing countries are going to raise. But I also think that we should not get stuck in IP. On its own it is not the solution, because it just gives you a recipe. You still need to know how to produce the vaccine. You don’t have the tacit knowledge, you don’t have the capacity, especially for the mRNA vaccines because it’s a new technology. Some vaccine manufacturers have said that anyone can read their patent and if someone wants to produce it they are not going to sue. But who is going to produce them? Is anybody in Sri Lanka, where I grew up, able to produce the vaccines without the help of the pharmaceutical industries? I doubt it. So I think the discussion around the Covid-19 pandemic has to be on what we call “IP++”. I know big pharma wants to recover their investments but I am sure that they’ve already done so.
Maybe these discussions need to take place now and there should be international systems built now for future pandemics, because I don’t think this is the end given the way the world is interconnected with us constantly moving from place to place.
What about healthcare policies within nations?
One of the important things that was unveiled during the pandemic was the inability of many national healthcare systems to cope. At the beginning of the pandemic, countries couldn’t upscale the production of personal protective equipment, simple things like masks. So at our session next week, there will be a whole discussion on government spending on public health systems.
But we will also discuss how the health policy and the economic policy need to come together in making decisions. Usually ministries work in silos: health does its own thing, economics does its own thing. When the two parties came together, the lockdowns were a lot more effective, the stimulus packages were effective. Because science and economics both weighed in. When they were not talking to each other, either the lockdown was extremely strict or there was no lockdown because they were concentrating on the economic situation. We need to reiterate that public policy needs to be made not just by economy or by health, but by a combination.
Looking beyond Covid-19, Sustainable Development Goal 3 concerns the eradication of epidemics such as malaria and HIV by the year 2030. How do you expect the session to address this specifically?
We saw researchers across the scientific world come together against Covid-19. There has been a solidarity among the scientific community and we need to credit them. But we want to see whether they can also come together for the diseases of the poor. We want to take the opportunity to shine the light on some of the things that aren’t being discussed. Can we keep this solidarity among the scientific community to address tuberculosis, malaria, HIV, yellow fever, river blindness, dengue?
There’s an attitude that, well, malaria is killing a vast number of people in developing countries, but there’s no malaria here in Europe, so why do we worry about it. But the repercussions of health issues are not just local and that’s what we are seeing. It becomes economic distress and then it warps into civil unrest and war, resulting in refugees. There’s always a link to people here. Every year five million children die before the age of five, mostly from preventable or treatable diseases. We want to make an appeal to the global scientific community by bringing to light how these diseases of the poor are not being taken into account in a more serious manner. The UN Secretary-General’s report to this commission notes that only 10 per cent of research and development (R&D) in medical sciences was devoted to 90 per cent of the world’s disease burden. To me this is mind-boggling.
I don’t know if big pharma is going to be interested in river blindness, but I think we can also call to their conscience, because I think the moment is right. Can we use this opportunity, when there is understanding and international solidarity to advance research on these issues, develop a malaria vaccine, pay attention to dengue fever? That’s one of the things we’re hoping to do at this session of the commission.
The second theme of the session is a bit different: namely, blockchain. It has sometimes been described as a solution looking for a problem. What is the importance to the commission of discussing blockchain?
Lots of developing countries hear about blockchain and they know that there are going to be implications of this new technology. But they have never been involved in the creation of these technologies and they are basically at the receiving end of technologies like blockchain, artificial intelligence, internet of things and so forth. Because of the noise around cryptocurrencies, I think the developing countries, especially the STI ministries, want to have a handle on it. What are the implications and what are the dangers? Can they afford to miss out on the technological revolutions? It’s that uncertainty about what this technology is about, and the ministers want to know what’s the hype and what’s the hope.
There’s the fear that cryptocurrencies are another Ponzi scheme. And in a situation of a collapse of some financial bubble, the impacts won’t be just on the people playing the game. It is going to be for everyone, just like a pandemic. The players do something in one locale and the reverberations if something goes wrong are going to be felt globally. So I think people want to know what it means that a bunch of rich people are playing with cryptocurrencies and doing crazy things like selling memes. What does this mean for emerging economies? Would they be affected? Are they going to be the ones who are on the receiving end? It’s just like the subprime mortgage crisis in the US where the impact was worldwide.
Finally, what are your hopes for the outcomes of this session?
We hope that the session is a place where you can talk to the consciousness of people and create international collaborations. This is something we hope, especially when it comes to health issues: helping each other develop innovations around health systems. This commission has been successful in building bridges, to get countries with technologies to build capacities in those countries that do not. We want to put forth big ideas and hopefully down the road things will happen.