04 Scarcity and abundance in a pandemic

The coronavirus pandemic confronted us with life-threatening scarcity of equipment and vaccines. It brought out the best - our science - and the worst - our lack of solidarity - in us. How can we shift to an abundance mindset to provide the best vaccines for all of humanity?

Transcript

Welcome to Cornucopia, the podcast in which we examine the shift to abundance. My name is Karim Benammar. Let's look at scarcity and abundance during a pandemic, and focus on the example of vaccines. So far, we've looked at the shift to abundance in fairly abstract terms, by examining the idea of the surplus, and by analysing what leads to scarcity. Now my claim is that the shift to abundance is something that is happening at this moment in human history, and so we should be seeing this shift in all aspects of our lives: in global terms, on the level of organisations and companies, and also in our own individual lives.

So, let's focus on a really global issue: the current coronavirus pandemic, and more specifically on how we are dealing with vaccines. Today's December 10, 2021 - I'm saying this so that we can place what I'm saying about vaccines in the current situation in the pandemic. I'm walking in a nature reserve here in the Netherlands, not far from where my mother grew up. It’s beautiful, a winter wonderland, like walking through thousands of Christmas trees. Sometimes you can spot a wild boar - I saw some yesterday. And apparently there are some wolves on the loose, although you'd be lucky - or unlucky - to see them. It's cold, just above freezing, and so it has that nice crispness in the air.

So at first sight, it would seem that a pandemic presents us with lots of examples of scarcity. Of course there was a scarcity of vaccines at the beginning because, we didn't have any, but there was also a scarcity of lots of things. A scarcity of personal protection equipment, a scarcity of tests, a scarcity of trained professionals, a scarcity of breathing machines in hospital, a scarcity of intensive care units. This new virus which grew into a pandemic overwhelmed our capacity to deal with it.

And that's not so surprising, because scarcity in a technical sense is just our needs being so much higher than our resources. And we didn’t have many resources because we weren’t planning for this virus, we didn't know what it was and what it was going to do, and so our needs rapidly grew above our available resources. Especially in the case of a virus that spreads exponentially, where the number of infected people grows very rapidly, we can't build up our resources at the same speed as our needs are growing. I suppose we could even think of it as a rule of thumb: when we are confronted with completely new needs, our resources won’t be a match for them, and we will have a situation of scarcity, even though it will be temporary.

Scarcity at this point can be terrifying, because we were running short of everything that we needed to give proper care, and we lost a lot of people because we couldn’t give them the care that they needed. So, of course, we rapidly built up our resources, we made more protective equipment, we sped up the manufacture of oxygen machines, we reassessed intensive care units, and we started developing vaccines. And soon we went from an absolute scarcity to a relative scarcity: we had some equipment, but still not enough for everyone. 

Then it becomes a question of distribution. When there is not enough to go around, who will get priority access? On what criteria should we base the allocation of scarce goods? Now there are many criteria we could consider: the highest need, the highest priority in medical terms, or those with the best chance of recovery. In reality, of course, it is often the richest buying up all the equipment, or the strongest or the smartest grabbing most of the resources for themselves. At the beginning of the pandemic, we saw some shameful scenes of countries outbidding each other to get protective equipment, even hijacking cargo from planes. 

In a situation of scarcity, we see that it is everyone for themselves: my needs and the needs of my community come first. It’s a good illustration of what scarcity does to us. Scarcity leads to fear, to a deep-seated fear, and this leads to this grabbing, sometimes violent behaviour. When our survival is at stake, our needs come before everyone else's. 

Now you might think this is a great example of why scarcity exists, why scarcely will keep existing and why scarcity brings out the worst in us. Where is the shift to abundance? If you don't have the things you need in abundance, then what good is an abundance mindset?

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Let’s continue with the story. It became clear very quickly that the way out of the pandemic was through the development of vaccines. We started developing vaccines all over the world, from the Chinese and Russians efforts in national laboratories to private companies in the West who pivoted from their current work on vaccines to deal with this new virus. Within a year we had several candidates, the Chinese and Russian vaccines and at least two different kinds of vaccines in Europe and America, one based on a more traditional vector technology, and some based on a new technology called mRNA. 

mRNA technology is a fascinating approach: we use code to program the shape of the virus without having to use any de-activated parts of the virus itself, and we immunise the body because it recognises the shape of the virus. In time, we found out that different scientific approaches yielded different results, different levels of efficacy. And we also found out that making vaccines at such a massive scale also turned out to be a challenging logistical undertaking.

So again, we were faced with scarcity, this time of vaccines, and had to come up with rules for allocating them and for priority criteria in administering them. And again, there were scenes of hoarding and putting one’s own needs first. The pandemic is a global challenge, yet there wasn't much of a global response. The World Health Organisation WHO tried to set standards of fairness and organise alliances to provide vaccines to countries that couldn't afford them, but overall, it was still a question of might makes right, and of everyone out for themselves. 

At this point you could be forgiven for thinking that I'm digging myself ever deeper into my scarcity hole here. I'm trying to convince you that there's a shift to abundance, and instead, I'm giving you an abundance of arguments for why scarcity exists. Please bear with me just for a little while longer. We’ll get to abundance eventually. 

The feelings I have looking back at the story so far as a global citizen is first, an amazing sense of pride in the scientists and the technology that delivered us these vaccines and in the tireless work of researchers. It’s really their finest hour. I also feel somewhat grateful to the pharmaceutical companies who managed to produce billions of vaccines, who managed to ramp up their production lines to provide vaccines at scale, and to the governments for organising vaccination programmes. 

Having said that, I feel a lot less happy about our global response to the pandemic. I think we should have made much more of an effort to send vaccines to countries worldwide. This pandemic has shown us that are not ready to tackle global problems at a global level. Our global organisations simply don’t have the budget or the power to make and enforce global decisions. I think it’s fair to say that scientifically and technologically, we have had fantastic results; in terms of production and economics we have had impressive results; but in terms of global cooperation, we have had disastrous results. 

This is definitely an important challenge for us, because all the great crises facing us - the climate crisis, the poverty crisis, the ecological crisis, possible future pandemics and other systemic threats to humanity - all of these are global crises. They all require a global approach. One of the things the pandemic has made abundantly clear is that we are not yet organised on a global level.

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Let's return to our story. We now have different vaccines developed by different consortia, and we have one type that is much more efficient than the others, for the moment at least. Now at this point, an obvious if perhaps naive question is: why not share the best technology that we have in order to deal with this global pandemic? Why don't we take the most effective vaccine - the mRNA type - and make sure that everybody has access to it?

In practice, it would mean sharing all the knowledge required to make that vaccine: the patents, the formula, the recipe, but also the equipment and production facilities needed. It would probably also involve enough money to help countries who can't afford to vaccinate their own populations. This sounds like a lot, but I believe we could do this - if we set our minds to it, literally. 

We need to approach this global challenge with an abundance mindset. Let’s share our human creativity - the creativity that brought us this new technology and the capacity to produce it at scale - instead of jealously guarding it, instead of hoarding it. We must let go of the idea that we can only help our own populations by denying others access to what they need. It’s as much a mental shift as anything else. 

It is really frustrating that we can create enough vaccines, yet we are refusing to do so because we are still applying scarcity strategies. It's not just an academic point here. Using scarcity strategies in an age of abundance, when applied to vaccines during a pandemic, costs lives, a lot of lives. It's an incredibly damaging thing to do, and it's also frankly a stupid approach to take. We don't have to do it like this - and yet out of fear, out of habit, on the strength of old convictions, we continue to do it in this way. So here you have my point about the shift to abundance.

How would we go about doing this? Let’s unpack the ways. First, the technology: the formula, the recipes, and the know-how needed in order to make the vaccine. There are two elements to this: a legal element - intellectual property - and a trade secret element particular to private companies. Both are fascinating. 

Let's start with the intellectual property: the mRNA vaccine was developed by two private companies, Moderna and BioNTech, but they made use of knowledge that had been developed before. The Moderna vaccine is based on a patent that was developed jointly with government scientists, and which the American government gave to Moderna. If this was developed with taxpayers’ money, this is in effect public knowledge. Why should we not use it to serve all of humanity? I'm pretty sure that the scientists involved would love nothing more than their research being used to solve a global crisis. 

There are several options to deal with intellectual property. You could open the patent completely, as was done with the polio vaccine. You could make a so-called patent pool, which allows other companies to use patents under certain conditions, and for a certain amount of time. And governments are legally allowed to requisition patents and manufacturing capacity during a health crisis. They only need to pay what they consider a fair price. Any of these three of these options would solve our problem.

Why is this not happening? Perhaps we shouldn’t be naïve. The great promise of mRNA technology is that it will lead to a whole new family of vaccines, capable of treating all kinds of diseases, including cancer. Giving away that technology is giving away a huge amount of potential future profits. The Russians and the Chinese don't have this technology now, so they would be competitors in the future. 

Again, this is very much a scarcity way of thinking. Why not share the fruits of human ingenuity? If other countries have access to this technology, they in turn may develop vaccines which will save us in the future. It seems massively short-sighted to me that you would stop countries from having access to technology which can help us all. Imagine if we developed a cheap and efficient technology to take carbon out of the atmosphere, which would be of great help with climate change, but we would then refuse to make it available. It would make no sense. When dealing with global problems, the only adequate response is a global response. This would allow us to use the best ideas, the best production at scale, and the best distribution systems that we've come up with globally. 

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So scientifically, technologically, and legally, there is no impediment to using mRNA vaccines all over the world. Now what about the commercial issues at stake? Here we have also seen different approaches: some companies decided to sell the vaccine at cost during the pandemic; others negotiated different prices for different countries. We could argue how much pandemic profit companies should be allowed to make, but from an economic point of view, the price of the vaccines is not really a major issue for wealthy countries. 

Price is an issue for middle and low-income countries. But here again, if we could take a global economic perspective, this would be surprisingly clear and simple. We can easily afford to buy vaccines for the whole human population. Recent estimates are that it would cost $50 billion to provide vaccines for those who can’t afford them, but it would save us $1 trillion - 1000 billion dollars - in economic revenue. A down payment of 50 to save 1000  seems like a pretty good investment. Financially, this should be a no-brainer. 

Again, we see the same pattern: a global problem requires a global approach, and yet we can't seem to get ourselves organised to raise $50 billion. It’s always the same issues: who will start, who will commit, is it real money or does it have all kinds of strings attached, how can it be spent effectively, quickly, and fairly? But the amount should not be the problem. 

Here are some ideas for how to raise $50 billion. We could tax the pandemic profits of companies that have done really well at a few percent. Since they’ve profited so much from this pandemic, perhaps they should also be first in line to help. But we don’t need to do this through taxation. Governments could just raise money, as they have done with far larger amounts to prop up their economies during the pandemic. Or perhaps we should look to ourselves, and be good global citizens and crowdfund $50 billion. It's not a small amount for a crowd-funding campaign, but with celebrities tweeting and companies matching donations, we should be able to turn it into a new ice bucket challenge. 

So, there are no practical restrictions to making the best vaccines available to everybody - no intellectual property restrictions, no legal restrictions, no commercial restrictions, and no financial restrictions. So what is holding us back? Why are we such terrible mess of this? Why are we squandering our amazing technological breakthroughs by refusing to share them? Our scarcity mindset is really sabotaging our creativity.   

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These are historical times. The current pandemic is the biggest story of my lifetime. It's the biggest and most pressing challenge that we are facing at the moment. Think of what this pandemic has cost us. Human lives, numbering in the tens of millions. An economic cost of thousands of billions of dollars, which has set back our fight against global poverty, which has decimated whole sectors, which has shattered entrepreneurial dreams. Think of what it has cost you - the loved ones you have lost or that you haven’t been able to see, the things you haven't been able to do, all those things that make life worthwhile that have been taken away from us.

Sometimes I think we are not aware of the historical situation that we are in, of the magnitude of the challenge that we are facing. This challenge requires a global response, it requires the best of what humans can bring, whether they are doctors, nurses, scientists, law enforcement, politicians, or financiers. As well as all the people who've been working throughout this pandemic to keep our food production and our logistics and our economy going. 

As you can tell, I'm passionate about this. I think that if we mobilise the best of what humanity has to offer, we can easily deal with a challenge of this magnitude - and with the coming challenges that humanity will face in the future. But it will mean letting go of some of our old habits. It will mean letting go of the fear that there is not enough. It will mean letting go always reacting from a mindset of scarcity, always believing that it's a competition between groups, between communities, between nations, always believing that the only way we can save ourselves is by stopping others from getting what we have. We are living in an age of abundance: an abundance of scientists and professionals of all kinds, an abundance of productive capacity, an abundance of creativity and ingenuity, and hopefully, an abundance of generosity and good will. Let us put these to good use. 

I hope that this episode has shown you that the shift to abundance is not just an abstract concern, but that it lies at the heart of our current situation and of our most important global challenges. Perhaps it has made you more hopeful about what we could do together, or it has made you curious about some the claims that I've made. Thank you for listening, and hope to see you on the next episode of Cornucopia.