The U.S. is returning to the fold of global health cooperation. President Joe Biden’s administration has reversed a decision to leave the World Health Organization and signed up to COVAX, a 92-nation vaccine collaboration snubbed by his predecessor. It’s a major boost for the global rollout of multiple safe and effective vaccines, seen as the best shot at an endgame to the COVID-19 pandemic.
Getting there will require altruism at a time of great pressure to act selfishly. Doses are a scarce, finite resource right now. Rich countries with deep pockets have the advantage in buying and deploying them, especially given the complexity of vaccine logistics. It wasn’t so long ago that countries were desperately outbidding their allies to secure masks and medical equipment. Programs like COVAX, which has secured almost 2 billion doses to vaccinate up to a fifth of countries’ populations by the end of 2021, are going to be vital.
Money for doses isn’t the only key, though. In the 21st-century vaccine economy, data is also power. Tiny Israel is set to immunize its population months before far bigger and richer countries, partly by ordering early — and reportedly at a higher price — but also by sharing patient information after vaccination. Deliveries of Pfizer Inc. and BioNTech SE’s COVID-19 vaccine were expedited earlier this month after a deal to share extensive data on the inoculation program, according to colleagues at Bloomberg News.
There are advantages for both sides. Israel gets the doses it needs to protect its people faster than anywhere else, while its tech-savvy healthcare system and incredibly efficient vaccine rollout make it a valuable proving ground for Pfizer’s vaccine, which was rolled out in record time.
The opportunity for the rest of the world is to learn from Israel’s experience. Data can be shared in ways doses can’t. Prime Minister Benjamin Netanyahu has said the trove of information will help other countries develop strategies to end the outbreak.
“There is nowhere else where you can see a whole society being vaccinated,” the former head of Israel’s national information directorate, Yarden Vatikay, said. “It’s a flagship to the world.”
The hitch is that while Israel’s vaccination program has already produced encouraging observations, we don’t really know the full terms and implications of this deal. The data shared with Pfizer is “aggregated” epidemiological data — no “identifiable” individual information is given — to monitor the effectiveness of the vaccine in real-time, the company says, and a redacted version of the Pfizer agreement has been released by the Israeli government. But Lawrence Gostin, a law professor at Georgetown University, says it looks “as clear as mud.” Privacy experts say there are unanswered questions over how much data is being shared and how well it’s safeguarded, which matters after a global step-up in tracking and hacking.
The lack of transparency could have troubling ripple effects as data-sharing deals spread. Pfizer says it’s evaluating similar “real-world effectiveness” proposals elsewhere. Who will decide how the data is used or accessed? And what kind of negotiating advantage does it confer? Is it the difference between waiting months for doses to be delivered or cutting to the front of the line? Could it prevent countries donating supplies to people abroad, as Norway is doing?
These may look like secondary questions in the heat of a global health crisis, when the priority is getting needles in arms. But if we’re trying to think globally about ways to level the vaccine playing field ethically, they matter. COVID-19 isn’t over until it’s over everywhere.
One solution might be to set up new organizations, similar to COVAX, to avoid giving too much power to the wrong kind of gatekeeper. Pursuing “data altruism” might mean setting up trusts that would safeguard information and decide who gets to access it, says Olivia Tambou, an associate professor of European law at Paris-Dauphine University. Hospitals collecting data could sign up to standards on governance and ethics, according to doctor and biostatistician Rodolphe Thiebaut.
Pushing for more transparent vaccine deals and fairer terms of access that include data protection shouldn’t be seen as putting up obstacles in a race, but leveling the playing field. It might also preserve public trust through what’s already shaping up to be a messy and trying year, with plenty of political in-fighting over vaccine supplies and the brewing debate over digital certificates. By the end of this year, with luck, our worst fears of vaccine inequality will prove unfounded. But better to act now rather than hope for the best.
Lionel Laurent is a Bloomberg Opinion columnist covering the European Union and France.
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