Editorial 1: The trouble with a Nobel for mRNA COVID vaccines
Context
- The 2023 Nobel Prize for Physiology or Medicine has been awarded to Katalin Karikó and Drew Weissman for developing the mRNA vaccine technology that became the foundation for history’s fastest vaccine development programme during the COVID19 pandemic.
mRNA vaccine
- An mRNA vaccine is a type of vaccine that uses a copy of a molecule called messenger RNA (mRNA) to produce an immune response. The vaccine delivers molecules of antigen-encoding mRNA into immune cells, which use the designed mRNA as a blueprint to build foreign protein that would normally be produced by a pathogen (such as a virus) or by a cancer cell. These protein molecules stimulate an adaptive immune response that teaches the body to identify and destroy the corresponding pathogen or cancer cells.
- The mRNA is delivered by a co-formulation of the RNA encapsulated in lipid nanoparticles that protect the RNA strands and help their absorption into the cells.
The Nobel prize in Medicine, 2023
- It acknowledges the work that has created benefits “for all mankind”, but if we had to be stricter about holding scientific accomplishments up to this standard, the subset of mRNA vaccines used during the COVID19 pandemic may not meet it. Yet, Dr. Karikó and Dr. Weissman, and others, deserved to win the prize for their scientific accomplishments. Instead, their triumph tells us something important about the world in which science happens and what “for all mankind” should really mean.
At the expense of public funds
- Much of the knowledge that underpins most new drugs and vaccines is unearthed at the expense of governments and public funds. The cost and time estimates of this phase are $1 billion and $2.5 billion and several decades, respectively. Companies subsequently commoditise and commercialise these entities, raking in millions in profits, typically at the expense of the same people whose taxes funded the fundamental research.
- There is something to be said for this model of drug and vaccine development, particularly for the innovation it fosters and the eventual competition that lowers prices, but we cannot deny the ‘double-spend’ it imposes on consumers — including governments — and the profit seeking attitude it engenders among the companies developing and manufacturing the product.
- Once Moderna and Pfizer began producing their mRNA COVID19 vaccines, they were also mired in North American and European countries’ zeal to make sure they had more than enough for themselves before allowing manufacturers to export them to the rest of the world; their use in other countries (including India) was also complicated by protracted negotiations over pricing and liability.
On COVAX
- COVAX is the vaccines pillar of the Access to Covid-19 Tools (ACT) Accelerator. The ACT Accelerator is a global collaboration to accelerate the development, production, and equitable access to Covid-19 tests, treatments, and vaccines.
- It is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), the Global Alliance for Vaccines and Immunisation (GAVI) and the World Health Organisation (WHO).
- COVAX, the programme to ensure poorer countries did not become the victims of their subpar purchasing power and had sufficient stocks of mRNA vaccines, fell far short of its targets. India, Russia, and China exported billions of doses of their vaccines, but their efforts were also beset by concerns that manufacturing capacity had been overestimated — in India’s case —and over quality in Russia’s and China’s.
Corbevax
- A counterexample to the path that Dr. Karikó followed is Corbevax: Baylor College of Medicine, Houston, and the Texas Children’s Hospital Centre for Vaccine Development developed this protein subunit vaccine and licensed it to India’s Biological E for manufacturing. They did not patent it. It helped in the development and access of a low cost COVID19 vaccine to people of the world without patent limitation.
Conclusion:
- We cannot blame our scientists for trying to profit from their work; the mRNA vaccine could have benefited everyone during the pandemic, but it did not. So, history should remember what actually happened during the pandemic and what the 2023 Medicine Nobel claims happened differently.
Editorial 2: Circular migration: looking at both sides of the debate
Introduction:
- Circular migration is a repetitive form of migration wherein people move to another place (the destination country) and back (country of origin) according to the availability of employment.
The definition
- This effectively means that instead of migrating permanently or temporarily (moving for a period of time to complete any contract based labour) to another location, people move to different locations for a brief period of time when work is available. It is a phenomenon mostly among low income groups who migrate to avail of seasonally available jobs in another country, city, place etc.
- Circular migration became quite popular in the 60s and 70s with the advent of globalisation and development. Increased access to modern forms of transport and communication, social networks and the growth of multinational corporations have aided the advent of circular migration.
Migration can defined as circular if it meets the following criteria —
- a temporary residence in the destination location
- possibility of multiple entries into the destination country
- freedom of movement between the country of origin and the country of destination during the period of residence
- a legal right to stay in the destination country
- protection of migrants’ rights
- a healthy demand for temporary labour in the destination country.
- One is called a circular migrant if you have completed at least ‘two loops’ between two countries.
As public policy
- With the increasing fluid movement of people, policy around migration is one of the biggest debates in the world. The movement of citizens from the Global South to the West in search of more employment opportunities or a better standard of living creates brain drain for their origin countries and competition for the citizens of the destination countries.
- Similarly, the flow of people moving from rural areas to more urban areas of the same country, results in the breakdown of infrastructure and agrarian stagnation. Therefore, migration of any kind has become a policy hazard.
- However, circular migration is now seen as the best way forward, as needs of development and individual economic advancement can be balanced out. It is seen as a balanced migration method which looks at migration not only from the point of view of the receiving country but also of the sending nation.
- For the country of origin, migration, especially international migration, is beneficial due to the flow of remittances which will boost and aid the domestic economy. The flow of foreign capital (eg, FDI) will enhance the economy, ensuring more infrastructure, more jobs and by association, a better standard of living.
- However, large scale transnational migration will also lead to brain drain, wherein the most talented people of your country will use their intellect and innovation for the advancement of another country.
- From the perspective of the host countries, especially those of the West, a lesser population and a higher access to education has resulted in a large dearth of low income low skill jobs which migrants have been able to fill.
- However, the influx of migrants have caused a wide range of anxieties and cultural conflicts in the host populations with most of them now calling for restrictions and outright ban on migration. Circular migration aims to quell all these fears.
- The negative effects of brain drain will reduce and a sort of brain circulation will be encouraged, wherein the individual can use his talents in both countries and still contribute to remittances.
Circular migration within India
- In India, internal migration, which is migration within a particular country or State, has almost always been circular. With the advent of jobs in the manufacturing, construction and services sector, there has been a huge flow of migrants from rural areas to urban cities.
- Between 2004–2005 and 2011–2012, the construction sector witnessed one of the largest net increases in employment for all workers, specifically for rural males. This has led to rural populations and their economy dwindling and urban spaces, while booming, witnessing infrastructural collapse as they are unable to properly house incoming populations.
- In India, the uneven development post liberalisation, has led to a lot of inter- State migration, with States like West Bengal, Odisha and Bihar having some of the highest rates of outmigration. Initially, while most of the migration was to Delhi, nowadays it has increased to southern States as well.
- Some reports have even stated how women get more autonomy and decision making power in the family due to the absence of men who migrate.
Issues with circular migration within India:
- However, in such migration, especially to southern States where the language barrier is a big obstacle, rural circular migrants are often at the mercy of middlemen or brokers. They are made to work in unhygienic and unsafe conditions with little to no protective equipment.
- Additionally, indigenous wage groups and unions resent these migrants as they are seen as taking away their jobs by agreeing to work for lower wages.
- The study also says that this kind of migration is merely subsistence migration — it’s the bare minimum. The migrants are able to barely provide for themselves and their families, with no scope for further asset creation or savings.
| COVID-19 Pandemic:There is also a certain precarity associated with these jobs as they are seasonal and often irregular. A lack of jobs in the host States means that they will either have to go back home or look for work in other urban cities.This precarity was on clear display during the pandemic in 2020 when migrants en masse started walking back to their hometowns when a lockdown was announced. |
Conclusion:
- It is high time that States start actively formulating policy to understand the extent of circular migration. While some States like Kerala have announced health insurance schemes for migrant workers (Awaz Health scheme), there needs to be more effort to ensure migrants rights. The precarity of workers needs to be addressed and there should be more efforts to integrate them in the destination States.
