Diarmaid Ferriter: We are not remotely all in this together

The phrase “We’re all in this together” is well worn and well debunked at this stage of the pandemic. It was never going to be anything more than hollow rhetoric, nationally and internationally.

We have, according to the National Public Health Emergency Team's Philip Nolan, a “leaky” country, which means some have been having a very nice time on holidays or using Ireland as a back door to get to their desired spots, while others suck up the tight travel restrictions. The gaps in togetherness have a long, ignoble history; after all, Shakespeare in The Rape of Lucrece in 1594 penned the lines:

"Why should the private pleasure of some one
Become the public plague of many moe?"

The pandemic sees some businesses decimated while others adapt and thrive and, in relation to education and care-giving, some are left particularly vulnerable while others adapt with minor rather than major consequences.

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It also sees many frontline workers lauded but not paid enough, a reminder of the enduring relevance of a comment made about Irish nurses as far back as 1942 by then president of the Irish Medical Association, Dr John P Shanley, who maintained “nursing is essentially a work of self-sacrifice for which the reward cannot be here”.

A proposed salary of €290,000 for the next secretary-general of the Department of Health, however, is deemed by the Minister for Public Expenditure, Michael McGrath, to be necessary to attract “quality” candidates.

Existing fault lines and inequalities will be deepened on top of new challenges arising from the long-term impact of the pandemic

There is no shortage of weekly messaging about how long this pandemic journey is going to be (“indefinite” was the scary word emanating from political sources this week), as well as reminders that vaccines are not a panacea, and that it is important not to give false hope.

This week Tánaiste Leo Varadkar cited a potential pandemic bill of €50 billion and commented that the longer the crisis endured, the “closer we go to the point where fiscal constraints emerge again”. One thing we can be sure of, however, is that the process of paying that colossal debt will be no great leveller.

Existing fault lines and inequalities will be deepened on top of new challenges arising from the long-term impact of the pandemic, especially in relation to quality of life, social isolation, mental health and the trauma engendered by loss and ill-health.

Vaccine nationalism

In the midst of that, the wider international question of vaccine nationalism complicates and exacerbates the situation. Recently the director general of the World Health Organisation, Tedros Adhanom Ghebreyesus, warned of a “catastrophic moral failure” due to the consequences of this nationalism as the world’s richest countries snap up available vaccine supplies, which can only extend the “living with Covid-19” phase.

There is, he suggests, a “real danger that the very tools that could help to end the pandemic” – multiple vaccines – will actually deepen global inequality.

During the early stages of the pandemic last year public health experts and economists identified a three-way conflict between those demanding access to vaccines as a “global public good”, pharmaceutical companies defending patent-based exclusive rights, and the vaccine nationalism of individual countries and international unions.

If the EU's clarion call is for its member states to vaccinate 70 per cent of their adult populations, where does that leave those high-risk people in poorer countries?

Given the various mutations of Covid-19 currently circulating and the new ones inevitably coming down the line, that is remarkably self-defeating and militates against the possibility of a global herd immunity while also guaranteeing increases in international tensions.

During the summer, David Fidler of the Council on Foreign Relations in Washington summed up the problem succinctly: “Ineffective nationalistic policies appear to create a gap between science and politics that makes the pandemic worse and undermines what science and health diplomacy could achieve.

In fact, vaccine nationalism reflects ‘business as usual’ in global health”. That is also apparent from the robust resistance to the idea of suspending intellectual property rights relating to Covid-19 vaccines.

Vulnerable poor

EU Commission president Ursula von der Leyen this week defended the decision of the EU to procure vaccines as a bloc, sensibly maintaining that if each member state had negotiated independently with pharmaceutical companies it would have been “economic madness” that would have led to just a few large countries having guaranteed doses.

But there is another issue here concerning global distribution: if the EU’s clarion call is for its member states to vaccinate 70 per cent of their adult populations by the summer, where does that leave those high-risk people in poorer countries in need of the vaccine more urgently than less vulnerable adults in the EU?

It leaves them alone, because globally, given the vaccine access imbalances, we are not remotely all in this together, notwithstanding widespread manifestations of community volunteerism and the efforts of devoted healthcare workers.

The initial response to Aids as it emerged in the 1980s was later described by the United Nations as “a story of wasted time and opportunities, of failure of leadership, of denial and discrimination”. Will the same conclusion be reached about the response to Covid-19?