Abstract

The recent efforts to mount an R&D response to public health emergencies of international concern have led to the formation of what we term a biochemical infrastructure of vaccine development and production. In principle, this infrastructure is expected not only to curtail existing pandemics but also anticipate and contain yet-to-emerge future threats. Critically, by nature of its geographical distribution and technical modularity, that infrastructure promises both to accelerate and expand access to essential medical tools, and in so doing, redress global health inequities. In practice, however, the biochemical infrastructure of vaccines remains highly uneven, fragmented and unjust. Moving beyond calls for ‘global health solidarity’, this paper examines the key actors, normative techniques and socio-technical assemblages, from viral platform technologies to intellectual property waivers and from accelerated regulatory pathways to advance market commitments, that serve to link ‘just-in-case’ and ‘just-in-time’ modalities of global health R&D. We argue that the biomedical infrastructure of vaccine development and production emerging in the wake of the COVID-19 pandemic is unfolding across an innovation ecosystem that is more-than-national and yet less-than global: a reconfiguration that may offer possibilities for a new, radically-overhauled, model of vaccine equity.

摘要

最近针对国际关注的突发公共卫生事件发起研发响应的努力导致了我们称之为疫苗开发和生产的生化基础设施的形成。原则上，这种基础设施不仅可以遏制现有的流行病，还可以预测和遏制未来尚未出现的威胁。至关重要的是，由于其地理分布和技术模块化的性质，该基础设施有望加速和扩大基本医疗工具的获取，并在此过程中纠正全球卫生不平等现象。然而，在实践中，疫苗的生化基础设施仍然高度不均衡、分散且不公正。除了呼吁“全球卫生团结”之外，本文还考察了主要参与者、规范技术和社会技术组合，从病毒平台技术到知识产权豁免，从加速监管途径到推进市场承诺，这些都有助于将全球卫生研发的“以防万一”和“及时”模式联系起来。我们认为，在 COVID-19 大流行之后出现的疫苗开发和生产的生物医学基础设施正在整个创新生态系统中展开，这个生态系统不仅是全国性的，而且还不是全球性的：重新配置可能为新的，经过彻底改革的疫苗公平模型。