Playing politics with the vaccine, risks at home and abroad

From the viewpoint of Frédéric Bizard, an economist specializing in social protection issues, France’s move toward vaccination mandates comes with major risks. In Paris-based daily Les Echos, he writes:

 
Can its vaccination policy tell you a country’s political regime? Amid the pandemic, vaccines have become a political tool, and the way a country chooses to wield it can make a major difference on multiple fronts.

Take for example the authoritarian regimes of China and Russia. Both countries quickly turned the vaccine into a tool of political propaganda on the international scene, hoping it would demonstrate the effectiveness of their regimes and paint them in a benevolent light. For them, the vaccine is decidedly political.

In contrast, some democracies are neutral; others have also used vaccines politically, though typically more for domestic purposes. Former U.S. President Donald Trump was focused on his impending November 2020 election. He applied a «whatever it takes” mantra toward getting the U.S. vaccine campaign off the ground.

Meanwhile, in France, President Emmanuel Macron announced on July 12 that the country’s vaccination policy would become much stricter. Most French people appreciated the move, their highly centralized state reaffirming its sovereignty, solidifying chances that the Machiavelli-inspired presidential initiative would find success months before the reelection campaign kicks off.

Yet, even while using vaccines as a political tool may be politically advantageous and benefit public health in the short term, it may be detrimental in the long term.

First, this approach is not generally applicable to all democracies. Germany, the Scandinavian countries and New Zealand have taken a decidedly apolitical approach to the crisis and their vaccination campaigns.

Using only scientific data and expert recommendations, these countries have made decisions in a rather consensual way, avoiding campaigns intended to target or exploit rival parties. And so far, analysis shows that, at this stage, this approach yields better results.

President Macron’s act of authority — the creation of the «health pass» system where the French populace will need to show either a negative COVID-19 test or proof of vaccination to participate in various public activities — took the French political class and the general public by surprise. It was clear that the move had not involved widespread consultation but was Macron’s initiative.

The move seems to have had the desired effect: it worked both in politics and in terms of accelerating appointments for vaccination, as thousands rushed to sign up for their first doses. However, we will have to wait to verify if it is effective in the long term. Nonetheless, this episode speaks volumes about the state of French public health and the functioning of our democracy.

Public health is based on both the individual and collective commitment to protecting and improving one’s personal health and that of the wider population. The French healthcare system is still focused on simply managing and responding to diseases, with only marginal interventions toward expanding healthy practices. Neither the collective nor the preventive approach has been integrated into the current model. We operate in a public health system that is 90% punishment and 10% incentive, which is guaranteed to fail at changing individual behavior.

Macron’s unilateral move undermines any attempt to develop a sense of individual responsibility in regards to health, which is a foundational part of creating health policy in a democracy and is almost non-existent in our current health system and management of the crisis. After 20 years of state control of the healthcare system, we are witnessing, with a certain consistency and yet the same inefficiency, state control of the management of the health crisis. It is the central state that decides everything, with the most rigid, inflexible attitude.

The British rely heavily on individual responsibility. It is embedded in their culture. In the UK, the number of daily cases is over 35,000, but the daily deaths remain under 50. At the peak of the pandemic, the number of cases was twice as high, while the death toll was 30 times higher.

This proves that at this stage the vaccine is effective in protecting us from a spike in deaths. Fragile people have had time to be vaccinated, the vaccines are available and it is up to everyone to make it their responsibility now. The British state liberates society whereas the French state constrains it even more, all the while our situation is still less precarious than theirs.

France is in a vicious circle where the sovereign relishes exercising his power, but the people still expect too much from him. This situation is the source of many of our society’s ills: the generalized mistrust in the powers-that-be, lack of social cohesion and French society’s low confidence regarding the country’s future.

Measures such as compulsory vaccination or the abrupt application of the «health pass» are likely to exacerbate pre-existing distrust and societal fractures in the long term. Yes: These two instruments are essential to putting an end to the pandemic. The answer is to make them as popular as possible.

Another pitfall of the politicization of vaccines is the tendency to see it through a national lens, rather than an international one, when developing their vaccine strategy. The same selfishness we would denounce at the individual level is multiplied by 10 at the national level. While more than 50% of the population of European countries and the United States are vaccinated, less than 1% of the population of poor countries have gotten the jab. Rich countries’ obsession with vaccinating those under 18 years of age and preparing stocks for a third booster dose completely ignores the reality of the unvaccinated global south.

But can we blame the leaders of these democratic countries for doing everything in their power to protect their populations and win votes for upcoming elections? This is where the limits of democracies, as identified by Alexis de Tocqueville, come into play — and they are hardly compatible with the global fight against a pandemic.

Whether it is for the fight against the pandemic or climate change, the solution to this flaw in democracy is the universalization of crisis management. The spirit of the Enlightenment must be kept alive, and France, its homeland, has been silent. Without a vaccine of our own, we have no weight in the international debate. The idea that all people are equal, regardless of borders and cultures, is far from a rhetorical abstraction. According to our French culture, the world is a civitax maxima, a universal community, the Kantian ideal shared by Montesquieu, Voltaire and Condorcet who boasted they were first and foremost citizens of the world.

The goal should be for an international policy, with a collective mandate under the impetus of France and Europe, to establish global governance of vaccine management that would lead to a better distribution of raw materials, production capacities and access to vaccines across the world. In failing to do so, the West exposes itself to the revolt of those left behind in the pandemic — not to mention the spread of new variants that may escape vaccine protection.

— Frédéric Bizard / Les Echos

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