Why are we not building vaccine production capacity all over the world, coupled with fully open sharing of the necessary tech? For those who count in QALYs, it would surely be the single most powerful + efficient intervention ever, and highly progressive at the same time.

One possible reason we're not making the stone-cold obvious, life-saving intervention, is one that @simonallison has explored: it doesn't fit existing interests. That simple? https://twitter.com/gchelwa/status/1355847415044202497?s=20

The counter from @BillGates:
"'At this point, changing the rules wouldn’t make any additional vaccines available' because, he claims, there are only a handful of manufacturers in the world with the necessary capacity to make the vaccines, and these are all at capacity already."

Per @business, Gates used his donor influence to push Oxford to team up with a pharma company. Maybe for the good of distribution, but it doesn't seem to have felt like that for the scientists... https://www.bloomberg.com/news/features/2020-07-15/oxford-s-covid-19-vaccine-is-the-coronavirus-front-runner

AstraZeneca seems to have been better than others - but the question remains whether accessing existing distribution capacity (which clearly wasn't enough, see EU issues ongoing) was worth giving up patents for.

Meanwhile, @thenation reports on growing criticism of Gates' from across the health and development sectors https://www.thenation.com/article/economy/bill-gates-investments-covid/tnamp/?__twitter_impression=true

The lack of financial transparency and apparent accountability of @gatesfoundation is a particular concern:

From a tax justice perspective, the idea that the Gates family gave up any meaningful control of their money - the traditional justification for giving foundations a tax advantage, ie subsidising with public funds - seems increasingly laughable.

Side note: the Gates Foundation does take some interest in tax issues, and has funded some organisations in the movement on eg tobacco tax and property tax.

But the Gates Foundation's lack of transparency, and refusal to respond to media inquiry on the subject of its own finances, seems particularly problematic when it exerts such influence over the global response to the pandemic https://www.thenation.com/article/economy/bill-gates-investments-covid/

Has Gates influenced in a way that reduces global access to COVID vaccination? Or that increases the family's or the foundation's returns? The first, hard to tell; but public statements seem to support the possibility at least? The second, impossible to say because opacity.

Given the degree of global influence, and not only in relation to the pandemic, there's very clearly an issue of accountability at Gates.

But that probably shouldn't distract from the immediate issue: why is the world not ensuring comprehensive access to vaccination for all?