Bioethicist Peter Singer describes himself variously as a social entrepreneur, health researcher, international public servant and “very proud Canadian.” The son of Hungarian refugees, he attended Upper Canada College on a scholarship before earning degrees at a string of top universities. He cofounded U of T’s Joint Centre for Bioethics, and then, Grand Challenges Canada, a non-profit funding innovation to improve lives in low-income countries. The ideas it supports—which include solar powered oxygen stations and a low-cost mental health counselling program—are expected to save up to 1.8 million lives and improve 64 million by 2030. But as challenges go, Singer says his current role as Assistant Director General of the World Health Organization is the most complex.
He spoke to Naomi Powell from his home in Vancouver, BC.
What has the pandemic taught you about human nature?
The top three lessons of the pandemic are equity, equity and equity. I mean, it’s really laid bare the inequities in our societies. And to get to the human nature part, the real question is, do we care? Are we really our brother’s keeper?
What do you think?
Well, 70% of the population is vaccinated in Canada and in high-income countries, compared to less than 5% in low-income countries. That’s a matter of life and death. And unfortunately, that gap is still there. So what it’s taught me about human nature is that underlying equity is solidarity. Underlying solidarity is empathy. And this is a real test of empathy. On vaccines so far, we’ve passed the test of science with flying colors, but we’re failing the test of humanity.
This health crisis is happening in a time of mass communication. How has that affected things?
It certainly made things easier because communication is a core issue in public health. But underlying these questions of information are questions of trust. In some cases, people have reasons not to trust the people that might be coming at them with vaccines. If, for example, based on race, they’ve been exploited historically by those people. That’s why community leadership is so important, because trust begins and ends in communities, which is also by the way, where pandemics begin and end.
What’s the antidote to that mistrust? More information?
No, you need more than one pill. People have spoken of the COVID infodemic, but underlying that is a ‘trustodemic.’ Trust comes from community leaders who’ve incorporated the information, thought about it and are, for example, becoming vaccinated and encouraging others to do so. In the Indigenous communities and Black communities, the role of community leadership, barbershops and churches is incredibly important.
Beyond the ethics, why should Canadians care about the global vaccine gap?
It’s in the self-interest of Canadians to care because if the fire is raging anywhere, it’s raging everywhere. If there are high rates of transmission anywhere in the world, that’s the way you generate variants. And those variants have a finite, non-zero percentage chance—and this hasn’t happened yet—of evading the vaccine. If they evade the vaccine, then we’re all back to square one. There was a consciousness dawning in Canada before the Delta variant that this was kind of over. Well, it wasn’t over. That’s the epidemiological argument.
What are the other arguments?
Well, this is a multitrillion-dollar problem for the world economy and the economy is not going to recover until the world is vaccinated. The billions associated with doing that pale in comparison to the trillions in economic damage. And finally, this is an issue of national security. You see peace and stability being disrupted around the world. It’s usually initiated by other forms of civil conflict, but it’s compounded by the pandemic.
Some countries have launched booster campaigns. Should those be shelved?
Boosters are giving people a third life jacket to people who already have two. What is the human cost of this? There was an analysis published in The Economist that showed if the G20 countries reallocated the doses of their stockpile and orders to high-risk people in low-income countries, it could save a million lives. Just imagine that you could make a decision as a leader that would save a million lives. It’s understandable that people want an extra little bit of peace of mind. But should that be at the expense of a nurse in Uganda who is risking her life to take care of people who have COVID?
How do we make sure that there are enough life jackets for everyone?
The WHO has made three requests of the G20. One, that countries might swap their contracts with COVAX (the global vaccine-sharing alliance) to facilitate reallocation. The second is to fulfill the dose-sharing pledges. At the G7, almost a billion doses were pledged by high-income countries, and about 15% has been delivered. Charity is good but vaccine donation alone is not a sustainable solution. A sustainable solution is self-reliance.
How do we build that?
Having vaccine manufacturing capacity at the regional level is extremely important. So the third request was to support the intellectual property waiver proposal (on vaccines) from India and South Africa, and share technology and know-how. Now, the issue is, will the companies provide the recipe and chefs to that hub so domestic production capacity can be developed? I do think the board members of these companies should reflect on their ethical responsibilities.
What can we do at the country level?
Take as a concrete example the $2.2 billion for domestic vaccine manufacturing or bioscience in the last federal budget, or the recent arrangement with Moderna to do manufacturing in Canada. Each of these things could have a foreign policy plank: training scientists and innovators from low- and middle-income countries in a very humble way, either in Canada or by extension. That is a big idea.
What gives you hope?
The power of young people. In Canada, take the young people who joined for the Vaccine Hunters group. I’ve had some interaction with them to help them take their model global. There’s a great example of young people who followed what is actually my top advice to young people, which is “find a problem and solve it.” Beyond that, whether it’s Black communities or Indigenous communities, community leadership gives me hope. And then the third thing that gives me hope is the power of science.
So I do have hope. I’m an optimist by heart, by training and by disposition. I also feel chastened, though, by some of the issues we talked about.
This interview was edited and condensed for clarity.
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