Vaccines for votes

A week or so ago, the Bharatiya Janata Party in Bihar released its poll manifesto, the first point on which was that should the party win, it would make a COVID-19 vaccine cleared by the ICMR available for free to every resident of the state. It was an unethical move, and Siddharth Varadarajan and I explained why.

Soon after, trolls on Twitter pointed out that Joe Biden had made the same promise ahead of the US presidential elections. And this morning, Indian Express quoted the Election Commission saying the BJP’s promise didn’t violate the poll code; the report also included a curious paragraph: that “the EC had taken the same stand on a complaint received during the Lok Sabha elections last year against the Congress’s NYAY scheme that guaranteed a minimum income of Rs 6,000 per month, or Rs 72,000 a year, for 25 crore people.”

The BJP’s promise still feels unethical to me. This isn’t for reasons that have anything to do with the poll code if only because the poll code’s scope doesn’t extend beyond the election itself, to the bigger picture.

At the outset, I don’t think vaccines should feature at all in election rhetoric (even if this may be wishful thinking with a majoritarian-populist government). But here we are.

The BJP is in power at the Centre – it runs the national government – and is hoping to come to power in the state. It isn’t necessarily including Nitish Kumar, the state’s incumbent chief minister and whose party the BJP is allied with, because the vaccine promise appeared only in the BJP’s manifesto, not in the alliance’s, and was announced with much fanfare by the Union finance minister. So Kumar was nowhere in the picture but the Centre was. This is a slight but significant difference vis-à-vis Biden’s promise.

State is a health subject in India but a COVID-19 vaccine, should one become available, will have significant participation by the Centre, from purchasing to distribution. Note that India’s states didn’t fight polio – they simply couldn’t. The country has a whole did and today COVID-19 presents an even bigger challenge.

A new study, echoing some older ones, has found that antibodies to COVID-19 fade over a few months. Assuming for a moment that vaccine-induced antibodies work like natural antibodies, and setting aside the fact that the question of antibody persistence is yet to be settled, access to vaccines (including the question of affordability) matters as much as its uniformity. That is, the level of access should be uniform across the epidemic’s ‘jurisdiction’.

For example, if a state with poor pubic health care and infrastructure to begin with is forced to administer the vaccine by itself, failures on its part could allow the virus to become endemic to that region, and allow it spread once again through the rest of the population once their antibody responses have weakened. So an additional pitfall here is if the BJP fragments the responsibility of distributing and administering a COVID-19 vaccine to the states, in an effort to legitimise piecemeal agreements based on political expediency, the vaccination drive will fail, especially in states like Bihar.

So while state governments will be able to decide whether to sell the vaccines for free, the decision depends considerably on the Centre’s cooperation. In effect, the BJP at the Centre abdicates the option to ensure everyone gets the vaccine at no cost when it offers to do so only in a specific area, and in exchange for votes.

Biden is not entirely in the clear either: ‘vaccines for votes’ is a prompt for voters to think of their choice of president as a question of life or death, which is nothing but a dire threat. But neither his case nor that of the Congress’s NYAY scheme are ones of abdicated responsibilities. Neither is yet in power in their respective countries, so neither is pulling back on their existing responsibilities, making their exercise contingent on electoral outcomes or vouchsafing the rewards to – from the epidemic’s PoV – an arbitrary section of the population.

Would you take Epstein’s money to fund your research?

Note: Jeffrey Epstein was found dead in his cell on August 10, 2019. The following post was written before news of his death emerged.

In 2016, I attended a talk by a not-unknown environmental activist in Chennai (not Nityanand Jayaraman, before you ask) who had spent many years stitching together community efforts to restore water bodies around Tamil Nadu. His talk covered the various challenges of his work as well as the different ways in which he overcame them. The one that stood out was his being absolutely okay with receiving donations to support his work from any and all sources, irrespective of their rectitude. He encouraged others to not shirk from any opportunity to accrue wealth because, to rephrase him, you never know why you are going to need it or when it is going to dry up.

This particular activist was a man of simple means but one thing he did have, and arguably needed to have, was the conviction that his work was useful and necessary. Notwithstanding his personal character (only because I didn’t know him that way), most people in the audience that day judged his work — or what they had been told of it — to be important and, of course, good. Most of us are not so lucky. We often have to be very careful about the way we view our work — as a public good or, more precariously, the ‘greater good’, for example — and the things we are prepared to do to justify working on.

Recently, scientists have been in the news in connection to this question thanks to an unlikely cause: Jeffrey Epstein. On August 5, STAT News published an interview of George Church, the noted American geneticist, biologist and teacher, where he apologised for having “contacts” with Epstein “even after the financier pleaded guilty in 2008 to soliciting a minor for prostitution”. The interview has so many parts about the behaviour of scientists around billionaires worth chewing on; consider the following example:

Universities are supposed to vet potential donors who ask to meet with a faculty member, especially if they want to fund research. Epstein made a donation to Church’s lab for “cutting edge science and education” from 2005 to 2007. “My understanding is this [vetting] is the responsibility of the development office, which is yet another reason why scientists are a little bit more relaxed,” Church said. “They feel they have administrators, who in theory do the difficult job of figuring out who’s legit.” Epstein’s donation went into what Church called “a general account used to get new projects going before we have enough preliminary data to warrant a formal grant application.”

Later, the article continued:

As for whether Epstein’s 2008 conviction gave Church (a father and grandfather) pause, he said, “I did read a couple of news articles” a decade ago, he said, “but they weren’t clear enough for me to know there was a serious problem.” (The full extent of Epstein’s crimes came out in an investigation by the Miami Herald in 2018; in the New York Times, a 2006 story [described] Epstein’s not-guilty plea … and one in 2008 characterized the allegations as “involving massages with teenage girls”). “But that is still no excuse for me not being abreast of the news.”

How much can you blame scientists for receiving money from tainted sources? I am not sure of the answer. Receiving and using money from corrupt individuals, and certainly those as morally and ethically corrupt as Epstein, is a problem because doing so:

a) Allows the corrupted to claim a form of redemption, especially when they can exploit a shortage of funds required for risky projects

b) Encourages the scientist to harbour an exceptionalism: that she gets to define what ‘good’ is through her work, and

c) Creates the demand, so to speak, that sustains the problematic supply, but this is an admittedly weak contention in this particular case.

At the same time, funding for research has been hard to come by. How often would a scientist stop to check if money sourced through a different department in her university came from a convicted sex offender – money that would ensure she and her students would get paid for the next few months, and possibly provide a way for her to produce research to further ingratiate herself with the university? Not very, possibly because she hasn’t been habituated to check.

This said, the scientist doesn’t get off the hook because the larger argument to be made, or problem to be solved, here is that scientists shouldn’t assume their responsibilities are restricted to their labs. They ought to be as aware of whoever is funding them as, say, journalists are expected to be if only because the same standards should apply to everyone, or at least to every community that prizes independence and self-regulation. This is necessary beyond considerations of one’s relationship with the rest of society, and towards eliminating the imbalance of power that is sure to erupt between a donor who knows how consequential their wealth can be and the researcher who stands to be manipulated by it. For example, she could be tempted to design future projects in ways that are likelier to attract funding and, of course, ruffle fewer feathers.

(I am aware of the difficulties of working scientists, so I don’t say that the solution – such as it is – is to berate them until they make better choices as much as large-scale reform over many years.)

Notwithstanding (important) questions of financial independence, the use of tainted money for a self-proclaimed ‘good’ would at the least form a moral shield for the corrupt funder to hide behind. However, the extent to which this should concern the scientist is doubtful, especially if she is able to insulate herself and the products of her intellect from the influence a sizeable donation is likely to carry. Another argument could be that we should frame these narratives around those who do ‘good’ instead of obsessing over how they render those who do ‘bad’.

For a tangential example, India’s National Green Tribunal recently slapped Volkswagen with a hefty fine of Rs 500 crore ($71 million) for cheating on emission tests, up from the Rs 171 crore recommended by a special panel. This was because, to quote the tribunal’s principal bench:

… the measure of damages has to be fixed taking into account not only the actual damage but also the magnitude and the capacity of the enterprise so that compensation has deterrent effect. … [The] worth of the company is stated to be $75 billion. Thus, apart from actual damage by a conservative estimate, deterrent element has to be considered, specially in view of international unethical practice.

Let us ignore for a moment that the Supreme Court has stayed this order and assume that Volkswagen deposited Rs 500 crore with the Central Pollution Control Board. We would have considered this a great victory, since Rs 500 crore would have increased India’s environment budget for 2019 by 15%, and expected the board to put the money to good use. Similarly, if rich people commit crimes and are convicted, their punishment could carry a big fine in addition to a prison sentence and commensurate to their personal wealth, to be deposited with an independent body staffed by experts from different fields who decide how that money is spent.

This said, it might also be worth asking if the research project is so important or so urgent that its stewards can’t look beyond the first available source of funds, towards less controversial options. Think of it as a contest between the kind of example we want to set as a society about the foundations of our knowledge systems and if it matters that the funds are directed towards studies that are unlikely to be undertaken through other means. For example, on July 11, Peter Aldhous reported for BuzzFeed that between 2012 and 2014, Epstein donated to projects on melanoma, Crohn’s disease, consciousness research and one to develop open source software for AI. Is it possible to appreciate these contributions while condemning the enormity of Epstein’s crimes at the same time?

It might be useful to draw a line here between the likes of Harvard University and the Massachusetts Institute of Technology on the one hand and, say, community colleges on the other. The former already boast of multiple donors and don’t stand to lose much by forgoing $250,000. However, the latter don’t have nearly enough and even $50,000 to a single institution could make a big difference. It would be a tragedy if there are no alternatives to Epstein’s money, but when there are, it becomes harder to justify the need for it. It is also not lost on any of us that ties between professors at these privileged universities and Epstein run even deeper, to the extent that they fly on his private jet to attend TED talks and then defend him in public using “empirical evidence” shorn of all social context.

All of these questions disappear if government sources pay more for R&D; put another way, such are the questions that raise their heads when private sources of funding overshadow public ones. However, the early 21st century has been characterised by, among other things, an increasingly pervasive mistrust of experts, if not expertise. Leaders of large nations like India, Brazil, the US, the UK, the Philippines and Australia have consistently placed business interests above safeguarding their natural resources, flying in the face of scientific consensus and protest. Public investment in higher education, healthcare and R&D has stagnated or has fallen in the last few years, increasing researchers’ reliance on the private sector. (In India, the government has on occasion expressed interest to the point of dictating which questions researchers should and shouldn’t pursue.) At this time, what is the right thing for a scientist to do?

The answer isn’t necessarily a blanket policy that says ‘accept the money’ or ‘don’t accept the money’. Instead, what is okay and what is not has to be negotiated by those who receive it, with knowledge of their specific circumstances, the relative importance of their work, what they think the consequences could be, and inevitably informed by their personal moral compasses. So the first thing scientists ought to do is step out of the neatly organised lab and into the messy real world, and not leave their public image to be mediated by a university press office with potentially divergent priorities. To paraphrase Church, there is no excuse for not being abreast of the news.