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On Thursday, February 25, Monica de Bolle joined Markus’ Academy for a lecture on A Chronic Pandemic? Vaccine Geopolitics. de Bolle is a Senior Fellow at the Peterson Institute for International Economics and a adjunct lecturer and former director for Latin American studies and emerging markets at the School of Advanced International Studies at Johns Hopkins University.

Watch the full presentation below and download the slides here.  You can also watch all Markus’ Academy webinars on the Princeton BCF YouTube channel.


Executive Summary

  • COVID-19 will likely be a chronic pandemic. The nature of the virus (SARS-CoV-2) makes it more dangerous and harder to control. In addition, zoonotic viruses are on the rise due to high human contact with the environment. Finally, the lack of global preparedness and cooperation has resulted in lack of communication, lack of social and political adhesion, and low genomic surveillance. 
  • Testing has primarily focused on PCRs which are diagnostic tests that tell you if you have COVID. However, they are not good for epidemiological control because they fail to catch people in the infectious window and therefore make isolation and contact tracing much more difficult. Countries are now emphasizing rapid tests to identify viral loads in the infectious window. 
  • As a virus replicates, it will mutate. Mutations are random and can be deleterious or advantageous for the virus, the latter of which is happening more frequently and are known as variants of concern (VOCs). Three weeks ago, there were three VOCs circulating (from the UK, South Africa, and Brazil). As of today, there are six known VOCs, many of which originated from places that have had large outbreaks, such as NYC. Moderna and Pfizer vaccines tested against the variants have faced lower efficacy but are still effective. 
  • In terms of vaccine geopolitics, rich and developed countries have more doses countracted that they need. There are three types of vaccines: genetics vaccines, viral vectors, and whole inactivated virus. The first two have high R2 squared with high efficacy but lack robustness. The whole inactivated vaccine, on the other hand, has much higher robustness and will likely fare better when confronted with new VOCs. Moreover, China and India are currently the only countries that produce the whole inactivated vaccines. Other countries are unlikely to develop such vaccines given the high cost and therefore may be dependent on China and India for a period of time.
  • Economic recovery is entirely dependent on vaccines. In a world with different speeds of vaccination, economic recovery pace will vary and will likely be faster in developed countries and therefore increase the income gap across countries. 
  • In conclusion, vaccines will have to be regularly updated, there will be fiscal consequences of the chronic disease burden, debt and deficit burdens will have to be evaluated for a chronic crisis, inequality will continue to be on the rise, high economic volatility may rise from sporadic lockdowns, and we must rebuild economics around public health.