An isolated approach to climate action hinged on nationalism and built on the superiority complexes of countries in the Minority World will not be enough to address the climate emergency. Climate multilateralism, despite its imperfections, remains a potent tool for addressing the tragedies of our commons.

Chapter 5 examines some of the rationales for pharmaceutical interventions, especially vaccines, and resistance to them. Vaccine-hesitant and anti-vaccine activists have questioned different aspects of the Covid-19 vaccination programme, and some have even argued that the whole virus is a scam and part of a plot to profit from selling vaccines. The discussion regarding vaccines and other potential pharmaceutical treatments quickly became highly politicized, especially after Donald Trump’s official endorsement of the malaria drug hydroxychloroquine. The debate about vaccines and treatments does not only reflect tensions between science and politics and expert and non-expert discourses. It also highlights the fact that there are divergent views within the scientific community itself on when new evidence may be ready to be put into political action. This chapter explores the divergent arguments used in this debate as well as their various and complex value-laden underpinnings.

A vaccine that overcomes scientific, funding, and R&D constraints and enters the market may still not become available to everybody who needs it. The public health goal of preventing or lessening disease through the administration of vaccines is not fulfilled at the point of market entrance. Rather, it requires that populations indicated for a particular vaccine are able to receive it. A separate dimension of investigating how well the vaccine innovation ecosystem functions is thus the problem of access to existing vaccines.

The pandemic has turned the world inward and toward such perennial false promises of self-sufficiency as localism and protectionism. The trade links made possible by global supply chains are being questioned along with all else that connects the global economy. Amid this questioning, in the ongoing battle to end the pandemic, tariffs and other barriers to trade in medicines and other medical goods must be eliminated; vaccine nationalism must be replaced by vaccine multilateralism; and trade restrictions on the global supply of food must be avoided.