LAUSR

A vaccine from scratch to stab in under 12 months was the scientific success of 2020 – but it opened up a world of new issues. First, the success, the achievement of scientists globally, the universities, governments, and companies who supported them, and the public who volunteered to enter trials. In record time, these collaborators cut through the fog and noise of pandemic chaos to deliver hope of a return to health and prosperity. The UK was well represented in this scientific advance, with the work of Oxford University, and the first vaccination at University Hospital Coventry and Warwickshire, whose medical director even pulled off the public relations coup of vaccinating William Shakespeare. The path to vaccination was murky. Questions were raised about procurement practices and conflicts of interest. Concerns remain about the rigour of the regulatory process, the trial populations and endpoints, and the safety of the vaccines. Anti-vaxxers must be won over. But the vaccines are real and they work. If the UK can be so important in science, and let’s not forget the therapeutic trials that led to the best available evidence on dexamethasone and other COVID-19 treatments, how can these talents be harnessed and secured in a post-Brexit world? Melanie Calvert and colleagues argue that the UK has a unique opportunity in regulatory science and innovation for health. They are so convinced that they explain how it can be done. Science has its limits, of course. At some point science must give space to wider considerations of politics and the economy, for example. The plentiful failures of the pandemic response were not best served by the uncomfortable dynamic between scientists and politicians. Gemma Bowsher and Richard Sullivan believe that science is not intelligence; being led by the science isn’t enough. Instead science and public health must be supported and integrated into an intelligence-led approach. We also need to be mindful of how other countries have succeeded, and not condemn ourselves to a national silo of maverick policy making. We need help and we need to help others. Vaccines are a prime example of how the Global South is last in line. The rich countries of the world have produced vaccines at unprecedented speed and bought the bulk up for themselves. Imagine those resources and that commitment being devoted to the immense health challenges faced by the world’s poor? COVID-19 is a threat, but it is also an opportunity to renegotiate the place of science in a post-Brexit post-Covid world as well as to show our commitment to equity and fairness on a global scale. In 2021, can we begin to remake the world we broke? With science and a global conscience at the forefront, we have a chance.