The Court of Marie Antoinette does ‘global “vaccine plus”‘

The real Marie Antoinette may never have advised a hungry people ‘to eat cake’. But the fictional Marie Antoinette has come to represent everything that is wrong with those who cannot see over their own privileged walls. On the 3 January 2022 the BMJ published a short piece with a large number of signatures making ‘an urgent call for global “vaccines plus” action’. The trouble, say our authors, is that some countries are relying on a vaccines only strategy when they should be developing the additional  measures that the authors support.

The ambition of this latter day court of Marie Antoinette would seem to be to offer the finest croissants, the juiciest pains au raisons, and the sweetest pains au chocolates to the world’s 7.9 billion people as a solution to the covid pandemic. 

So let us look at what they suggest.

Vaccines for all

Of course!  Yet strangely in a world where a huge number have yet to have a vaccine at all (while in the rich world 3-4 vaccine shots are becoming the order of the  day) this is their last demand. Each of the specific things they say are needed to improve global vaccination is 100% correct. What is missing is a recognition that ‘we’ cannot feed ourselves upon more cake today and vaccinate the rest of the world with the same cake. Our unworldly court of Marie Antoinette seems to be assuming ever more vaccine croissants for ‘us’ leaving only the hope of possibly stale ones for ‘them’ in a year’s time – if they can hold out.

A Masked Ball for all

The court of Marie Antoinette is convinced that Sars-CoV-2 is ‘an airborne pathogen’ and wants an official ruling on this. Some of the court, have declared in the past that any mask is good, and even a panty liner inside a mask can offer additional protection.

Now they say that, if masks work, only the finest should be adopted.  ‘Respirators (e.g. N95, P2/FFP2 or KF94) should be preferred in all indoor settings where people mix, and for healthcare workers at all times.’ 

You have to admire the ambition of this as a proposal for a world in which most of the world’s women have never worn a panty liner. Do they imagine that in the slums of Dharavi or Kibera people are served by Amazon and the people there can choose between buying the right kind of mask or a fine French wine?

Public Palaces for all

No matter. We must move on because ‘It is [also] time to go beyond opening windows and aim for a paradigm shift to ensure all public buildings are optimally designed, built, adapted, and utilised to maximise clean air for occupants ..’ We can all, it seems, inhabit modern day Palaces of Versailles.

Maybe first though we should open the windows and use the resources to supply decent sanitation and water supply to hovels and so save people from other infectious diseases?

Test, Trace and Compensate 

And so with a flourish our aristocrats of global public health propose cake for breakfast, cake for lunch and cake for dinner. What the WORLD needs is an ‘effective find, test, trace, isolate’  and ‘sufficient financial and practical support for isolation should be implemented everywhere, particularly in low- and middle-income countries and deprived parts of high-income countries.’   

Surely the real Marie  Antoinette could not have been so out of touch with the hand to mouth ways in which so many of the world’s population live? Do our latter day ones’ have to be reminded that many countries do not even know within 10% what their populations are, let alone all their peoples’ addresses?  Would not even the real Marie-Antoinette  have reflected on their casual ignorance in thinking that the poorest states in the world could provide ‘sufficient financial and practical support for isolation’?

Me, me, me public health

Of course there is nothing in the demand for ‘GLOBAL vaccine plus action’ that is global. It is call by people who have relentlessly focused on covid in their own rich countries for the rich countries to do more of the same. The term global is a transparent rhetorical ploy. 

It has to be not because it is impossible to think of a better world but because in this world choices have to be made and the court of Marie Antoinette wants a few of us to eat more and more cake so it declares – why can’t the whole world eat cake just like us?  

Yet they must know that if the ‘world’ was to listen to them then, in practical terms, the inequalities that have already grown between countries will increase even more. Or is it that they understand only too well that their ‘global public health’ is for the few.  It is their palace, their castle, their Bastille surrounded by the highest walls. 

If so it needs its 1789.

One comment

  1. I find the likes of Trisha Greenhalgh both illuminating and depressing. How can you hold the title of ‘professor’ but have such terrible critical thinking ability and complete lack of any self-awareness? I’m starting to think that philosophy should be made a compulsory subject in schools.


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