Inequitable by Design: The Patent Culture, Law, and Politics Behind COVID-19 Vaccine Global Access

COVID-19 vaccine access has been highly inequitable worldwide, with coverage depending largely on a country’s wealth. By the end of 2021, 64.1% of people living in high-income countries had received at least one dose of the vaccine, compared to only 5.4% of those in low-income countries. Similarly, only high- and upper-middle-income countries had received the most effective vaccines. The uneven distribution of these lifesaving vaccines is made complex due to the convergence of several factors, but it suggests that the extraordinary expanding and ossifying market and political power of a few vaccine manufacturers founded on intellectual property and complementary policies is a decisive factor in shaping our healthcare systems and securing equitable access to vaccines. This Article analyzes the power dynamics of vaccine manufacturing and distribution of U.S. pharmaceutical companies in the context of global COVID-19 vaccination. Drawing on the health-justice and law-and-political-economy scholarship of the last decade, this Article demonstrates how a “patent culture” shaped by intellectual property law fundamentally neglects health-equity principles while politicizing healthcare access. These contemporary frameworks suggest that the global COVID-19 vaccine-access problem is the result of avoidable policy choices made by big manufacturers and affluent governments. Despite a long history of inequities in access to healthcare, policy choices—as predicted by Hart’s inverse equity theory—have favored a purposely inequitable-by-design vaccination program driven by the wealth and power of those allowed to control vaccine production and supply globally. Finally, this Article proposes ways to challenge the normalized and institutionalized patent culture that has commodified access to lifesaving medicines beyond national borders. As it examines national and international legal strategies to address the vaccine-access problem, the Article suggests equity-based principles of public value, transparency, and inclusivity to guide healthcare governance and future reformation of the vaccine-access landscape. An interdisciplinary analysis of the first year of the global vaccine rollout provides an account critical to future policies aiming to address the structural conditions needed to attain equitable health outcomes, even after the pandemic

Experimental Investigation of the Secondary and Backscatter Electron Emission From New Spacecraft Surface Materials

The emission of secondary and backscattered electrons influences spacecraft surface potentials and the surrounding plasma. Modern spacecraft use new materials for which secondary emission properties have been unavailable. In this work, the total electron yield (i.e., the sum of secondary and backscattered electron yields) was measured for niobium-C103 alloy, molybdenum Titanium, Zirconium, Molybdenum (TZM) alloy, tantalum-tungsten alloy, Elgiloy®, graphite lubricant (DAG 213®), and titanium nitride. The surface properties of tungsten were also measured for comparison with past test data. The materials were readied as spacecraft flight materials and temperature-treated ( annealed ) to predicted peak flight temperatures. The yield properties for 10 eV-5 keV incident electron energies for all samples were measured. Both unannealed and annealed states were tested, except DAG 213, which was only tested annealed. Three-parameter and four-parameter models were used to fit the secondary and backscattered electron yield data, respectively. The emitted electron energy distributions are also obtained and fit with a Chung-Everhart model for secondary electrons and a Gaussian function for backscattered electrons. The secondary and backscattered electrons\u27 current densities were calculated for different ambient plasma conditions. For ready reference, the normalized primary electron, secondary electron, and backscattered electron current densities versus ambient electron temperature were computed and plotted from 1 eV to 8 keV

Machine Medical Ethics

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. This collection is the first book to address these 21st-century concerns

Neonatal screening in Sweden and disease-causing variants in phenylketonuria, galactosaemia and biotinidase deficiency

Phenylketonuria, galactosaemia and biotinidase deficiency were the first three inborn errors of metabolism to be included in the Swedish programme. This thesis describes these conditions with an emphasis on screening performance and disease-causing genetic variants in the patients. Classical galactosaemia (GALT deficiency) is caused by a defect in the conversion of galactose-1-phosphate and UDP-glucose to glucose-1-phosphate and UDP-galactose, resulting in accumulation of toxic levels of galactose-1-phosphate and a deficiency of UDP-galactose. Early treatment prevents severe sequelae and life-threatening infections. The incidence of GALT deficiency in Sweden is 1/100 000, which is lower than the reported incidences for other European countries. The Swedish NBS programme has high sensitivity and specificity, with a positive predictive value (PPV) of approximately 0.5. The increase in PPV was achieved after the decision to adjust the recall level in order to avoid detection of milder variants, which probably do not require treatment. The genetic studies revealed pathogenic variants on both alleles in all patients with GALT deficiency. Only a few variants were found in more than one patient, with the most cited variant, p.Gln188Arg, occurring most frequently. A high proportion of the variants have not been described before. Women with GALT deficiency who have been fortunate enough to become mothers have been recommended not to breast-feed because of the increase in toxic galactose metabolites seen at the end of pregnancy and after delivery. We observed the same increase, but the levels returned to normal within three weeks after birth in two consecutive pregnancies, in a woman who chose to breast-feed her babies. Our findings have been confirmed by other groups and women with GALT-deficiency are no longer discouraged to breast-feed. Phenylketonuria (PKU) is caused by a defect in the conversion of the amino acid phenylalanine (Phe) to tyrosine (Tyr). Without treatment, patients develop mental retardation. Inclusion of the Phe/Tyr ratio has decreased the number of false positive screening outcomes to the present PPV of 0.92 without any known missed cases. The recall levels have been lowered several times since the start of screening. An increase in the incidence of patients with milder disease has been observed with time. We were able to show that the impact of the adjusted recall levels was low. Instead, milder genetic variants, which are more common in Southern Europe, are found more often, which is an effect of the large number of non-Nordic immigrants who have come to Sweden during the last 25 years. The immigration has widened the spectrum of detected pathogenic variants. Biotinidase deficiency (BD) is a rare disorder affecting the recycling of the vitamin biotin. The most common symptoms are unspecific and progressive with eczema, hair loss and delayed psychomotor development. The majority of patients remained unrecognised before the introduction of screening. With NBS, the incidence of BD in Sweden is the same as in other Western countries (1/60 000). With adjustments of initial recall levels, virtually only infants with profound BD are detected in the screening programme. Disease-causing variants were detected in all alleles, with p.Thr532Met occurring most frequently. In conclusion, the Swedish screening programme for PKU, galactosaemia and BD is well-functioning with an internationally comparatively low rate of false positive outcomes. Future research will tell if attenuated forms of the disorders, that are not targets in the Swedish programme, may benefit from early detection and ought to be included in the programme

Performing Hysteria

"We seem to be living in hysterical times. A simple Google search reveals the sheer bottomless well of “hysterical” discussions on diverse topics such as the #metoo movement, Trumpianism, border wars, Brexit, transgender liberation, Black Lives Matter, COVID-19, and climate change, to name only a few. Against the backdrop of such recent deployments of hysteria in popular discourse––particularly as they emerge in times of material and hermeneutic crisis––Performing Hysteria re-engages the notion of “hysteria”. Performing Hysteria rigorously mines late 20th- and early 21st-century (primarily visual) culture for signs of hysteria. The various essays in this volume contribute to the multilayered and complex discussions that surround and foster this resurgent interest in hysteria––covering such areas as art, literature, theatre, film, television, dance; crossing such disciplines as cultural studies, political science, philosophy, history, media, disability, race and ethnicity, and gender studies; and analysing stereotypical images and representations of the hysteric in relation to cultural sciences and media studies. Of particular importance is the volume's insistence on taking the intersection of hysteria and performance seriously.

From Financialisation to Innovation in UK Big Pharma: AstraZeneca and GlaxoSmithKline

The tension between innovation and financialisation is central to the business corporation. Innovation entails a 'retain-and-reinvest' allocation regime that can form a foundation for stable and equitable economic growth. Driven by shareholder-value ideology, financialisation entails a shift to 'downsize-and-distribute'. This Element investigates this tension in global pharmaceuticals, focusing on the two leading UK companies AstraZeneca and GlaxoSmithKline. In the 2000s both adopted US-style governance, including stock buybacks and stock-based executive pay. Over the past decade, however, first AstraZeneca and then GlaxoSmithKline transitioned to innovation. Critical was the cessation of buybacks to refocus capabilities on investing in an innovative drugs pipeline. Enabling this shift were UK corporate-governance institutions that mitigated US-style shareholder-value maximisation. Reinventing capitalism for the sake of stable and equitable economic growth means eliminating value destruction caused by financialisation and supporting value creation through collective and cumulative innovation. This title is also available as Open Access on Cambridge Core

1962 List of Accounting Firms and Individual Practitioners

https://egrove.olemiss.edu/aicpa_guides/1931/thumbnail.jp

Anti-computing

We live in a moment of high anxiety around digital transformation. Computers are blamed for generating toxic forms of culture and ways of life. Once part of future imaginaries that were optimistic or even utopian, today there is a sense that things have turned out very differently. Anti-computing is widespread. This book seeks to understand its cultural and material logics, its forms, and its operations. Anti-Computing critically investigates forgotten histories of dissent – moments when the imposition of computational technologies, logics, techniques, imaginaries, utopias have been questioned, disputed, or refused. It asks why dissent is forgotten and how - under what circumstances - it revives. Constituting an engagement with media archaeology/medium theory and working through a series of case studies, this book is compelling reading for scholars in digital media, literary, cultural history, digital humanities and associated fields at all levels