A key excerpt:

> Administration officials speaking to media late last week hinted that something like that might eventually be possible, with one unnamed federal official telling reporters on a conference call that Moderna might have more luck with a second, narrower request for approval if the company showed some “humility” when it made the submission. But the idea that approval of a vaccine might depend—even a little bit—on whether the manufacturer says ‘pretty please’ speaks volumes about what role scientific judgment is now playing in the approval process.

American pharma has an overhang on the world unequal to its size as a population. 350m consumers isn't nothing, but set against the world, its not everything either. So you would hope "the market" manages just fine with Canada, Europe, Inda, China, Australia, Indonesia, Japan, Korea..

The problem is that so much of the R&D is tied up in the US markets cash, as IPR value to supply services to that market.

We used to do drug design by charities, funded by the state through tertiary education and research labs. Thats how things like Insulin emerged from Canada. Welcome trust in the UK similarly.

I liked that model. I'd like to think the EU drug funding, and Indian pharma production and Canadian (Apotex) models of manufacture and distribution have a role to play here.

Novo Nordisk was a drug to investors. It single handedly rose Danish GDP by significant digits, and then .. it went away again. Thats a rush, a financial high.

People need to stop drinking sugary caffiene drinks, and sip tea. It's healthier. We need to stop chasing the US drug market for instant billions, and instead focus on making mRNA production faster, safer and scaleable. Outside of the USA.

I wish the american vaccine market wasn't in disarray, but I don't see this as necessarily harming anyone but Americans, IFF (and its a big IF and only IF) the rest of the world behaves rationally and reaches into their pockets.

So yes, that does sort-of acknowledge America was "bankrolling" a lot of the worlds pharma development, but not without benefit. it was not zero sum, its not a trumpean problem. It was (within limits) win-win but none of us outside America like the market as much as that, and the downsides are now huge and apparent: American changes in habit will cost us global health, unless we wean ourselves off american drug money. We should buy vaccines from Moderna at european and asian market norms, not at US market norms, and they (Moderna) should be glad we're consistent in buying, not resentful we don't want to pay US inflated prices.

I feel sorry for Moderna investors.

Those who want to exercise their judgement about their own personal safety with respect to preventable illnesses won't be allowed to - vaccines won't be available at any price.

But even if they are, a substantial fraction of the populace will elect to do "wellness", making herd immunity an impossibility.

A few years ago we would have extra infrared cameras and scrutiny at airports for flights arriving from China or African countries depending on specific outbreaks in those countries.

The idea that we could be doing that for flights from the USA is no longer unthinkable.