Red Ocean Vaccines

Red ocean thinking has left the health, economic well-being, and even democracy of Europe at risk.

I’m an American living and working in France which, normally, is a very nice place to be. The weather is great, the people are friendly (really - they are - especially compared to people from South Florida), and food — oh la la. Besides, you can drive to Italy, Spain, and the Netherlands.

But, like other European Union countries, France is missing something other first-world countries enjoy: widespread access to vaccines. Virtually anybody who wants a vaccine in the US or UK can get one by now. In France, like the rest of the EU countries, that’s not the case. My local vaccination center says they will administer 3,432 vaccinations over the next 28 days and there are no appointments available. The two next vaccination centers say the same thing albeit with a different number of vaccines available.

When complaining about this online I’ve found most people agree it’s a mess with two noted exceptions: people with ties to the pharma industry and EU apologists. A pharma person explains:

Pharmaceutical companies (almost) always like to start clinical trials first in the US (there's more profit once the drugs get approved and there is a large population that allows faster enrollment of patients). Therefore, it is common for the US to be the first place filings for approval come as the clinical trials are first to completion… Also just to add, the US had the lead now for three vaccines approved for emergency use (Pfizer, Moderna, and J&J). That is a huge advantage, and one not yet complicated by the AZ supply chain battle between the UK and EU.

When I asked the obvious question, why not just defer to the US approvals in this case — given the severity of the situation — she answered:

No, the EU cannot defer to the US for approval. There are separate legal processes for drug approval, this is true across the globe. It is best for patient safety this way. Again, clinical trials are often region-specific, as are often manufacturing sites. Therefore, data that the US uses to approve drugs is based on clinical trials which differ from other regions, and more importantly, the manufacturing sites which supplied the drug for those clinical trials and subsequent commercial manufacturing may also differ, meaning there would then be no oversight of the safety and reliability of a manufacturing site that was outside of the jurisdiction of the information/data package sent to the FDA for approval.

These answers are nonsense. There are more people in the EU than in the US. There’s nothing significantly different about those people. The manufacturing, as I explain below, are the same.

This all comes down to a red ocean rub: they’re doing it this way because that’s how they always do it. The EU accepted industry boundaries. They’re using vaccine protocols not because they make sense, which they don’t, but because that’s the way things have always been done … never mind the body count nor the ruined economy.

The manufacturing argument is bogus, especially in this case where much of the drugs are being manufactured in the EU and exported to the US. Even if that wasn’t the case, the pharma companies could’ve been required to certify their plants are the same in the US and EU.

For cost reasons, most plants manufacturing the same thing are similar if not identical. The more complex the things being manufactured, the more similar the plants are. Intel is known to paint the walls the exact same color and renewing the paint at the same time in every manufacturing fab, no matter where it is in the world, and use the same carpet preferably from the same batch.

Why are plants identical? Because if paint vapors or carpet fibers from one plant get into the ventilation system and pollute a production facility, and it takes ages to diagnose the source of contamination in the US, they want to correct the problem in China without doing the same exercise again. It’s cheaper and leads to higher quality products. Lower cost and higher value: value innovation.

Similarly, Pfizer and the other pharma companies do not want multiple manufacturing facilities set up differently for the same reason: it leaves multiple channels for quality control problems. No manufacturer wants that, especially for high-tech complex products. Their plants may not be identical but they’re certainly not significantly different enough to warrant an entirely separate certification process for an emergency vaccine causing a worldwide pandemic.

Other theories about why the EU is so far behind other countries similarly fall somewhere between easy to rebut and ridiculous:

Cost. The US pays Pfizer about the equivalent of $5 dose more than the EU. Vaccinations require two doses so EU bargaining saved about $10 per person … less than countries payout for two hours of subsidized layoffs work at minimum wage. It was atrocious, incompetent bargaining.

Infrastructure. Some argue the US has stronger healthcare infrastructure. Nobody who has been in both countries for a significant amount of time, like I have, would believe this. The US may have better facilities for exotic diseases at high-end hospitals and clinics but, for ordinary stuff, like administering vaccines, there is no comparison: France wins. Every person here has the same healthcare card linked to both the national system and also private supplemental insurers. Most doctors don’t have a billing department: they simply run your card and central computers take care of everything. There is also a centralized medical records system. In any event, vaccines (when available) are not even insurance-dependant: anybody eligible for one is eligible at no cost with or without insurance.

Paranoia. Others argue the US or UK are hoarding vaccines to start a “vaccine war” and that, in any event, the vaccines are ineffective against new strains of the virus. These are the equivalent of QAnon freaks: there’s no need to seriously parse this. Even if the US wanted to hoard vaccines they couldn’t: COVID vaccines expire. As for long-term effectiveness … who knows. But paranoia against the unknown is never an excuse for action against the known, the current strain of COVID.

Most blue ocean strategy moves I focus on involve businesses. Some involve government. However, this one crosses everything and involves life and death. EU bureaucrats accepted market conditions as a given and treated COVID vaccines as if they were a new type of new cough syrup, going so far as to take their winter vacations while the British and Americans remained hard at work.

As a direct and proximate result of red ocean thinking and behavior, people are dying. Countless people are unemployed. Physical and mental health is breaking down; the French are about as happy as they were right before storming the Bastille. They’re justifiably livid.

Next year is an election year and France and Front National hard-right ideologue Marine Le Pen will no doubt call for a Frexit based on this fiasco. Countering that with weasel arguments won’t work, especially blaming the EU which she’s been arguing France should leave for ages now. It’s long past time the EU in general or the individual countries alone think blue and start to get out of this mess. The as-is situation is a threat to the health, economy, and even democracy itself of the continent.