 For more videos on people's struggles, please subscribe to our YouTube channel. The number of COVID-19 cases continues to vary widely across the world, as well as within countries. One hopeful sign is that the vaccinations which were researched and developed during the first wave of the pandemic continue to be effective now. However, this raises a number of issues including that of vaccine inequity, as the vaccination rates in the global North are much higher than those in the global South, especially in Africa. There is also the question of the second generation of vaccines. This brings the question of the big pharma companies such as Pfizer and Moderna, whose desire for profits means that only a certain kind of vaccine will be developed. Immunologist Dr. Satyajit Rat addresses these issues. What we are seeing in the COVID-19 pandemic this week is slowly gathering evidence for the globally downward trajectory of the Omicron strain fuel explosion of outbreaks that we have seen. This is true here where I am sitting in India across most, if not all, states that in places where there had been massive, extraordinarily rapid increases in case numbers leading to huge local outbreaks, all of them are well on the declining phase. On the other hand, this is not necessarily true across the world and that provides both a cautionary note and the sobering notion that we are not dealing with a uniform pattern of the global pandemic. The pandemic, even though it is global, still consists of local outbreaks that have their own trajectories, their own directions that march in a sense each to its own local drum beat. So for example, in Russia, oddly enough in South Korea, as well as in China specifically in Hong Kong, case numbers are still quite worrisome and even in the rich global north, while case numbers are steadily declining, they are still nowhere near the numbers that would make people feel comfortable, that would make public health authorities feel comfortable. So we are by no means over and past the pandemic at this stage, both because of the extreme variation globally and because even though there are declining trajectories, levels have still not come down to the point that one can, that communities and especially public health authorities can begin to ignore matters. Something interesting that comes up more and more is the clear indication that even though the vaccines that have been deployed the world over are vaccines based on the two-year-old on 2020 virus strains and those vaccines clearly cannot prevent infection by the Omicron strains, they still very well prevent the occurrence of severe illness and death as a result of the Omicron strain. And this difference has become more and more apparent as these numbers have been analyzed over the past two months and what that throws up into sharp relief is a number of issues to consider when thinking about COVID vaccines. Firstly, the issue that vaccine effectiveness against serious disease and death is quite stable and may be quite long-lived. This is a good thing but on that background, we should also consider the extraordinary and growing global inequity where in rich and upper middle-income countries 70% or more people have been fully vaccinated, eligible people have been fully vaccinated whereas in the poorest countries single digit percentage numbers have been fully vaccinated. This is not simply a stark inequity, it's a shameful inequity and it's an inequity that has consequences in real life as the Omicron period has shown us because even a vaccine designed with an old virus strain is showing good protection against severe disease and death. What this leads us to think about should be the fact of how is vaccine design the emergence of new generation, the design creation and distribution of new generation vaccines for COVID and the monitoring of emerging strains, new strains of the COVID virus. How are these two to be linked to each other productively from a social good public health perspective when vaccine design and production is so entirely in the hands of profit-making companies and the interesting example to keep in mind when we think about the linkages between vaccine profits, technologies and the R&D directions that do or don't get taken is quite apparent if we look at the mRNA vaccine technologies versus the non mRNA vaccine technologies Pfizer and Moderna have been making and selling mRNA vaccine technology based vaccines, 70% or more of their sales are to the rich countries of the world and their profits are much larger than the profits of other countries on dose. The other companies that have been selling non mRNA vaccines have been distributing much more to the global south as well as to the WHO Covax Initiative and so on and so forth. This is not to say that they haven't been making multi-billion dollar profits but it is to point out the difference and a technological excuse for the difference that keeps getting brought up is that the mRNA vaccine technologies do not survive without an ultra cold chain in the distribution the poor global south cannot manage this. What is overlooked is the fact that technologies to deliver mRNA vaccines without ultra cold chain are available. Indian small startup companies have been trying to develop those sorts of mRNA based vaccines and yet those non-ultra cold technologies have not been used have not been developed as a second generation vaccine by companies like Pfizer and Moderna raising the possibility that their profits are trumping any sense of attempting to ensure vaccine outreach on equitable dose. All of these are issues we need to keep in mind when we think about what health activist groups across the world should be thinking in the longer term as a lessons from the pandemic and what we should be demanding from governments as well as from global systems this much for this week.