February 28, 2021

Opinion

Science at the epicenter of Peru’s pandemic: a crisis of values

It is about time we have another serious conversation about the accountability of researchers, research organisations and their funders.  

Back in September 2020, I wrote an article that reported on an undesired and unexpected effect of pandemics: a crisis of confidence in scientists. But I did not imagine then what was still to come. 

The Peruvian scientific community has been hit by a scandal that has consequences well beyond its boundaries. It must respond immediately, if it doesn’t want to be involved in this shameful affair and be brought down with it. This is not the time for more ‘cronyism’ among researchers.

The scandal 

The scandal has been dubbed #vacunagate (vaccine gate). The research team involved in phase three trials for the Chinese vaccine Sinopharm used ‘extra’ doses (outside of a trial) to inoculate research staff, university authorities, people with personal or professional relationships with the researchers, and public servants from ministries involved in negotiating with the Chinese laboratory, as well as some of their family members. Both ministers of state, the (now ex) President and his family also received doses. 

Public reaction

Understandably the reaction has been widespread and negative; a mixture of anger, hopelessness and shame.

Perhaps it has affected us so much individually because it reveals our own weaknesses. If we’re honest, how many of us are relieved not to have been tempted with the opportunity to ‘get vaccinated’, or to get loved ones vaccinated? Would we have been able to let it pass? 

But I believe that the impact it has had on our morale also relates to the fact that this scandal originates in, and will have consequences on, an institution that had endured (albeit with some blows) until now and that gave us hope: Peruvian science.

Throughout the pandemic we have seen political and economic institutions fail us dramatically. But scientists stepped up to the challenge: from performing a basic public education and sensemaking service, to advising the government (even if the government rarely listened), and innovating in the development of new technologies to overcome the shortage of oxygen, ventilators and COVID-19 tests. 

One university above others stood out: Universidad Peruana Cayetano Heredia. It now stands out again, but for the wrong reasons.

An absence of morals

At the start of the scandal an idea was presented, sold and bought by the public: there were people who had been legitimately vaccinated and others who had received vaccinations when they shouldn’t have.

Those legitimately vaccinated were people linked to the vaccine trials at the Universidad Peruana Cayetano Heredia (number two in the QS World University Rankings) and the Universidad Nacional Mayor de San Marcos (number three). 

Out of those illegitimately vaccinated, our attention, as usual, fell on the public servants and political leaders who were seen to have jumped the queue and lied publicly about it.

But this isn’t the full story. It isn’t just that people ‘jumped the queue’ to get the vaccine. Rather, giving out vaccines outside of clinical trials before they have been approved for use is never justified. 

It not only puts people’s lives at risk, but also puts the integrity and results of the whole vaccine study at risk. Mateo Prochazka, a Peruvian scientist working in Public Health England, explains this. I also consulted with an expert in bioethics, Douglas MacKay (University of North Carolina at Chapel Hill), who confirmed that negative cost on society definitely outweighs any private benefit.

When I asked Douglas MacKay what the reaction in the United States would have been to news like this, he told me: I don’t know, it wouldn’t happen.

In Peru, however, it seems to have been sanctioned by the National Health Institute and Peru’s authority in charge of approving the import and use of medicines (senior members were given the vaccine), as well as by the universities in charge of the study – although it must be said that some researchers and students from Cayetano and San Marcos have made it clear that they did not approve and are calling for the resignation of their authorities.

The vaccination of the chancellors and vice-chancellors of Cayetano and San Marcos is, however, evidence that this was a practice sanctioned at the highest level. Furthermore, close to 500 people were vaccinated. It wasn’t even a secret operation at the university; the principal investigator at Cayetano has said in his numerous appearances before Congress and the media: this is just how it’s done.

Peruvians now accept that there is a serious ethical fault: a preference for personal gain over the common good.

It borders on criminal

The story is further complicated.

By issuing vaccine doses outside of a clinical trial and before it had been approved for use, the doctors who injected it fell into another ethical breach by putting third parties at risk. And in this case, they broke the rules established by the National Health Institute. They now face charges akin to drug trafficking.

The vaccine approval process is not a whim. Phase three determines in a larger population if there are risks that were not identified in earlier phases that test the vaccine candidate in much smaller groups. 

The vaccination of public servants, politicians, businessmen and lobbyists (‘to raise funds for an ICU’) leaves no doubt about the absence of a moral compass for principal investigator Germán Málaga and his team. But it also ventures into the territory of criminal activity.

The latter implies a commercialisation of the vaccine (for donations and favours) and turns the scientists of Cayetano and San Marcos into accessories (quite active ones) of what seems to be a new chapter of corruption in Peru. 

It is now rather clear that the Chinese laboratory sent the extra doses as a bribe (explicit or tacit) to the members of the ministries in charge of negotiating the purchase of the vaccine – and this coincides with that team’s rejection of offers from Pfizer and AstraZeneca. 

These courtesy doses, in the thousands, include many that were earmarked for the Chinese Embassy in Lima. The university sought the import of the vaccine candidates, received them and then delivered them to the Embassy. No questions asked.

Accountability

After a long and protracted response from the universities, the chancellor and vice-chancellors of Cayetano resigned after students and researchers raised their voice. We are yet to see what the response from San Marcos’ authorities will be (San Marcos is a public university and the oldest university in the Americas).

Am I being unfair in focusing my attention on Málaga, his team and the universities? I do not think so. 

This does not excuse any of the others involved. And I hope there is social sanction for absolutely everyone. Public officials who were vaccinated in the middle of the negotiation must answer for their actions – early findings suggest that this is a case of high-level corruption.

This is also a case in which the research funder, Sinopharm, acted unethically. 

But the Universidad Peruana Cayetano Heredia and the National University of San Marcos had the power to decide and act ethically – and they didn’t.

Unfortunately, I think that the Peruvian academic community must feel like the rest of us who thought ‘what would I have done?’. They’re probably relieved that they didn’t have the chance. 

Accusations of opacity in their finances and practices, abuses of power, buying of academic publications to rise in university rankings and complacency towards political and economic power across all universities have been on the back of our minds for too long in Peru. But this behaviour has only had limited domestic consequences. 

The impact this new scandal can have on Peruvian science is significant. These trials are not little projects intended to be published in obscure local journals. The clear moral incapacity of two of the best Peruvian universities will be known globally – even if those involved are a minority. 

It will have an impact on the funds available for research in Peru; on the opportunities for scientific collaboration available; on the conditions that will be imposed for the participation of Peruvian scientists in international initiatives; and on its credibility.

The crisis of confidence in Peruvian scientists may end in a crisis of confidence in Peruvian science. The researchers, research centres and institutions involved should be held accountable.

What next?

The need to talk more about accountability of researchers, research organisations and their funders isn’t new. In 2019, I asked ‘if researchers should get to pick who wins and who loses?’ after an Evidence Action research experiment led to the unintended deaths of non-consenting participants in Bangladesh. The incident was framed as researchers accepting failure and learning from it, but really it should have been a story of private actors making a cost benefit analysis on behalf of the public, and in which the public are left worse off. 

And my recommendations back then are reinforced by this case. We need: greater clarity in the roles and responsibilities of private funders and private research agents with respect to issues of public interest; greater demand of evidence and ethical arguments before supporting and celebrating the potential of an idea; and an adequate level of accountability of researchers’ and funders actions’ – and their consequences.

Based on the Peruvian case I would like to add the following three:

  1. Greater public awareness and education about the roles and responsibilities of researchers on issues of public interest. The Peruvian public did not know – not even the researchers involved in the trial – that it was unethical to use the unauthorised vaccines. Had this been perfectly clear from the start more than one would have refused the vaccine and someone would have rung the alarm.

  2. Greater scrutiny of science by the media. Science, unlike showbiz or sports, is not closely scrutinised in the news media. Science is treated as a source of good news stories (‘Peruvian scientist is part of Nasa team’) or curiosities (‘scientists discover a new species of frogs in the Amazon’). But science is a business, it is fraught with politics, accusations of plagiarism, abuse of power and so on. We need to treat it accordingly.

  3. Greater diversity. I think that impunity in research is more likely when we create or support the formation of super-powerful silos. The Evidence Action team is part of the same community as JPAL, IPA, the IGC and the like. Their networks of research associates overlap significantly. Their funders overlap too. There are no dissenting voices within. This happens in every discipline. The Cayetano team in charge of the project in Peru were very much the same. The leading researcher, hyped up by the government, the private sector and the media, the university, widely seen as the best in its field, were undisputed. But this is not surprising as there was an absolute lack of disciplinary diversity. I wonder, if the team had included anthropologists or political scientists, I bet they would have noticed something did not feel right.
About the author:

Enrique Mendizabal:  Founder, On Think Tanks

Read more from: Enrique Mendizabal

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