Build back the state

Vaccine rollout in US - and even more so in Europe - shows that it is just as important to get the details of public-private partnerships right as it is to start with an ambitious overall objective

The development of Covid-19 vaccines in less than a year was clearly a major achievement. But the rollout has been far from perfect. In the United States, Operation Warp Speed met its manufacturing targets but stumbled in coordinating initial shipments. The plan neither prioritised vaccine recipients according to need, nor did it go far enough to address racial inequality in the distribution.

Clearly, creating safe and effective vaccines and creating equitable vaccination programmes are two different things. States’ Mission-oriented innovation agencies, especially the Defense Advanced Research Projects Agency (DARPA) and the Biomedical Advanced Research and Development Authority (BARDA), have proven