Design of an mRNA Vaccine Manufacturing Platform to Target M. Tuberculosis; An Analysis of the Sociotechnical Factors Promoting Vaccine Distribution Inequality in Low-Income Countries

With increasing globalization, the threat of a global pandemic is as high as ever. COVID-19 is the latest example revealing how quickly an outbreak can spread across the earth and devastate society. Fortunately, the COVID-19 pandemic also led to the design, approval, and manufacturing of vaccines to target the coronavirus at an unprecedented rate. This rapid response was in part made possible by the advent of mRNA vaccine technology, the focus of my technical project. My technical work aimed to design a manufacturing facility to produce a mRNA vaccine that targets M. Tuberculosis, currently the world’s deadliest infectious disease. The design of this plant naturally raises the question: who should get access to the vaccine? This question motivates my STS research. During the COVID-19 pandemic, low-income countries universally experienced lower vaccination rates than their high-income counterparts. Using actor network theory and the moral theory of distributive justice, my STS research dives into factors that promoted this inequality and explores how the global vaccine distribution network must change in the event of a future pandemic. In our technical work, my capstone group sought to design a mRNA vaccine manufacturing plant. We knew we wanted to target a disease with a global impact, which ultimately led us to select tuberculosis, a leading cause of death in the world. Furthermore, lower-income countries tend to experience a greater disease burden from tuberculosis compared to high income countries. As a result, my group determined a design constraint for our project was to ensure our vaccine is accessible to lower-income countries at a reasonable price. By the end of the semester, we designed a manufacturing plant capable of producing 10 million doses of a tuberculosis mRNA vaccine in 6 weeks. To ensure our vaccine was affordable for lower-income countries we designated 74.5% of our annual doses to be sold at a subsidized price. Despite forgoing additional profits, we estimated our facility to be highly profitable, highlighting its economic viability while still serving lower income countries. My STS research investigates how vaccines should be distributed in the event of a global pandemic. I specifically explore the global vaccine distribution network throughout the most recent pandemic, COVID-19. Using actor network theory, I reconstruct the COVID-19 vaccine distribution network taking into consideration both human actors like governments, pharmaceutical companies, and patients as well as non-human actors such as vaccine technology and storage infrastructure. From this analysis, I identify that the capability of high-income countries to buy vaccines directly from pharmaceutical companies, bypassing international agencies, was a shortcoming in the global vaccine distribution network, enhancing inequality between high-income and low-income countries. To address this issue in the event of a future pandemic, high-income countries must restrain from abusing their economic power to control the global vaccine supply. This is a tall task considering the capitalistic and nationalistic forces inherent in society. My technical and STS work has provided me with a new perspective on the impact engineers have on society. While engineers do not dictate all aspects of global vaccine distribution, our design decisions do impact who will ultimately be able to obtain a vaccine. It is critical we keep all populations in mind especially when designing a product as important as a life-saving vaccine. It is not enough for a product to only be accessible in certain parts of the world when the entire globe is burdened by a disease. This principle applies to all of engineering, not just pharmaceuticals. As engineers, it is our ethical responsibility to serve the whole public rather than just the portion of the public that fulfills our personal interests.