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University of California Press

About the Book

How vaccines became the world's most powerful and widely distributed health intervention, and the inside story of the challenging race to deliver COVID-19 vaccines globally.

Fair Doses is a story of vaccines: how they came about, why they are important, and how they have been made globally available—although our quest for vaccine equity is still ongoing. In this fascinating deep dive into vaccines, Dr. Seth Berkley, an internationally recognized infectious disease epidemiologist and public health leader, offers an inside view of the challenges of developing and disseminating vaccines for a broad swath of illnesses, from Ebola to AIDS to malaria and beyond.
 
COVID-19 was a lesson about the devastation a novel virus can bring on our world. When the first signs of the spread of this new infection appeared, Berkley co-created COVAX, a global initiative aimed at ensuring equitable COVID vaccine distribution. The COVAX team had to navigate vaccine nationalism, vaccine diplomacy, intentional disinformation, political forces, and the conflicting incentives of vaccine companies in its race against the virus. In record time, the group organized 193 countries, built the world's largest portfolio of COVID-19 vaccines, raised more than $12 billion, and delivered two billion doses of COVID-19 vaccines to 146 countries.

Future pandemics are an evolutionary inevitability, and future global response needs to be much faster and more equitable. Drawing from his personal experience, Berkley lays out a bold vision of preparedness that will help the global community take advantage of rapid advancements in science to make our world safer from infectious diseases.
 

About the Author

Seth Berkley, MD is an infectious disease epidemiologist currently advising vaccine, biotechnology, and technology companies, and is Adjunct Professor and Senior Adviser to the Pandemic Center at Brown University. He served as CEO of Gavi, the Vaccine Alliance from 2011 to 2023; cofounded COVAX; and founded and served as CEO of the International AIDS Vaccine Initiative.
 

Reviews

"Fair Doses is an unflinching and insightful account of the global effort to deliver vaccines at a time of unprecedented crisis. Seth Berkley takes readers inside the high-stakes decisions, political wrangling, and scientific and technological breakthroughs that shaped the world's pandemic response and saved millions of lives. His unique perspective makes this book essential reading for anyone who wants to understand how global health works—and how it must change to prepare for the future."—The Right Honourable Sir Tony Blair, former Prime Minister of the United Kingdom, and Executive Chairman of the Tony Blair Institute for Global Change

"Fair Doses is an unflinching insider account of how science, politics, and human nature collided in the battle to vaccinate the world. It exposes how vaccine nationalism, bureaucratic gridlock, political indifference, profit-driven markets, and misinformation cost millions of lives. But it also tells how a small, committed team nonetheless managed to deliver two billion lifesaving vaccines to people in the most vulnerable, hardest-to-reach corners of the world."—Atul Gawande, surgeon, former assistant administrator for global health at USAID, and author of Being Mortal

"In Fair Doses, Berkley gives a gripping account of the value and impact of vaccines, especially in poor countries. Particularly impressive and insightful is the fast-paced account of the COVID-19 pandemic and the COVAX facility developed by Gavi, the Vaccine Alliance to help provide affordable and equitable access for all to COVID-19 vaccines. Designed to ensure that poor countries would not be at the back of the queue for lifesaving vaccines, COVAX struggled to fulfill its own mandate. The book sets out the human and physical obstacles that stood in COVAX's way. From fear to political calculations and miscalculations, profit motives, and health system challenges, Berkley's account shows us how the best intentions can be undermined. Beyond pandemics, this book is a compelling personal account of a dedicated public health professional's journey through science and the financial, philanthropic, and operational logistics needed to translate scientific discoveries into saved human lives. Berkley is an inspiring scientist, strong administrator, and empathetic professional who believes all lives are equal and should be equally saved."—Ngozi Okonjo-Iweala, Director-General of the World Trade Organization, former Managing Director of the World Bank, former Minister of Finance of Nigeria, and author of Reforming the Unreformable

"Berkley may well have done as much lifesaving as any physician in history. He has been at the center of the global vaccine effort for decades. Organizational innovation is often as important as scientific progress if lives are to be saved, and here Berkley has been extraordinary. Anyone looking to work in global health or even to find examples of positive global cooperation should read this wonderful book."—Lawrence H. Summers, Charles W. Eliot University Professor and President Emeritus of Harvard University, former United States Secretary of the Treasury, former director of the National Economic Council, and former Chief Economist of the World Bank

"Louis Armstrong once sang, 'Nobody knows the trouble I've seen.' That could be the anthem for public health after COVID. It certainly is part of the story of Fair Doses. But such 'troubles' did not stop those like Seth Berkley—this good and wise man—who labored hard and fought against shortsighted interests to raise massive amounts of money to buy vaccines for those who could not afford them. Millions live today not knowing to whom to be grateful. We all owe two kinds of gratitude to Berkley and his colleagues. One debt is for masterminding one of the largest distributions of lifesaving vaccines in history. And the second debt is for writing about it, leaving us a precious gift—both a historical archive and a road map for the future. My family and I are among those who know that, thanks to our own fair doses, we survived COVID with an overwhelming urge to celebrate the living and all the good people who made it possible."—Larry Brilliant, CEO of Evity Technologies, inaugural Executive Director of Google.org, and author of Sometimes Brilliant