Thu, 25 Feb 2021

This is a transcript of Episode 3 of The Conversation Weekly podcast: Coronavirus vaccines: what's getting in the way of the global rollout, published on February 18, 2021. In this week's episode, we hear about an ongoing battle to relax intellectual property rules around coronavirus vaccines and new research on why China is closing down coal-fired power stations faster in some places than others.

NOTE: Transcripts may contain errors. Please check the corresponding audio before quoting in print.

Gemma: Hello and welcome to The Conversation Weekly.

Dan: Each week we bring you expert analysis on the world's biggest stories.

Gemma: And groundbreaking new research, explained by the academics behind it.

Dan: Today, we're talking about coronavirus vaccines - how and where they're getting manufactured and why there is a fight over the intellectual property rights that regulate them.

Ronald Labonte: Countries have that vaccine manufacturing capacity, but right now they can't access it.

Gemma: And we'll hear from an expert on Chinese energy on why the country is shutting down coal-fired power stations - and what this means for the wider region.

Hao Tan: 291 coal power generation units had been decommissioned in China.

Dan: I'm Dan Merino in San Francisco.

Gemma: And I'm Gemma Ware in London and you're listening to The Conversation Weekly.

Dan: Gemma and I are in the UK and the US. But the story we're gonna hear today is about how countries with lower incomes are struggling to get vaccines. A key reason for this is that companies in rich nations generally hold the intellectual property rights over the vaccines.

Gemma: OK Dan, before we get into all, can you just run through the different types of vaccine that have already been licensed.

Dan: Sure, so first we have whole virus vaccines. These are when you inject a whole but harmless version of the coronavirus into your body and this generates an immune response. These use either harmless versions of the coronavirus that are still alive, this is called a live attenuated vaccine, or a dead normal version of the coronavirus, this is called an inactivated vaccine. Another kind is called an adenovirus vaccine - these use harmless adenoviruses to deliver a gene from the coronavirus into your body. Your cells then use that gene's directions to make a piece of the coronavirus. It's totally harmless, it's just a little protein, but it triggers a really strong immune response.

Gemma: OK, which vaccines are we talking about here?

Dan: A couple of the Chinese vaccines are using dead version of the coronavirus. And ones using those harmless adenoviruses include the Oxford/Astrazeneca vaccine, the Johnson & Johnson vaccine and also the Sputnik vaccine in Russia.

There's also mRNA vaccines, like the Moderna and the Pfizer vaccines. When you get one of these, a bit of mRNA - a form of genetic code - is shot into your arm. Like with the adenovirus vaccine, your cells read these genetic instructions to create the same protein from the coronavirus. Again this triggers a really strong immune response, it's totally harmless.

Gemma: OK, and are there any other technologies being used?

Dan: There are a ton of different things being tried, but the ones I explained just now are the ones that have been approved so far.

Gemma: OK so we've got all these different types of vaccine but how are they actually made?

Dan: So I actually spoke with someone who really helped explain how vaccines are manufactured.

Anne Moore: My name is Dr Anne Moore and my research interests are in vaccines.

Dan: Anne is a Senior Lecturer in Biochemistry and Cell Biology at University College Cork in Ireland. She first explained how adenovirus vaccines - like the Oxford/Astrazeneca vaccine - are manufactured.

Anne: So what you do, say for adenovirus, you would take some of your master virus, and you would infect some cells, some very special cells that you understand all of the attributes about those cells. And you grow those up. The virus will infect the cells and produce more virus. And then you've enough cells in there where you have this bulking up a virus over the course of a few days, and this will be in anywhere from four litres of cell culture up to higher volumes, maybe 20, 30 litres.

And then you have what we call downstream processing then where you're purifying the virus vaccine away from all of the other components that you're not interested in. That can be a very, very difficult process. So even though it only takes a few days to grow a batch of virus. It can take a long time to not just to purify, but also to prove that it is pure and it is sterile and it is what you say it is.

Dan: So what about the genetic material vaccines?

Anne: It's much more synthetic. You don't have any cells, so you don't need any vats to grow anything in. The synthesiser is chemically conjugating one nucleic acid onto the next one in the right sequence.

Dan: That sounds almost more assembly line-like where the other one is much more staged?

Anne: Yeah, I guess we call that continuous versus batch manufacturing. So the kind of move in industry is to go down this more continuous method where it is, as you say, an assembly line.

Read more: How are COVID-19 vaccines made? An expert explains

Dan: How many vaccines can one facility make at a time. And where are we at right now as far as output?

Anne: I suppose thinking about one facility making the vaccine from start to finish is a little bit untrue, because classically in the pharma industry, you would have different facilities doing a different part of the job.

I guess, constraints at the moment is more about actually getting your hands on the materials that you need to make the final product. Everything has many moving parts and that is becoming a constraint in manufacturing now because there is a big demand to make as many vaccines as quickly as possible.

Dan: Is the pace something that you are happy with?

Anne: I think, you know, considering this virus only emerged in November 2019, we are doing incredibly well, if you look back and say we actually even have a vaccine and we have almost half a dozen licensed at this stage is an incredible achievement. It kind of comes down to commerce. We didn't have any buffer in the system in the sense that there was no spare capacity. And there was a recognition that that was needed because a pandemic would happen, but nobody was actually willing to support it.

Nature abhors a vacuum and pharma abhors an empty facility, you know, nobody's going to leave something empty just in case pandemic happens.

So I think it is a huge global scramble to rededicate facilities to a coronavirus vaccine to upskill employees, to get more employees in, to actually do the work. And I think there will be an inflection point where these facilities that are now being kitted out will come on stream and will be then pumping out millions more vaccine doses than we're seeing at the moment.

Gemma: So Dan it sounds like Anne is saying good job so far everyone, but the world could have perhaps prepared a bit better.

Dan: Yeah, absolutely and I guess that's a major lesson from this pandemic too. But she touched on a hugely important part of the story here: economics. The fact that these vaccines are being produced by large, for-profit, pharmaceutical companies.

Anne: Who made the vast proportion of vaccines for the world.

Dan: Anne told me that there are essentially four major vaccine manufacturers in the world, and for the most part, they have their manufacturing facilities in the US and in Europe. There's a shift though happening as India is now actually the biggest vaccine manufacturer globally. They've actually got a licence to make large batches of the Oxford/Astrazeneca vaccine.

Gemma: So who is getting the coronavirus vaccines that this small number of companies are producing?

Dan: The answer to that also is basically who has the money. A bunch of different countries spent a tonne to pre-order batches of the different vaccines. And this was happening even before these vaccines were approved.

According to the Duke Global Health Innovation Center by early February 2021, the world's high-income countries had pre-ordered 4.2 billion vaccine doses, compared to a total of 670 million ordered by low-income countries. Many of the world's wealthiest countries have far more than they need to cover their entire populations.

So to find out what it's like in a part of the world where COVID vaccinations still feel very far away in the future, I called up a researcher who's actually working across west Africa to try and solve this problem.

Mosoka: My name is Mosoka P. Fallah, I'm from Liberia.

Dan: Mosoka is a lecturer at the University of Liberia in the School of Public Health, and also a part-time lecturer in Harvard's School of Public Health. He's been very involved in the research on Ebola, and consults for the company Merck as an expert on Ebola vaccine licensing. He spoke to me last week from Sierra Leone, and described the situation there.

Mosoka: I can speak from west Africa because at least I've travelled, in recent times, Libiera, Sierra Leone, I was in Burkina Faso and then I transited through Togo. Basically, what I do know for now is that there's nothing substantial towards vaccine.

Dan: He said a few countries in the region, including the small island of Cape Verde have been able to start to procuring some doses of the vaccine. But these are the exception.

Read more: COVID-19 vaccines: how and when will lower-income countries get access?

Mosoka: There's attempt by the regional body, like African Union to access the vaccine. There is minimum effort, at least I know one, from a cell phone company to procure very little vaccine but it's just a drop in the ocean. So basically Africa right now does not have any substantive way to acquire the vaccines.

Dan: Mosoka explains the reasons for this are almost entirely economic.

Mosoka: Fundamentally it's the economic costs of acquiring the vaccine. You know, As someone really involved with the outbreak, I think the African countries tried to protect themselves preemptively, but it came at an alarming cost.

Dan: The cost of the vaccines is simply prohibitive for many of these countries.

Mosoka: Most of them are heavily indebted and there are no sense that they will have any debt relief. So basically this means, from an economic point of view, they cannot afford at the current market price.

Dan: There is an ongoing multinational effort to secure vaccines for countries that can't afford them. I'm talking of course about the Covax initiative, led by the World Health Organization. The initiative wants to get 2 billion vaccine doses out to these countries in 2021.

But it's at an incredibly slow pace. Mosoka explained that many west African nations covered by the alliance are only expecting to have 3% of their populations vaccinated by mid-2021. To put that that into perspective, as of February 14, 3.9% of the entire US population had gotten both doses of a coronavirus vaccine, 11% had already had one dose.

Anne Moore explained that manufacturing a vaccine is difficult and there have been a ton of delays already. This begs an obvious question: why aren't more countries manufacturing vaccines that have already been approved, like the Moderna or Astrazeneca vaccines, for example. To understand why this is happening, we have to broach an ugly international issue. This is intellectual property rights around pharmaceuticals. To help me understand that, I called up Ronald Labonte.

Ronald: I'm a professor and have a distinguished research chair at the University of Ottawa in the School of Epidemiology and Public Health.

Dan: Ronald told me that the world has a lot of untapped vaccine manufacturing capacity.

Ronald: The annual global vaccine manufacturing capacity is estimated at somewhere between six and a half and eight and a half billion doses per year. But UNICEF probably using a larger database of potential manufacturers, estimates that in 2021, the volume of that output could be as much as 20 billion.

Meanwhile, the 2021 production run of the top three vaccines at the moment, right, the Pfizer vaccine, the Moderna, the AstraZeneca, the total manufacturing capacity that these three companies have is only 3.2 billion.

Dan: Sort of running in parallel to Covax is something called the COVID Technology Access Pool or CTAP, it's led by the World Health Organization. This is something of a information sharing club to help scale up the global production of vaccines.

Ronald: And that pool was designed to have manufacturers make their patents, their medical know-how available to all other manufacturers. Since its launch, not a single COVID-19 patent-holding company has joined CTAP. A lot of countries have that vaccine manufacturing capacity, but right now they can't access it. And interestingly half of this vaccine manufacturing potential is actually in developing countries: Argentina, Bangladesh, China, India, Brazil, Egypt, Cuba, Indonesia, Iran, Mexico, Taiwan, Thailand, South Africa.

Dan: The intellectual property system for drugs is governed by the World Trade Organization. Specifically, it's regulated by an agreement called TRIPS, which stands for the Trade-Related Aspects of Intellectual Property Rights agreement.

Ronald: And this agreement obliges all WTO member states to offer 20 years of monopoly protection on new patented products. There is a group of 35 least developed WTO member states that are still exempt from these obligations, but all the other countries that are members of the World Trade Organization have to play by these rules.

If the patent holder has a patent that applies to that particular country, that country cannot just automatically reverse engineer, try to develop a generic equivalent. It has to offer or provide or guarantee, a period of monopoly protection, during which time the company is basically able to set whatever price or whatever conditions it wants to set in access to its product. It's the only agreement in the World Trade Organization that is not liberalising, it is protecting.

Dan: The pandemic has now put this TRIPS agreement seemingly at odds with an international effort to ramp up vaccine production. This is due to be discussed on March 1 and 2 at the World Trade Organization's General Council. A number of countries are bringing up a request - first tabled in October 2020 - for a temporary waiver of the TRIPS agreement when it comes to COVID-19.

Ronald: India and South Africa, and a bunch of other countries, have formally signed on with a petition to create this waiver and over a hundred developing country member states of the World Trade Organization also support it.

So what they're arguing is that, is that in the absence of a waiver, there are too many, uh, legal obligations, too many impediments, too many cumbersome rules around the flexibilities of the TRIPS agreement that would allow, other vaccine manufacturers to very quickly scale up and produce more of the vaccines that are effective.

It would be enforced until the World Health Organization declared the global pandemic was over. In other words, that global herd immunity had been reached.

Dan: Waivers have issued for other WTO stuff, like things for bananas, for example. But there's only been one waiver for TRIPS, relating to the licensing rules around exporting generic medicines.

Ronald: So it is possible, by consensus, if all the countries agree, then yes, we have the TRIPS waiver. Or if I believe it's three quarters of the member states agree if they come and they hold a vote on that.

Dan: This path to expanding global manufacturing capacity for coronavirus vaccines - and presumably ending the pandemic faster - is being blocked by a few powerful countries.

Read more: Dummy's guide to how trade rules affect access to COVID-19 vaccines

Ronald: Australia, Brazil, Canada, the EU, Japan, Norway, Switzerland, the UK and the US oppose it, or if they don't oppose it they're saying, well, we really can't support it at this time because there's no real evidence that it's needed.

Now, the argument being made by this small handful of opposing countries, all of them, high-income countries, pretty much. Most of them already having inked a number of their own bilateral vaccine, advanced purchase agreements, so there they've taken care of themselves. Their argument is that existing TRIPS flexibilities for compulsory licenses or parallel importing is sufficient. And they also argue that patent holding companies well, they can issue voluntary licenses to other manufacturers to produce their products at negotiated prices, and indeed, many have done so with a number of other vaccine manufacturers.

Dan: But again, price limits how many places can actually afford to make a deal with the patent holders. And that's where these flexibilities built into TRIPS come into play. They could theoretically allow countries to make their own vaccines without having to deal with the pharmaceutical companies at all. But Ronald says getting these flexibilities approved is next to impossible - it's only happened once before - and it would take forever to be done on a wide enough scale as the flexibilities need to be approved on a case-by-case basis.

Ronald: What it really comes down to is that they don't want to touch the intellectual property rights regime of the TRIPS agreement, which is so profitable to the patent-holding pharmaceutical industry.

Intellectual property it's seen as one of the engines of the new kind of post-industrial economic growth. So we want our patent-holding companies to become profitable, to become rich because if they're rich, then supposedly our countries become rich. So there's a kind of a mercantilism going on here.

Dan: To Ronald, it's frustrating to see pharmaceutical companies posting big profits from coronavirus vaccines.

Ronald: The only reason the vaccines got done so quickly, wasn't because of the wonderful inventiveness and the use of intellectual property rights that the vaccine manufacturers, were able to put in place. It was because of massive, massive amount, billions and billions of dollars, in public support. And billions and billions of dollars more in advanced purchase agreements by governments that, that kind of gave the assurance of making a tonne of money at some point in time and recovering all of those costs. It wasn't because we had an intellectual property regime system.

Dan: Ronald has been advocating hard for the TRIPS waiver - including writing a few articles for The Conversation. But he admits, if the waiver passes through the WTO, the outcome are also unknown.

Ronald: Now it may mean that, or it may be that, that if the waiver were approved, that it would take a while for all of its actions to sort of begin to play out. And, it may not make the huge difference that a lot of people think it could make. But we don't know that.

We're in a global pandemic emergency. The longer we wait, the worse it's going to become, the more variants we might get. And the countries that are going to take the longest in actually being able to vaccinate their population to some sort of a kind of the national herd immunity are going to be the low-income countries.

Dan: When I asked Mosoka Fallah about what changes to IP and intellectual property rights might mean, he immediately pointed to the example of antiretroviral drugs and HIV/Aids. As soon as the IP was opened up, the price went down.

Mosoka: Once, multiple countries like Brazil and South Africa manufactured HIV, drugs, antiretroviral, we saw that the prices went down and countries could access it.

Fundamentally, in an ideal situation, if they release the IP to countries that have the capacity to manufacture, the pipeline going to increase. There's going to be more vaccines, the prices are going to be reduced.

Dan: This won't happen easily.

Mosoka: But the catch of this is that, if we allow of them to to give their IP, and there is an another outbreak tomorrow would they have incentive to do research? So the key trigger to think about is, how do we find means to meet these countries halfway, give them some funding for the R&D?

Dan: Mosoka is particularly incensed by the vaccine nationalism surrounding COVID, because it is so different from what he saw during the Ebola crisis. Today, there a shared pool of Ebola vaccines, ready and waiting to stop any outbreak no matter where it happens.

Mosoka: So that within 24 hours, where there is an Ebola outbreak, you can make a request that the vaccine can go to that country, irrespective of their ability to pay. So that's a very good arrangement.

Dan: Towards the end of our conversation, Mosoka relayed to me a teaching, from his close friend and collaborator, the late Swedish epidemiologist, Hans Rosling.

Mosoka: And one morning, he said to me: "Mosoka, keep this in your mind. Everything you do in Liberia you are protecting Washington DC and London. If you don't do a good job in Liberia, London and DC are vulnerable."

Dan: The is as true for COVID as it is for Ebola.

Mosoka is part of a group of scientists working on a joint letter advocating for more equitable access to COVID vaccines. There are two main actions they plan to push for. First, more funding for the Covax alliance. This would help the group buy more vaccines for countries that can't afford them. Second, that intellectual property rights be relaxed or waived.

Finally, Mosoka argues that richer countries, should simply give vaccines to poorer places. This isn't even an ethical argument, it's actually just the safest thing to do for everyone on earth.

Mosoka: And so at some point in time, if you vaccinated, say, 50% or 60% of the rich population, then you begin to do to share with others because even from a protective point of view, from a selfish point of view, if you don't protect us, you are at risk because there is mutation happening. And so we are trying to propose potential alternatives. We're not saying give 100%, can you give 10%? But for your own survival, try to share some of that vaccine.

Gemma: He makes a compelling argument doesn't he?

Dan: He really does, not only from the ethics, but just the broader public health argument. Like, if your neighbours' house is burning down, not only should you save them because, I don't know, maybe it's the nice thing and the right thing to do, but also because it's gonna burn your house down too.

If you're interested in reading more about vaccine manufacturing, vaccine nationalism and the intellectual property rights around vaccines, you can read stories by Ronald Labonte, Mosoka Fallah and Anne Moore on The Conversation. The links to their stories, and plenty of other further reading by experts, are in the show notes.

Gemma: Right, so for our next story we're going to hear about an important shift that's happening in China. So Dan, what do you think when I say the words "coal and China".

Dan: Well, I imagine China's burning a lot of it. And because its coal, it's just spewing tonnes of pollution out into the atmosphere. Am I far off the mark there, Gemma?

Gemma: No, you are right. In fact, China is still the world's biggest producer and consumer of coal, by a large margin. But there's a change underway, and China is closing down some of its coal power stations.

Dan: Well that's gotta be good. Is it for environomental reasons, or what's going on?

Gemma: You'd think so but actually the reasons aren't just about the environment, and they're a lot more complex than that. So to find out more, I spoke to a researcher who has just published a study on what's happening.

Hao Tan: My name is Hao Tan and I'm a researcher with Newcastle Business School within the University of Newcastle in Australia. My research is focused on energy transitions, especially that in China and its global implications.

Gemma: So Hao could you set the scene for us? How much coal does China use every year?

Hao: China is the largest coal user in the world. In 2019, China consumed about 53% of the coal produced in the world. In 2020, this share could even go higher because the country's economy has had rapid recovery from the pandemic since early 2020, where all the major economies are still struggling with restriction to economic activities.

Gemma: Ok. So biggest consumer of coal, and I think the biggest producer of coal as well?

Hao: Exactly. China is also the largest coal producer in the world, yes, you're right. So it's not surprising that the majority of the coal used in China is from domestic sources. In 2019, about 90% of the coal used in China was domestically reproduced and the rest was imported from overseas.

Gemma: Why? What is this coal being used for?

Hao: About half of the coal is for power generation. So right now China has about half of the coal power stations in the world.

Gemma: But it's also used for industry?

Hao: Yeah, for steel making, for heating, a range of purposes.

Gemma: When it does use coal from outside of the country, where does that coal come from?

Hao: Indonesia, Australia, Mongolia and Russia. So coal from those four countries account for over 90% of the coal imports of China.

Gemma: And in terms of domestic coal, is it coming from all over the country or are there particular parts of China, which are the biggest coal producers?

Hao: The majority of the coal produced in China actually is from western China. Eastern China used to produce a coal, but they are no longer producing coal anymore.

Gemma: So you've set out to picture here where China is the world's biggest producer and consumer of coal, but it's got plans to change that, hasn't it? It's trying to shift away.

Hao: Yes, so China, as we know, has recently announced its commitment to zero emissions by 2060. I think to achieve this goal, it has to radically reduce the coal use in the country.

Gemma: Let's turn now to talking about your research. Could you explain what the most recent research you've done on coal power stations has been in China?

Hao: This is a part of an ongoing project funded by the Australian Research Council. In this project, my colleagues from UNSW and Macquarie University and myself, look into the energy transitions in east Asian countries and particularly the role governments play in those transitions. And in this research project we look into not only the rise of renewable energy industries, but also the dynamics of traditional energy industries, such as coal.

Gemma: And what did you find? How many coal power stations have been closed?

Hao: So between 2010 and 2019, a total of 291 coal-power generation units had been decommissioned in China, accounting for 37 gigawatts of capacity. For context, currently there's 50 gigawatts of power generation capacity in operation in Australia.

Gemma: And what share of the overall coal power generation was that?

Hao: Right now it's still a small share in terms of the total coal power generation capacity in China. China currently has over 1,000 gigawatts of coal power generation capacity.

Gemma: So it's a small amount, but it's happening at a faster rate than it used to?

Hao: Yes, yes. And, more interestingly, we found that in more economically advanced regions, the closures have been more substantial and more rapid. For example, take Guangdong province, a relatively developed region June in China.

Gemma: That's in the east?

Hao: That's right. This is one of the 30 provinces in China but, since 2015, coal power capacity retired in this province accounted for over 10% of the total coal power capacity retired in the country. Meanwhile, we see that the new power stations are still being built, particularly in poorer western provinces in China. In fact, since 2015 and 2019, the total coal power capacity of the country increased, by about 18%.

Gemma: Ok, so it's a complex picture there that you're painting, isn't it? That there are power stations closing, but there are others opening. So in the areas where you did see them closing, can you explain a bit about why?

Hao: We found that, while in other countries, climate change is probably the main cause of, closures of coal power plants, a distinctive feature in China is that closure of coal plant stations there largely follow a developmental logic. By developmental logic, we refer to the local government's ambitions to replace many energy- and pollution-intensive industries with industries based on more value-added activities, such as advanced manufacturing and services.

Gemma: And the land is very valuable, I imagine?

Hao: Yes, especially in those rich regions land has become very expensive. So that becomes a economic incentive for the closures of power plants.

Gemma: And what does that mean for those countries you mentioned at the beginning, who export a lot of coal to China?

Hao: If we're talking about countries like Australia and Indonesia, an advantage of their coal exports is that they can actually transport the coal to China's coastal regions with relatively cheaper transportation costs. But with this geographic redistribution of the coal power capacity, I think the prospect of coal exports from these countries to China is a bit gloomy in the future.

Gemma: I think particularly with Australia, there's real trade tensions with coal at the centre of them?

Hao: Yes, in the middle of 2020, China has imposed an unofficial ban to Australian coal exports to China. And ships of coal have not been able to unload it to Chinese ports. So in December, the coal exports to China, for example, from Australia has completely stopped.

Gemma: How does this shift that you're seeing in China fit into a wider pattern of energy transition, which, you know, you said at the beginning that you study the wider region?

Hao: So those countries race to develop new carbon energy technologies is not just about climate change. It's probably more to do with growing internationally competitive industries. This reflects the strong tradition of the development state in those countries, where governments have the resources and motives, to directly support a creation, transformation and growth of new industries.

Gemma: So what you're saying is that while there's an overall kind of concern about climate change and a need to shift away from coal, that actually it's more economic drivers that are the reason behind the closures in eastern China. Is that, is that what you're saying?

Hao: Yes. You can say that. Yes.

Gemma: And what do you think about this 2060 net zero emissions target? Do you think it's achievable in the timeframe?

Hao: I think we still need to see more evidence to assess whether this commitment is achievable and whether the Chinese government is serious about that. I think two immediate indications include, first, the coming 14th five-years plan, which is going to be released by the Chinese government very soon. And second, whether the trend of emissions - so as we know, into 2013, actually the emissions in China has declined between 2013 and 2017. But unfortunately in recent years, that emission has picked up again. So we will look very closely whether that trend can be reversed.

Gemma: Well thank you very much Hao, it's been fascinating talking to you, and I appreciate you explaining your research to us.

Hao: Thank you Gemma.

Gemma: If you want to read more about this, you can find a link to a story that Hao Tan wrote recently with some of his colleagues, in the show notes.

Dan: To finish off this episode we've got a few recommendations sent in via voicemail from our colleague Clea Chakraverty, politics and society editor at The Conversation in France.

Clea Chakraverty: Hi everyone. I'm Clea Chakraverty, politics and society editor from the The Conversation France.

This week I would like to discuss a very sensitive topic that is shaking France at the moment. At the beginning of January 2021, lawyer Camille Kouchner published a book called La Familia Grande in which she reveals how her father in law sexually abused her twin brother when they were teenagers. The book triggered a huge outcry as the man she accused is a well-known academic and is close to various elite circles in France.

The book also broke the taboos around incest, child abuse and abusers in a new way. Following its release, thousands of French people came out with stories of incest and abuse with the #Metooincest.

As historian Anne-Claude Ambroise Rendu from Universite Versailles St Quentin wrote for The Conversation in French, incest and child abuse are quite common within families, but they are too often silenced.

Recent data published by a team of researchers from INED, also for The Conversation, back her claim: in France one woman out of 10 has faced sexual abuse while growing up, whether from outside her family or within.

This week authorities are discussing a possible revision of the law surrounding sexual abuse of minors. The reckoning for this historic abuse has only just started. Thanks so much for listening.

Gemma: Clea Chakraverty there from The Conversation in France.

Dan: Alrighty, that's it for this episode of The Conversation Weekly. Thank you to all of the academics we've spoken to in this episode.

Gemma: And thanks to The Conversation editors Nicole Hasham, Caroline Southey, Moina Spooner and Clea Chakraverty.

Dan: You can find links to all of the expert analysis we've mentioned in this week's episode in the show notes. Or head to TheConversation.com, where you can sign up to get a free daily email by clicking "Get newsletter" at the top of the homepage. I promise you, it's actually a good newsletter.

Gemma: This episode is co-produced by Mend Mariwany and me, with sound design by Eloise Stevens. Our theme music is by Neeta Sarl. Final thanks also to Alice Mason, Scott White and Imriel Morgan.

Dan: And one final thing, if you like this podcast, please tell your friends about us and go please give us a review on Apple Podcasts - it really does help!

Gemma: Thanks for listening, until next week.

Authors: Daniel Merino - Assistant Editor: Science, Health, Environment | Gemma Ware - Editor and Co-Host, The Conversation Weekly Podcast | Anne Moore - Senior Lecturer in Biochemistry and Cell Biology, University College Cork | Hao Tan - Associate Professor, Newcastle Business School, University of Newcastle | Mosoka Fallah - Part-time lecturer at the Global Health & Social Medicine, Harvard Medical School, and Lecturer at the School of Public Health, College of Health Sciences, University of Liberia | Ronald Labonte - Professor and Distinguished Research Chair, Globalization and Health Equity, LUniversit dOttawa/University of Ottawa The Conversation

More Beijing News

Access More

Sign up for Beijing News

a daily newsletter full of things to discuss over drinks.and the great thing is that it's on the house!