In 1917, the US Bureau of Animal Industry was worried about a mysterious cattle infection killing unborn calves. It realized that a cow that had an abortion was highly likely to become immune to it, calves born and raised in such an affected herd had tolerance of the disease, and so the phrase ‘herd immunity’ took birth. As the covid pandemic engulfs the world in wave after tsunamic wave of sickness and death, the only light at the end of this tunnel seems to be humans achieving vaccine-induced herd immunity. The rapid development of covid vaccines has been the biggest triumph of science in recent times. A combination of fundamental research in mRNA, the marvel of gene sequencing and the instant availability of data off the internet gave the world a new kind of vaccine within a year of the disease’s global outbreak.
But even as the world strives for elusive immunity, the question of how to vaccinate almost 8 billion people as rapidly as possible has not yet been answered. There are multiple obstacles to vaccinating the proportion of our population needed to achieve herd immunity: the production of enough doses, their logistics and transportation, and affordability. Good protocols on who needs to be immunized earlier and systems to track the vaccinated need to be created. Privacy issues around health records and demographic identity need to be addressed. Often, social and religion-based resistance needs to be overcome, and people need an incentive to be vaccinated. Additionally, it is not enough to vaccinate an entire country, or even an entire continent. Viruses mutate rapidly and cross oceans with remarkable ease.
A lot is being done, though in a haphazard manner. The much-hyped CoWin app in India often has glitches. In the US, paper-based records are being used. Many countries are not even bothering with a mechanism. For those who are, the mechanisms are centralized, and while this has its benefits, the virus behaves in a distributed and decentralized manner. Central command-and-control has constrained our ability to react to the pandemic in a timely manner and held back the creation of local and flexible systems.
This crisis is an opportunity to build a decentralized, robust and scalable track-and-trace backbone for this pandemic and those that will inevitably follow. It is possible to combine digitization, decentralization, data localization and data privacy to build an agile and responsible health management ecosystem that is inclusive of institutions and citizens. A technology that could aid this is blockchain. One way to describe it is as a digital, secure and public record book of transactions. It is a universal ledger in the cloud with strong cryptological protections that is distributed among various parties, and updated by the consensus of a majority of participants. A blockchain enables a high-trust environment through transparency, security and immutability, and also decentralization through distributed ownership and a consensus mechanism for decision-making. It can impact every industry, but healthcare could benefit the most.
Among its promising use-cases, it can improve how companies track vaccines and medicines, and also provide people with a secure and private digital health record. This backbone can also enable counterfeit-resistant ‘vaccination passports’ in a more transparent, safe and open manner, without compromising personal data.
A blockchain-based backbone can provide for bullet-proof safety of data, so that personal health records belong only to the person concerned and can be shared only with her explicit consent. It will be virtually non-hackable. A private-public consensus mechanism could prevent the misuse of data by any central authority.
Another exciting use-case is how a cryptocurrency can be linked with this blockchain, which could then be used as an incentive for people to vaccinate themselves. A crypto could be used to ‘buy’ other health benefits or for vaccine donations to the poor. The technology building blocks exist. A startup called ODE Holdings, for instance, has an application that stores data in a secure data vault and allows people to own, control and share it by consent while upholding digital freedom and privacy.
Blockchain can be a life-changing technology, though it’s sometimes like a hammer looking for a nail. If this technology can nail our vaccination and vaccine passport problem and help us achieve herd immunity, it would indeed change the world. The best time to start something like this was yesterday. But the next best time is now.
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