Abstract
Governments must become active shapers of medical innovation and drive the development of critical health technologies as global health commons. The 'race' for COVID-19 vaccines is exposing the deficiencies of a business-as-usual medical innovation ecosystem driven by corporate interests, not health outcomes. Instead of bolstering collective intelligence, it relies on competition between proprietary vaccines and allows the bar on safety and efficacy to be lowered, risking people's health and undermining their trust.