As country after country adjusts to life in lockdown, the only real exit strategy to this pandemic and its associated social and economic impacts, is the discovery of a vaccine. There are already reports of promising candidates in the pipeline as well the start of human trials. And this progress is largely thanks to public investment in biomedical research and development (R&D).
The UK has so far committed a total of £250 million towards the R&D for a Covid-19 vaccine – the single largest contribution from any country to the global vaccines research programme. But there is a real danger that, without effective safeguards, big pharmaceutical firms could profiteer from price gouging which would prevent widespread access to coronavirus treatments and threaten the world’s ability to stop the spread of this pandemic.
Public funding already plays a significant role in vaccine development because Big Pharma has long viewed vaccines as an uncertain commercial prospect. Developing vaccines for infectious diseases like coronavirus can take several years by which time the crisis may have passed and with it the demand for the vaccine. And so it is seen as a costly risk for Big Pharma to undertake especially as the industry’s main priority is profit and not public health.
Historically and controversially, vaccine projects have been abandoned because of the absence of financial incentive – and this has had deadly consequences. An Ebola vaccine breakthrough was left on the shelf years before the epidemic broke out in 2014. But with no further investment to test or produce the vaccine, there was no vaccine available during the outbreak and over 11,000 people were killed from Ebola.
In 2016 US public investment led to a potential SARS vaccine. The genome of SARS has an 86% similarity with Covid-19 and therefore could have been a potential coronavirus vaccine. The SARS vaccine showed promise in early tests but then all commercial interest fell away as SARS was no longer a public health threat and so there was no more investment for clinical trials or getting the vaccine to market. One of the leading scientists on this discovery gave testimony in congress in March 2020 where he said: “We could have had this ready to go and been testing the vaccine’s efficacy at the start of this new outbreak in China.”
The pharmaceutical industry is not been fit for purpose during normal times let alone times of global public health crisis. Instead of investing in public health priorities such as vaccines for infectious diseases, new antibiotics to tackle antimicrobial resistance and treatments for conditions that affect communities in the Global South, Big Pharma investment decisions are based on the areas of greatest profitability. This is why investment is directed towards developing drugs for chronic diseases and modifying existing drugs with no additional health benefit. It has also been reported that Big Pharma spends more on financialised practices such as buying back their own shares than they do on R&D. This helps to raise their share value but is not actual investment in health innovation.
Since the Covid-19 outbreak, some pharmaceutical companies have entered the race to find a vaccine but largely in partnership with public researchers and with public funding. In spite of millions in taxpayer money going towards vaccines, there are no guarantees that any final vaccine will be available for all. New discoveries are patented by pharmaceutical companies that conduct later stage drug development on publicly-funded inventions. Patents provide a minimum 20 year monopoly protection during which no other company can make or sell that drug. With no competition, companies holding patented products are able to charge eye-watering prices.
Just last week the US company, Gilead tried to shamelessly classify its experimental drug that could be a potential treatment for Covid-19, Remdesivir, as an ‘orphan drug’ in the US. This classification is reserved for drugs that are used to treat rare diseases and comes with a further seven-year monopoly period. Covid-19 is, of course, the opposite of a rare disease and so this was a blatant attempt to abuse the system. The drug itself had been developed based on US government-funded research. In response to a wave of public backlash, Gilead rescinded the orphan drug status within days – but it illustrates where Big Pharma’s instincts lie in terms of profiteering even during a global pandemic.
The government needs to take active steps to ensure that public investment benefits global public health rather than allowing Big Pharma to socialise the risks and privatise the rewards. The government needs to impose strict conditions on all public funding towards Covid-19 treatments and vaccines to ensure any final product is affordable and accessible to all. This can be done by stipulating that any new discovery is openly licensed to ensure that no one company can monopolise supply.
More widely, the UK government also needs to back a recent proposal by the Costa Rican government for the WHO to set up a global pooling mechanism for rights to health technologies as well as the related data and research. All technologies and research data in this pool would then be openly available and accessible to any government or researcher to ensure that there is global co-ordination to tackle this pandemic together. It’s an internationalist solution for a global pandemic that secures equitable access to much-needed treatments and vaccines for all.
This is the time for all countries to come together and take active steps to put public health ahead of corporate profiteering. It is uncertain how sustainable social distancing and lockdown measures will be over a longer period of time as well as the impact of the associated social and economic disruption. As with other parts of the economy, governments cannot afford to sit back and hope for the best – the time to intervene to ensure a Covid-19 vaccine is available for all is now.