Covid-19: Big Pharma and the search for the vaccine

This article is featured in Issue 2 of Rupture magazine which will be on sale soon at Rupture.ie

A second wave of the Coronavirus pandemic is sweeping across the world with countries recording record daily case numbers and the World Health Organisation (WHO) warning that the death toll could be much higher than during the first wave earlier this year. Many countries that had emerged from stringent lockdowns over the summer months have reimposed restrictions for the same reasons they did earlier in the year, namely, to protect already stretched public health systems.

In much of the advanced capitalist countries, the political class has decided to put all of its eggs into the basket of vaccine development rather than adopting a Zero Covid elimination approach which would require massive state investment in healthcare and hamper the profit-making abilities of big business. For billions of people across the globe this means that all our futures are tied in with the development of a vaccine.

Public health versus private profits

Testifying before a US Senate Public Health Committee meeting, Dr. Peter Hotez of the Center for Vaccine Control in Texas commented that unless health research and development funding changes, we will continue to be “fighting these outbreaks with one hand tied behind our backs”.

Hotez and his research team spent over a decade studying SARS (Severe Acute Respiratory Syndrome) in China and MERS (Middle-East Respiratory Syndrome), two diseases from the coronavirus family which had the potential to become global pandemics but were regionally contained. He believes they developed a vaccine against these diseases which could potentially be further developed to provide cross-protection against Covid-19. However, the vaccine has been sitting in a refrigerator for over four years because funding to continue their research dried up.

Once the diseases had been regionally contained and the opportunity to make massive profits disappeared with it, there was no incentive for major companies to continue to invest in the research despite the potential public health benefits such medical knowledge may accrue. Small groups of people on the boards of Big Pharma decided to tie one hand behind our backs because it was more profitable for them.[1]

There is no guarantee Hotez’s vaccine would have worked, or indeed that a successful one will ever be developed – there are currently over 200 vaccines candidates in development with, at this stage, 11 in Phase 3 large-scale human trials. This is the stage when most vaccines fail. But this example demonstrates that public health research and product development is not best served through private ownership by Big Pharma of research, production and distribution.

Big Pharma looking for another big payday

For Big Pharma, the old adage of ‘never let a crisis go to waste’ holds true. Despite the human suffering caused by Covid-19, the worse the crisis gets, the more lucrative the potential payoff for them. At the end of the day, like any other private company, they are balance sheet managers interested only in what can produce the greatest profit, they just happen to make pills and medicines. Improving people’s health is not the goal, just a route to it.

The pharmaceutical industry is estimated to be worth over €1.2 trillion a year and is dominated by a relatively small number of companies such as Eli Lilly, Johnson & Johnson, Pfizer, Abbvie and Merck, many of whom are based in Ireland.[2]

Currently, these companies and others are in a ‘race’ to find a vaccine – but the race isn’t against the disease, it is against each other to develop one first. The madness of this approach means that teams of scientists are working separately rather than together – locking their potentially life-saving research and discoveries away from each other to protect the potential profits of their bosses while the disease rages on. Any vaccine or treatment developed will be patented and become the Intellectual Property of the company to profit from.

To demonstrate this, we just need to look at how new potentially life-saving treatments are nothing more to them than money-spinners and ask whether a Covid vaccine will be treated any differently?

There are any number of examples of new medicines or treatments which pit public health against the private profits of Big Pharma. Recently the drug Remdesivir, produced by Gilead, was approved as a treatment for Covid-19 in the US. It costs $9 to make but is sold for $4,000 to patients. A cancer treatment Kymriah by Novartis costs €450,000 and a drug to treat Hepatitis C costs €1,000 per pill. Similar exorbitant prices are charged for drugs to treat HIV and AIDS. These astronomical prices mean patients can’t afford to get the treatment they need, and public health services such as the HSE or NHS are forced to ration the drug or select the ‘most deserving’ patients.[3]

Big Pharma argues that they need prices like this to incentivise development of new treatments, but really it’s just to boost profits. When the HSE agreed to purchase Orkambi following a public campaign by Cystic Fibrosis sufferers, the profits of producer Vertex Pharmaceutical Ireland skyrocketed by 46%.[4] The reality is that developing new research and product development isn’t really at the core of what Big Pharma does, because it is expensive and could fail.

A study by the California Institute for Health and Socio-Economic Policy found that 64 of the top 100 pharmaceutical companies spent twice as much on advertising as they did on new research, while 27 companies spent 10 times as much. This demonstrates how the pursuit of profit holds back innovation which could improve the health of people across the world. They would rather spend money advertising profitable medicines than develop new ones. Often much of their research is spent on ‘Me Too’ or ‘Evergreen’ drugs – these are already existing, profitable drugs which they make slight tweaks to so that they can extend the patent on them.[5]

Socialised risk, privatised profit

The reality is that 66% of all spending on health research is publicly funded and carried out by research teams like Dr. Hortez’s in public universities. Not all research will result in a major new find or innovation but this ‘basic research’ can advance medical knowledge and lead to innovations further down the road. However, if research is successful Big Pharma will simply buy the research, create the product and seek a patent so they have exclusive rights to profit from it.[6]

In fact, between 2010 and 2016 every new drug that was approved in the US had been funded by the state (totalling $100 billion of public money) before being patented by companies. Despite the public funding the development of the treatment or drug, once the company gets a patent the public is forced to pay again simply for access to it.[7] The risk and cost of the research is paid for by the public, while the profits only benefit the companies. A more everyday example of this process can be seen by looking at Apple and the iPhone. Most of the important parts in a smart phone were developed by public research paid for by us, Apple simply re-packaged it and has reaped the rewards.[8]

The exact same process is now underway in developing a Covid-19 vaccine. Governments around the world are engaging in public-private partnerships with Big Pharma. The public are funding the research and development of a vaccine in return for a limited number of doses or shots in return, the remainder required to vaccinate the population will be bought at market rates. In the US, ‘Operation Warp Speed’ has seen $10 billion in public funds ploughed into the development of 8 different vaccines, in the UK billions have been given to six different companies, while the EU has engaged in a similar project.

A vaccine for people not profits

Author Gerald Posner, who has written extensively about Big Pharma recently commented, “[t]o allow [pharmaceutical companies] to have this power during a pandemic is outrageous.”[9]

One of the most successful vaccines of recent decades was developed to treat Polio. During the mid-twentieth century Polio epidemics caused thousands of deaths and left tens of thousands with some form of paralysis.

In contradistinction to the approach we see adopted by states today – rather than relying on and being at the mercy of the private sector, nation-states mobilised massive resources both financial and human to research, develop and test a vaccine. When the vaccine was developed, a mass public campaign of vaccination was rolled out to attempt to eradicate the disease. Rather than having different teams of scientists ‘racing against each other’ for profits, the resources were brought together to advance human health. The vaccine, despite an estimated worth of $7 billion was not patented, with the inventor Johan Salek declaring that it was owned by “the people”.

This approach, though not perfect, is an example of an alternative to the current situation which has resulted in the development of Covid nationalism as capitalist governments have each retreated into the nation state rather than working for a co-ordinated global response.

In some ways, humanity is lucky that this pandemic is one which has a relatively low mortality rate across the population as a whole and in many cases can be treated. In this era of new pathogens and viruses – more likely to emerge because of environmental destruction – we might not be so lucky next time. A more deadly, untreatable virus could emerge resulting in tens or hundreds of millions of deaths. The warnings from this pandemic need to be taken on board, society needs to be re-organised so that the massive wealth and resources at humanity’s disposal are developed for the public good rather than the profits of major corporations.

Notes

1. Hixenbaugh, M. (2020) ‘Scientists were close to a coronavirus vaccine years ago. Then the money dried up.’ NBC News 5 March 2020.

2. Mikulic, M. (2020) ‘Global pharmaceutical industry – statistics & facts’ Statista 26 October 2020.

3. Lerner, S. (2020) ‘Big Pharma prepares to profit from the coronavirus’ The Intercept 13 March 2020.

4. Deegan, G. (2018) ‘Orkambi drug deal with HSE sends firm’s revenue soaring to €35m’ Irish Independent 03 October 2018.

5. California Nurses Association (2016) ‘RN Report: Pharma giants spend far more on marketing, sales than they do on research and development’ National Nurses United 21 October 2016.

6. Global Justice ‘Pills and Profits’ October 2020.

7. See note 3.

8. Bregman, R. (2017) ‘Look at the phone in your hand – you can thank the state for that’ The Guardian 12 July 2017.

9. See note 3.