As the Covid-19 pandemic rages across America and the world, scientists are working to develop a safe, effective vaccine. But developing a vaccine is only the first step. Just as important is making sure that the vaccine is mass produced and made available to everyone at no cost.
The only way that can happen is if we cut big pharma corporations out of the process. We need to return to what worked in the past: “The so-called golden age of U.S. vaccine R&D,” a public program of vaccine development and production driven by public health imperatives, not private profit. All told the US taxpayer, “played a significant role in developing more than half of all the vaccines invented last century, including 18 of 28 vaccines for preventable diseases. Vaccines for flu, measles, and rubella are only the most famous.”
Under our current profit-driven pharmaceutical paradigm, vaccines for infectious diseases simply do not offer the kind of return on investment that big pharma corporations believe they deserve. Most major pharmaceutical companies have already pulled out of vaccine development altogether. The shift was a direct response to the movement away from a public vaccine program to a private profit driven system.
"The business model of the pharmaceutical industry is to use their monopoly power to charge outrageous prices so they can make outrageous profits. Instead of prioritizing public health, they are driven by a singular goal: Picking our pockets and stealing our money."In 1967, dozens of U.S. companies had vaccine research departments and manufacturing capabilities. The administration of Richard Nixon accelerated the trend of privatization and by 1979 that number had fallen to single digits. That year the Office of Technology Assessment tried to raise an alarm with a report that concluded, “The apparently diminishing commitment—and possibly capacity—of the American pharmaceutical industry to research, develop, and produce vaccines may… be reaching levels of real concern.”
What’s left is a highly consolidated and non-competitive oligopoly of vaccine producers—and none of them have the capacity to produce a coronavirus vaccine at scale.
Despite that, current U.S. policy presumes that these corporate actors are the only ones capable of bringing vaccines to market. But there are many historical examples to the contrary.
During World War II and its aftermath, the U.S. military entered into partnerships with industry and academia to develop vaccines. This joint effort generated innovation that lasted long after the end of the war. As it turned out, many of the obstacles to vaccine production were not scientific, but organizational.
Because of World War II, basic concepts for many vaccines which scientists had developed years prior were lifted from the laboratory and turned into working vaccines. A newly formed flu commission was part of a broader network of federally-run vaccine development programs. While it can take eight to fifteen years on average to develop a new vaccine today, the commission gained FDA approval for their vaccine in less than two years.
“At the time intellectual property protections were less of a barrier to information sharing than they are today. Without these restrictions teams were able to consolidate and apply existing knowledge at a rapid rate,” according to historian Kendall Hoyt. Summarizing the situation, Hoyt notes that a “cooperative, duty-driven approach to vaccine development persisted into the postwar era, even after the urgency and structure of wartime programs dissolved. This contributed to high rates of vaccine innovation through the middle of the 20th century.”
Today? The pharmaceutical industry takes research and development funded by taxpayers, and then charges Americans the highest prices in the world. Taxpayers have already spent $13 billion on the development of coronavirus treatment and vaccines. And that number continues to climb, as tracked by Public Citizen’s excellent tracking resource. The last thing we should do is give away our hard paid research and capacity to a pharmaceutical corporation so they can price gouge us on a vaccine that we’ve already paid for.
The business model of the pharmaceutical industry is to use their monopoly power to charge outrageous prices so they can make outrageous profits. Instead of prioritizing public health, they are driven by a singular goal: Picking our pockets and stealing our money.
It is also not only a question of “fairness,” although it is entirely unfair for the American taxpayer to pay twice, it is a question of capacity and competency. The so-called golden age of vaccine development did not come about from bleeding heart sympathies. It was a necessity following the absolute carnage and devastation of the 1918 pandemic influenza that killed 675,000 Americans and at least 50 million people worldwide. There is no private entity that can manufacture and distribute a global vaccine to match a pandemic’s scale.
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Even with tens of billions of dollars of taxpayer money, there is no way a single company can produce enough vaccine to arrest a global pandemic that has already infected 28 million people and killed 900,000 of those. Rather than competition between a limited number of firms, we need cooperation across the whole sector.
Public ownership of the sector would allow us to leverage the full force of the industry to rapidly scale up development and production in times of crisis—like we face now. In fact, no country on its own could deploy a vaccine globally to arrest and reverse the pandemic. It is only through global cooperation that we can arrest and reverse a global pandemic.
We need public ownership of the vaccine industry right away. Public ownership is inherently flexible, and therefore public firms can be designed to meet specific public needs. Free from the structural constraints of profit-maximization, public vaccine institutes could be created with a different bottom line: public health.
It’s only in modern times we have pretended that private industry has had the ability to deliver public health goods. The pharmaceutical industry spends more money on stock buybacks and marketing than it does on research and development—money that, in the public sector, could be reinvested into R&D and accelerating the development of life-saving vaccines. Big Pharma's boardrooms are making decisions only based on profits, not public health. And the money they don’t put in their own pockets, they put in politicians’ pockets to corrupt the entire field away from public health towards private profit.
Vaccines are not market goods. Preventing a pandemic is not actually profitable for a pharmaceutical company. Vaccine development is a task that, historically, the government is much better at accomplishing. We must learn from that history and reclaim vaccines for the public.
If we allow private industry to direct the Covid-19 vaccine distribution, they will withhold access by enforcing their intellectual property rights (gained through government action). That’s how the pharmaceutical industry gets the high prices they crave. And even if the US were to craft a law to force a company to not withhold access, no company has the manufacturing or logistical capacity to deploy a vaccine on a global scale needed to protect the 7.8 billion people around the world. Borders are meaningless to a virus, and as the world has “shrunk” through global travel, transit and interconnectedness, as long as the virus can flourish somewhere, everywhere will be at risk.
Unfortunately, the current policy of the Trump administration is written by the pharmaceutical industry and the nationalist foot soldiers who care only about profits and themselves. With no care or understanding of public health and what it takes to arrest and reverse a pandemic, the U.S. is currently leading the effort against coordination.
Only by taking the vaccine industry into full public ownership, with small “d” democratic controls in place, can we provide an internationalized response to this and future pandemics that properly recognizes vaccines as a global public good.
Vaccines developed in the public sector could be licensed through a global pool—or developed and marketed without patents altogether—so that they are available to all, ensuring the prompt and equitable access necessary for coherent public health interventions. A federal vaccine development agency could break with industry’s tradition of secrecy and commit itself to data sharing, accelerating innovation around the world.
This op-ed is part of an ongoing series on public medicines. View the first in the series here, the second here, and the third here.