Putting big pharma in charge of global vaccine rollout was a big mistake | Nick Dearden

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Pfizer had an exceptionally good pandemic. Today he announced that his Covid-19 vaccine made $37 billion last year, making it easily the highest-grossing drug in any given year in history.

That’s not all. For a company that was until recently the most unreliable industrial sector company in the United States, Covid-19 has been a public relations coup. Pfizer has become a household name over the past 12 months. The company has been grilled at parties in Tel Aviv, and there are cocktails bearing the name of its vaccine in bars around the world. The US president called Pfizer chief executive Albert Bourla a “good friend”, and the big man parked his jet next to Boris Johnson’s during last year’s G7 summit in Cornwall.

The global rollout of the vaccine has created levels of inequality so great that many are calling it “vaccine apartheid.” Pharmaceutical companies like Pfizer have led this rollout, setting the terms under which they sell the vaccines and deciding who to prioritize. Ultimately, their approach affects who gets and doesn’t get vaccines.

From the start, Pfizer made it clear that it wanted to make big bucks from Covid. The company says its vaccine costs just under £5 per dose to produce. Others have suggested it could be much cheaper. Either way, the company is selling shots at a huge profit – the UK government paid £18 per shot for its first order, £22 for its most recent purchase. It means the NHS has paid a premium of at least £2billion, six times the cost of the pay rise the government agreed to give nurses last year.

It has been claimed that the company initially tried to pitch its drug to the US government for an exorbitant price of $100 a dose. Tom Frieden, a former director of the US Centers for Disease Control and Prevention, accused the firm of “war profiteering”.

Pfizer sold the vast majority of its doses to the world’s wealthiest countries – a sure strategy to keep its profits high. If you look at its global distribution, Pfizer sells a tiny fraction of its vaccines to low-income countries. Last October, Pfizer sold a measly 1.3% of its supply to Covax, the international body set up to try to ensure fairer access to vaccines.

Pfizer did not sell many doses to poorer countries, but also did not allow them to produce the lifesaving vaccine themselves, through licensing or patent sharing.

Indeed, at the base of the Pfizer model, there is a set of intellectual property rules, set out in trade agreements. These effectively allow big pharma to operate as monopolies, with no accountability to share the knowledge they possess, even if society needs it.

Early on, the World Health Organization (WHO) recognized that we would need to ramp up production very quickly – and that individual companies like Pfizer simply wouldn’t have the capacity. They urged companies to share vaccine recipes, creating a sort of “patent pool” known as CTAP, which would have enabled openness and collaboration. Companies would still have been paid, but they could not restrict production.

This kind of suspension of normal trade rules in times of great need was previously common, as with penicillin during World War II, or smallpox vaccine knowledge sharing in the 1960s.

But in this case, the Pfizer chief went on the offensive, calling CTAP “nonsense” – and saying it was “dangerous” to share companies’ intellectual property. It has been claimed that 100 factories and laboratories around the world could have made vaccines, but were unable to do so because they cannot access patents and recipes like those held by Pfizer.

Pfizer has taken a similar line on the new facility that has been set up in South Africa to try to learn about mRNA vaccines so it can share this breakthrough medical technology with the world. Because neither Pfizer nor Moderna will share their know-how, the scientists had to start from scratch. News from last week suggests they are getting there, belying claims by the pharmaceutical industry that it is impossible to manufacture such a vaccine in poorer countries.

Many will say that even if Big Pharma behaves ruthlessly, we have to accept it because the service they provide – inventing life-saving drugs – is so crucial. But that doesn’t hold. Companies like Pfizer behave more like hedge funds, buying and controlling other businesses and intellectual property, rather than traditional medical research companies.

The truth is that they are not the only inventors of the vaccine. It was the work of public money, university research and a much smaller company, the German BioNTech. As a former US government official complained, our calling it the “Pfizer” vaccine is “the biggest marketing stunt in the history of US pharmaceuticals.”

A 2018 Stat News analysis concluded that Pfizer only develops a fraction — about 23% — of its drugs in-house. And a US Government Accountability Office report from the previous year noted that the industry model is increasingly one of simply buying up small companies that have already developed products. This allows them to monopolize this knowledge and maximize the price of the resulting drugs. Pfizer has funneled $70bn (£52bn) to its shareholders, directly through dividend payouts and share buybacks. This dwarfs its research budget for the same period.

To put today’s numbers into context, the world’s top-grossing drug in a single year so far was Humira, which treats autoimmune diseases, and which made its owner, AbbVie, $20 billion. dollars in 2018. Humira was studied by a US congressional committee, and is a classic case of how big pharma operates today: buying a drug that has already been invented, patenting it all the way, and increase the price by 470% over its lifetime.

Companies like Pfizer should never have been tasked with a global vaccine rollout because it was inevitable that they would make life-and-death decisions based on what is in the short-term interests of their shareholders. We must dismantle the monopolies that have given such power to these financialized beasts and invest instead in a new network of research institutes and medical factories around the world that can truly serve the public.

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