Stephanie and Ben discuss who developed the vaccine; who is profiting from it; and the fight for global vaccine equity on this episode with guests David Mitchell of Patients for Affordable Drugs and Andrew Goldstein, a public hospital primary care doctor, assistant professor of medicine at NYU, activist, and organizer with the Free the Vaccine and People’s Vaccine campaigns.
Who paid to develop the COVID-19 vaccines? Primarily taxpayers. David gives us a history lesson: before the COVID-19 pandemic, the Federal government invested $17 billion in vaccine technology because drug companies weren’t investing in this high-risk, low-return research. When the COVID-19 pandemic hit, these vaccine technologies were ready to be tested. Taxpayers invested another $20 billion in clinical trials, creating production capability, and pre-ordering the product. We took the risk out of the endeavor for the pharmaceutical companies. (We socialize the risk, and privatize the profit.)
Are there strings attached to taxpayer dollars for pharmaceutical development? Not really. David explains that the National Institutes of Health contributed to every new drug approved by the FDA in the US between 2010-2019. NIH is the single largest medical research agency in the world. When the drugs are ready for commercialization, they turn the intellectual property (IP) over to pharmaceutical companies with no strings attached. The drug companies can set any prices they want. (For an example, see the new Alzheimers drug from Biogen, that will cost $56,000 a year.)
In the case of the COVID-19 vaccines, the US government did negotiate, showing that it is possible to have life-saving innovation at reasonable prices for patients. The Pfizer vaccine is currently $19.50/dose. Pfizer has told their shareholders recently that they want to raise the price of a dose to $150-$175. Many Americans may still need a booster in the future, which will be an opportunity for the drug companies to raise prices if the government doesn’t negotiate.
What is standing in the way of developing nations purchasing enough vaccine to inoculate their entire population? Andrew shares that so much of our response to this global pandemic has been approached differently nation-by-nation. Rich nations who gobble up all the available doses are also preventing maximum production of doses, creating false scarcity and “vaccine apartheid.”
Trade deals with wealthy nations result in forced austerity for developing nations, keeping them impoverished. Most of them have a tiered healthcare system, with very frail public health mechanisms. Some might have a universal public system, but they tend to be low quality. A secondary private system exists for wealthy people who pay full price out of pocket. Even if wealthy countries donate vaccines, those countries may be selling them to cash-paying patients.
Patent rights are preventing developing nations from producing generic vaccines to save their own populations. In the fall of 2020, South Africa and India called on the World Trade Organization for a Trade Related Intellectual Property Rights (TRIPS) waiver, an emergency public health authority to waive patents on vaccines and the technology to produce them. Unfortunately, there are also a lot of trade secrets that aren’t patented that companies are unwilling to share. The TRIPS waiver is a necessary but insufficient solution to free the vaccines.
Will the donations of vaccines from G7 countries be enough to meet global need? There are about 6 billion vaccine eligible people on earth who will need two doses = 12 billion doses. G7 countries are announcing a total of about 1 billion doses, but they’re already backing away from that amount and they haven’t tied them to a timeline. Philanthro-capitalism won’t be enough to get 10 billion doses in the next year to meet the global need.
Every other developed country bargains for pharmaceutical prices. We don’t, and we pay four times more as a result. H.R. 3 – the Elijah E. Cummings Lower Drug Costs Now Act would let Medicare negotiate for all drugs, including vaccines. The bill would extend those lower prices to the private sector, cap annual price increases at no more than inflation, lower out-of-pocket maximums down to $2000, and would direct savings to NIH to ensure new drug innovation. We expect the bill will pass the House. The Senate Finance Committee is working on a similar bill, and we expect to see it in July. President Biden supports the bill and it can pass through reconciliation.
Get involved to help win vaccines for all:
Share your story at PatientsForAffordableDrugs.org
Doctors Without Borders: https://www.doctorswithoutborders.org/what-we-do/news-stories/story/pushing-peoples-vaccine-covid-19
Justice is Global action sign up: https://actionnetwork.org/forms/take-action-to-end-the-pandemic-everywhere-2/
Policy case by NYT op-ed board: https://www.nytimes.com/2021/04/24/opinion/covid-vaccines-poor-countries.html
Policy deep dive: https://www.bu.edu/gdp/files/2021/04/GEGI_WP_Baker_FIN.pdf
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