Recently, the US government bought virtually all remdesivir supplies for the next three months from US pharmaceuticals company Gilead, following recent results which showed that the drug might shorten recovery times for covid-19 patients. This is hugely problematic for two reasons. Firstly, it denies the rest of the world this treatment. Secondly, the high price charged by Gilead—estimated at over 500 times its production cost, despite receiving an estimated US$70.5 million in public development funding—provides a stark reminder that the current system leaves all the power in the hands of pharmaceutical companies to decide who gets the medicines they need and who does not.
As people around the world pin their hopes on a vaccine to put an end to this pandemic, big pharmaceutical companies continue to issue promises on fair, equitable access. Yet the case of remdesivir is just the latest example of why, when the stakes are so high, this does not always happen.
Consider HIV/AIDS. In 1996, a treatment for HIV/AIDS was developed and priced at £6500 per person. Despite the determination of HIV/AIDS campaigners, it took eight years—and many millions of unnecessary deaths—before the treatment was made available at prices that were affordable for people in countries such as South Africa and India.
Nor are the outrages only historical. Pneumonia currently kills over 2000 children under the age of 5 every day. That’s one child’s life lost every 39 seconds. But a vaccine was found 40 years ago. For the last 20 years patent owners Pfizer and GlaxoSmithKline have kept prices high, leaving millions of children unable to access it. They are estimated to have made billions of pounds in profit.
If governments are serious about combatting coronavirus and ensuring access for all, then there is a solution—a people’s vaccine. A vaccine that is patent free, with mandatory worldwide sharing of all covid-19 related knowledge and intellectual property, a commitment to transfer the technology, and to urgently build much needed extra manufacturing capacity. This would hasten development of a vaccine and maximize its supply. Provided at transparent cost price, without profit, free of charge to people, across the world.
The World Health Organization (WHO) and Costa Rica recently launched a voluntary scheme to share knowledge, data, and intellectual property for vaccines and treatments for the coronavirus, which is a major step in the right direction. It is supported by several governments, including Portugal and the Netherlands.
The primary barrier standing in the way of delivering a vaccine to all is allowing big pharma companies to continue putting their exclusive patents and profits first. There is no justification for intellectual property rationing supply of this global public good. Mandatory global sharing of the knowledge, data, and intellectual property would remove the need for today’s unnecessary and expensive bidding war between rich governments to secure preferential access.
Let’s not forget, taxpayers are already providing the lion’s share of funding for research and development into a vaccine. Public money is bearing the risk of innovation. Approximately 75% of all funding that has been pledged by rich countries and institutions has gone to private corporations. Governments urgently need to act and the least they could do is to make funding conditional on ensuring a vaccine is patent free and available to all.
Currently hopes are pinned on a model which relies on initiatives such as The Global Alliance for Vaccines and Immunizations (GAVI). GAVI’s laudable aim is to improve vaccine access in poor countries, but crucially it does not challenge the model of pharmaceutical monopoly responsible for inequality of access in the first place.
GAVI spend billions of development aid buying expensive vaccines for poor countries when those vaccines could have been much cheaper. Their charity also doesn’t extend to billions of people in middle income countries where vaccines are too often unaffordable.
Governments, global institutions, and the pharma industry must make the right choice. Though history provides us painful lessons, there is inspirational precedent. Jonas Salk, the inventor of the polio vaccine was asked 65 years ago who owned the patent on his vaccine. He said: “The people. There is no patent. Could you patent the sun?”
Anna Marriott, Oxfam GB health policy adviser. She is the lead for Oxfam’s health policy work internationally. She has written and published a number of reports on Oxfam’s focus areas of healthcare financing and delivery. Her Twitter handle is @Anna_Marriott
Nabil Ahmed, Oxfam international head of executive strategy. Nabil works on inequality strategy for Oxfam internationally and co-hosts the Equals inequality podcast. His Twitter handle is @NabslMA