[Ip-health] Independent Premium (Long Reads): The vaccine is only half the story’: If a cure is found, the world must be ready for the challenges that follow

Thiru Balasubramaniam thiru at keionline.org
Wed May 6 03:04:15 PDT 2020

The full text of Samuel Lovett's Long Read can be found here;

The vaccine is only half the story’: If a cure is found, the world must be
ready for the challenges that follow

If an effective vaccine is developed, unfettered capitalism and entrenched
notions of nationalism cannot be allowed to paralyse humanity’s next step
in tackling the coronavirus pandemic, writes Samuel Lovett

As governments and pharmaceutical companies race to develop an effective
vaccine for Covid-19 – one that would allow a gradual transition back to
the life we knew – the global establishment finds itself drifting towards a
series of stumbling blocks that, if left neglected, will undermine the
meaningful scientific progress that is made in the coming months.


There are numerous questions that health authorities and governing bodies
must face as scientists creep closer to finding a cure: how will it be
manufactured on a global scale? Who will be responsible for production? How
will it be distributed? Will patents be abandoned? Will knowledge be
shared? Will governments provide universal coverage? Who will be
prioritised? “What’s important in all this is that people think about these
things now,” says Ellen ‘t Hoen, an expert in medicines policy and a
researcher at the University Medical Centre Groningen. “Not when the
vaccine becomes available as that’s too late.”

There is much to learn from previous pandemics and the “cracks within the
system” that they exposed, according to Heidi Chow, the director of Global
Justice Now’s campaign for equitable pharmaceutical policies. “We’ve got an
innovation system that is geared completely to profitability rather than to
public health,” she says. “So during these times of global health crises,
there’s this tension that starts to pull.”


The Wellcome Trust, a UK-based health research charity, estimates that
there will be insufficient supply to meet the global demand for at least a
year after the vaccine becomes available. “Volume is going to be a serious
issue,” says Dr Mohga Kamal-Yanni, a consultant in global health and access
to medicines. Bill Gates has already taken measures into his own hands,
pumping money into the construction of production plants for seven
promising vaccine candidates. The billionaire has acknowledged that
“billions” will be wasted, but given “the situation we’re in”, he says,
“where there’s trillions of dollars … being lost economically, it is worth
it”. But it’s still unlikely to do the job.

One emerging hope is the creation of a global pooling mechanism that allows
companies, governments and scientists to share production techniques,
knowledge and resources. “If we get a vaccine that works, we need to get it
out to as many people as fast as possible – which means putting patent
issues to one side and sharing all the IP, all the biological sources, all
the manufacturing processes,” says Dr Mohga. “Once we have that, then
there’s multiple companies across the world who can produce the vaccine.
Cooperation is key.”


For some, America has already shown its colours. “You’ve seen the US going
around trying to buy up companies that are developing vaccines,” says ‘t
Hoen. “They don’t display much love for the multilateral system, but under
this administration it’s beyond the pale.” Dr Mohga points to reports that
the US diverted a shipment of face masks travelling from Bangkok to
Germany, describing it as “modern piracy”. “If there is a vaccine produced
by an American company, such as Johnson & Johnson, you can only imagine
what Trump will do,” she adds. “He would try to block exports.”

Despite this, The Independent understands there was an early “openness”
within the Department of Health and Human Services (HHS) to commit to a
unified response, with officials said to have been “willing” to engage in
an atmosphere of cooperation. But the president’s public vacillations and
attacks have thrown this into doubt. “It’s going to be very difficult to
get the US to commit to anything to do with the WHO,” says James Love,
director of Knowledge Ecology International, an NGO that specialises in
intellectual property and health policy. “We’ve told HHS ‘what if Germany
or Switzerland gets there first? Won’t you want access?’ All they need to
do is entertain the idea of sharing IP [intellectual property] and get the
ball rolling. It’s nothing lost.” At this point, though, it’s impossible to
predict if the White House will fall in line when, for the past four years,
it has been irrevocably “America First”.


But in an age of nationalism that has reshaped the way we look at and
interact with the outside world, certain people and governments may well
struggle to subscribe to any notion of global collectivity – especially if
vaccine production capacity is constrained. “If a vaccine came out in the
UK, for example, I don’t know what the public sentiment would be if the
government prioritised healthcare workers of the world first over British
citizens,” says Chow.


“There are some companies that don’t believe in cooperation and are more
focused on the value of competitive advantage and unfettered capitalism,”
says Paul Fehlner, the former head of intellectual property at Novartis.
“But especially for the acute phase of the pandemic, you’d be very foolish
as a company to take a super hard position.” One senior pharma consultant
at Deloitte said it was “very unlikely companies will be at liberty to
either price the vaccine too high due to the size of the market and the
urgency for its need”.


“Remember,” adds Fehlner, “unless you’ve committed up front, it’s all
variable.” That’s why the Covid-19 pool is a “great idea”, he says. “I’d
like to see some organisations funded on the condition they put their info
into that pool. But I don’t see that paradigm shift occurring unless the
fundamental investors in healthcare insist on it.”

Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International
41 22 791 6727
thiru at keionline.org

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