For some in the global pharmaceutical industry the coronavirus is a ‘once in a lifetime business opportunity’. Others, however, say this is no time for market forces and are calling for a ‘people’s vaccine’. Foreign Editor David Pratt reports

Consider this for a moment. Imagine a vaccine against coronavirus was ready right now. A vaccine that was available for all and not based on the ability to pay.

One to which the poorest half of humanity, some 3.7 billion people, would have access. The cost no doubt would be staggering yes?

But what if I were to say that it’s possible to vaccinate those billions of the world’s poorest people for less than the profits made every four months by the world’s 10 largest pharmaceutical companies. Last year, these 10 companies alone made $89 billion in profits, an average of just under $30bn every four months.

Or what if I told you that the cost of vaccinating the entire world is estimated at around $20bn. This is roughly the equivalent of two hours of global GDP, a tiny fraction of the trillions that the crisis has already cost.

Doubtless these figures might come as a surprise to many, but that’s precisely why humanitarian agency Oxfam, along with other organisations and prominent world figures, were at pains to highlight them last week as a global campaign stepped up to ensure a universally available "people’s vaccine".

That vaccine, of course, has still to become a reality and is not yet available on the market. But across the world the effort to be first to develop it, own the patent and reap the potentially massive profits to be made, has become something of a holy grail for "big pharma", as the global pharmaceutical industry has been dubbed.

“Pharmaceutical companies view Covid-19 as a once in a lifetime business opportunity,” Gerald Posner, author of Pharma: Greed, Lies And The Poisoning Of America told US online news portal The Intercept. “They’re all in that race,” insists Posner, adding the global crisis “will potentially be a blockbuster for the industry in terms of sales and profits”.

All these issues surrounding the vaccine and who should get it are sure to occupy the minds of health ministers of the 194 countries that comprise the World Health Assembly tomorrow when they hold their annual meeting that was meant to be in Geneva, but like other gatherings during these strange times will now be conducted virtually.

As the decision-making body of the World Health Organisation (WHO), the Assembly is tasked with supervising financial policies and reviewing the proposed programme budget.

For precisely those reasons it’s certain to find itself under growing pressure from a political and industrial lobby over the contentious issue of "ownership" and availability of any forthcoming Covid-19 vaccine.

Some observers have already warned that the ugly and unedifying international battles witnessed over testing kits and protective equipment (PPE) will pale alongside those expected over who "owns" and has access to any vaccine. How this bitter and potentially discriminatory scenario might unfold was vividly depicted last week by David Pilling, the Financial Times correspondent who for many years has covered the global pharmaceutical and biotechnology industry.

“Imagine if, in a year’s time, 300 million doses of a safe and effective Covid-19 vaccine have been manufactured in Donald Trump’s America, Xi Jinping’s China or Boris Johnson’s Britain. Who is going to get them?" Pilling asked in an article last Wednesday, voicing the thoughts and concerns of many.

“What are the chances that a nurse in India, or a doctor in Brazil, let alone a bus driver in Nigeria or a diabetic in Tanzania, will be given priority? The answer must be virtually nil,” Pilling concluded, describing exactly the kind of disastrous outcome global health officials, humanitarians and social justice activists are campaigning to prevent.

Any vaccine should be deployed to create the maximum possible benefit to public health and not be about profit and control, argue these concerned activists. Many in high places agree with them.

Just last week a measure of the power politics involved became apparent when France warned national pharma giant Sanofi it would be “unacceptable” for any country to have priority access to a Covid-19 vaccine.

The row surfaced after Paul Hudson, Sanofi chief executive, told Bloomberg News that the US “has the right to the largest pre-order because it’s invested in taking the risk”. Hudson was referring to the Trump administration’s pledge to help finance the company’s experimental Covid-19 vaccine.

But an angry French president Emmanuel Macron quickly countered by announcing that any vaccine must be treated as “public good for the world, and not subject to the laws of the market”.

So incensed was Macron that the French leader is said to have summoned Sanofi’s top management to the Elysee Palace this week.

Macron, however, is far from alone in insisting that a vaccine should be universally available. In an open letter to the World Health Assembly before tomorrow’s meeting, three African leaders and more than 140 public figures, including 50 former world leaders, have urged that any vaccine should be patent-free, produced at scale, and made available at no cost to people everywhere.

“We cannot afford for monopolies, crude competition and near-sighted nationalism to stand in the way,” said the letter, organised by UNAIDS and Oxfam.

But despite Macron’s knuckle-rapping of Sanofi, things look set to become even more acrimonious before they get better in the international fight over the vaccine.

For its part big pharma and many of its wealthy government backers insist their position is justified.

Both have long defended their high prices and strict patent rules by pointing to the need to protect their intellectual property (IP) given the time and expense involved in research and development, says Ethan Guillen, a global health consultant.

Guillen himself would appear to be no ally of big pharma, having previously been part of the team that helped launch the Medicines Patent Pool, an organisation that licenses medicine patents to have them produced generically for use in developing countries.

According to Guillen, as many big companies see it, they “would have little incentive to invest in development without years of high prices first. Only then can they permit widespread production of low-cost generic versions that would benefit everyone”.

At the core of all this, of course, lies the thorny issue of patents. There are not many within the ranks of the big phrama industry that would agree with the great American doctor, researcher and virologist Jonas Salk who developed one of the first successful polio vaccines.

Asked back in the early 1950s who owned the patent on his vaccine against the polio virus, Salk famously responded: “The people, I would say. There is no patent. Could you patent the sun?"

Left to some within big pharma seemingly hell-bent on making profits, critics joke that even the sun would likely not be exempt from efforts to patent it.

For years, pharmaceutical corporations using intellectual property rights have been able to push up the price of medicines, where they get the exclusive right to produce that product for 20 years.

Oxfam highlights the case of when, in the face of HIV/Aids pandemic which was claiming millions of lives, the world’s biggest pharmaceutical corporations, backed by the US government, tried to preserve the patents on their hugely expensive medicines, and to prevent far cheaper generic versions being produced and used.

In the White House at the time was President Bill Clinton, whose administration was determined to ensure the South African government stopped using generic medicines meant to save their citizens' lives.

During that period nearly 7,000 Africans were dying of Aids every day because they could not afford HIV medications, for which US and other Western drug companies charged up to $15,000 a year, even though the generic non-branded version now cost only $75 annually. Only a global outcry and campaign forced the US and big pharma companies to back down at the time.

“These high prices for branded patented medicines spelled a death sentence for the millions of poor people living with HIV/Aids as they were priced beyond the reach of anyone but the richest,” observed Oxfam in its recent briefing document, compiled to help make its current campaigning case to prevent the same happening again with the coronavirus vaccine.

Yet still big pharma rolls out its familiar defence of property rights, while activists respond by pointing out the so-called Doha declaration of 2001 on Trade-Related Aspects of Intellectual Property Rights, or TRIPS Agreement.

Drawn up by the World Trade Organisation, TRIPS makes it clear that government could override patent in times of public health emergencies.

Right now this is a useful weapon for activists, as is the fact that the new coronavirus has upended the pharmaceutical companies' old patents and property rights argument.

Currently, powerful governments with a long track record of enforcing global intellectual property rules on behalf of their corporations and against the developing world have suddenly loosened up now that they face their own health crises.

Last month, Germany and Canada did just that, taking advantage of the TRIPS Agreement and what is called "compulsory licensing" when they amended public health laws in order to fast-track Covid-19-related medicines, equipment and vaccines when they are needed.

Last week, here in Scotland, the rights group Global Justice Now called on the Scottish Government to do likewise. In an open letter to First Minister Nicola Sturgeon, it called on Holyrood to use its powers to override any patents that are put on new medicines and vaccines for Covid-19 in order to block big pharma companies from profiteering from the pandemic.

Among the numerous signatories were The Poverty Alliance, STUC, Unison Scotland, Unite Scotland, Common Weal, Jubilee Scotland and academics from Strathclyde Law School.

And so just as the virus goes on, so the fight goes on with activists warning that there remains every reason to be concerned over efforts by the US government and its big pharma partners pressing their case for gaining exclusive control over any vaccine patent.

Last week, Oxfam singled out leaked documents that revealed how the Trump administration is trying to stymie a draft resolution put forward by the European Union (EU) at tomorrow’s World Health Assembly meeting, which proposes the voluntary pooling of patents for coronavirus vaccines, treatments, and tests.

The documents suggest the US has attempted to delete EU references to those pooled patents, instead rewording the proposal in favour of big pharmaceutical companies.

According to Oxfam, this would give the “pharmaceutical companies exclusive rights to produce, and set prices for, any vaccines, treatments and tests they develop, even if taxpayer money has been used to fund their research and development”.

Faced with such an unpalatable possibility, it’s perhaps worth remembering, as specialist correspondent David Pilling of the Financial Times has pointed out, that the development of most vaccines have been the result of international collaborations.

In the case of Ebola it was discovered in Canada, developed in the US and manufactured in Germany. And now, when it comes to the medical, scientific and research communities, there remains a degree of global collaboration.

But those within big business with their eyes on vast profits and exclusive control over a game-changing product like the coronavirus vaccine are not so collaboratively minded.

While it is perhaps unlikely that any one country or company will ultimately have the vaccine totally to themselves, that will not stop some from trying.

Speaking last week as one of the signatories to the open letter to the World Health Assembly, South African president Cyril Ramaphosa, who also chairs the African Union, called for a “people’s vaccine” that would act as a global public good.

Few reasonable people would disagree with Ramaphosa’s contention and that of his co-signatories that access to the vaccine needs to be prioritised first for frontline workers, along with the most vulnerable people as well as poor countries with the least capacity to save lives. In what it describes as a four-point plan, Oxfam, along with other humanitarian groups, has laid out a blueprint for doing just that. The groups have called for a mandatory sharing of all Covid-19-related knowledge.

Along with this they would like to see a commitment to deliver additional global vaccine manufacturing and distribution capacity.

Thirdly, they would welcome a globally agreed plan with a “locked in fairness formula” so that supply is based on need, not ability to pay.

And last but not least, they want a similar commitment to fix the broken system for the research and development of new medicines.

Given what the world has endured these past months and continues to face, is this so very much to ask for the future? Lessons so need to be learned from this crisis.

To talk of patents and profits in the midst of such a pandemic is to miss the point and verges on the obscene.

A vaccine for all is what any civilised society would wish for and aspire to. No-one should be left behind.