On November 9, the U.S. pharmaceutical company Pfizer and its German partner BioNTech announced that its COVID-19 vaccine candidate had proven to be 90 percent effective based on preliminary results. (Just this morning, Pfizer stated that in late-stage trials, its vaccine proved 95 percent effective.) A week later, Moderna, another U.S. pharmaceutical giant, publicly disclosed that its vaccine is 94.5 percent effective against the coronavirus.
The news has been instantly galvanizing. Arriving on the heels of the confirmation of Joe Biden as president-elect of the United States, social media was awash with optimism. Many celebrated the Turkish-German “power couple” at the heart of Pfizer’s vaccine team. Others lauded the company for providing a vaccine that would be freely distributed. Others still praised Pfizer for not taking research and development money from the Trump administration, and Dolly Parton for partially funding the Moderna vaccine.
But we must be careful not to heroize Pfizer, Moderna, or any other pharmaceutical company working on a coronavirus vaccine. These are private entities that have deliberately engaged in competitive rather than collective research in a race to market. Their endgame includes enormous profits from a global pandemic in which millions of people will die. They are not offering a “free” vaccine—unless by free we mean free to citizens of rich nations that have brokered preferential agreements worth billions of dollars. More than 50 percent of all leading vaccine candidate doses have already been purchased through such bilateral deals. Poorer nations have found themselves mostly shut out, with some speculating that it will not be until 2022 that they will be able to vaccinate their populations.
Pfizer has stated explicitly that it plans to profit from its coronavirus vaccine. BioNTech, Pfizer’s much smaller partner, was at one point worth $25.8 billion—more than Deutsche Bank—after its market valuation increased following the vaccine announcement. Morgan Stanley analysts estimate that Pfizer and BioNTech stand to make nearly $13 billion from the vaccine next year alone.
This profit, when it comes, will have been the result of a shrewd gamble. Pfizer, unlike other companies, declined start-up funds from the Trump administration’s Operation Warp Speed—not out of opposition to the White House’s mismanaged coronavirus response, but because, as Pfizer CEO Albert Bourla explained, the company wanted to “liberate” its scientists from “bureaucracy.” A more likely explanation is that by paying for its own research, Pfizer avoids the potential for U.S. government march-in rights. Under the 1980 Bayh–Dole Act, the U.S. government can ignore patent rights and license a medicine, at considerably lower cost, if it has funded that research. By declining public funds, Pfizer retains the rights to all profits and sidesteps a potential outcry over profiteering using tax-payer capital, regardless of the fact that mRNA technology central to the vaccine was largely discovered and developed in publicly funded labs at universities around the world over decades.
So far, Pfizer and Moderna have avoided partnering with poorer nations that lack the funds to pay for its vaccine. Unlike a number of other pharmaceutical companies involved in coronavirus vaccine trials, they have yet to sign on to COVAX, a vaccine alliance coordinated by the World Health Organization, UNICEF, the World Bank, and the Bill & Melinda Gates Foundation. COVAX organizes a vaccine pool, which gives participating countries access to a wider array of vaccine candidates while also helping poorer nations secure shares. Pfizer says it is currently in talks with the COVAX alliance, but in the meantime it has made preferential agreements for early doses of its vaccine with Canada, the United States, the United Kingdom, and the European Union. Moderna also says it is in talks with COVAX (it received very early funding from the Coalition for Epidemic Preparedness Innovations); because it did accept $1 billion in R&D money from Operation Warp Speed, hundreds of millions of the company’s first doses are already tied to a supply agreement with the United States.
It is no surprise that Pfizer and Moderna want to capitalize on their vaccines. Pharmaceutical companies have long used monopolies established by strict patent regimens to restrict supplies of life-saving medicines and inflate their prices. But the COVID-19 pandemic is precisely the kind of catastrophic event that should lead global leaders to rethink this model for the development of essential medicines. Why should the business plans of pharmaceutical corporations determine the health and economic outcomes for the entire planet during a global pandemic?
By letting the patent and pricing rights of companies such as Pfizer go unchallenged, rich nations like the United States are effectively allowing corporations to dictate the means of vaccine distribution. Other recent health crises have shown how lethal and unequal this status quo really is. In 2009, for example, millions of low-risk individuals from the United States were vaccinated against H1N1 long before frontline workers in Sub-Saharan Africa because of a shortage of supply. In the 1990s, antiretroviral medicines that substantially reduced AIDS deaths in the Global North were too expensive for countries where 80 percent of people with HIV/AIDS lived, leading to millions of excess deaths.
How much faster could this pandemic end, and how many more lives could we save, if scientists were incentivized by governments to maximize sharing? The current approach, with dozens of companies racing as rivals to develop and test a product with specifics only revealed near the end of the process, leads to major inefficiencies in testing, manufacturing, and access. Though Moderna claims it will not enforce its COVID-19-related patents, CEO Stéphane Bancel has said he does not envision a way for the company to produce more than 1 billion doses in 2021 without stretching the engineers it has overseeing manufacturing in the United States and Europe.
Vaccine companies should be compensated for their development and innovation, but their profit margins should not determine global distribution. In the long term, the creation and support of an infrastructure such as the global network proposed by COVAX is of extreme importance. This will not be our last pandemic. Thinking ahead, we need to move from the current system, which prioritizes the highest bidder, to one that tends to the realities and necessities of global public health. Modeling data for effective vaccine distribution in March showed that 28 percent more lives would be saved by equitably distributing the vaccine globally by population, rather than the current strategy of rich countries first, poor countries later.
Countries without preferential agreements must have early access to a vaccine, either through redistributed supply such as through COVAX or scaled-up production. The United States will likely vaccinate the entirety of its own willing population before tending to frontline workers and immunocompromised persons in other countries. If it favors nationalistic treatment over global health, it can still openly share vaccine production information, exercising march-in rights if necessary, so that other nations can immediately begin vaccine production without the hardship of paying for patents or going through complex legal battles.
The coronavirus pandemic has been raging for nearly a year. It is understandable that people in rich nations want to restore some kind of normalcy in their lives. But now is the time to demand from world leaders from rich nations, especially the incoming Biden administration, the liberation of the vaccine from big pharma. Biden has said in an interview with the activist Ady Barkan that he would be willing to share an unpatented vaccine with the rest of the world. He needs to be continually reminded of that promise, and provide specifics for how that would be implemented.
In 1955, Jonas Salk announced the development of the world’s first polio vaccine. He declined to patent it, because he wanted to maximize its global distribution. When asked who owned the polio vaccine he famously replied, “well, the people, I would say. There is no patent. Could you patent the sun?” Pfizer and Moderna are not Jonas Salk. These are for-profit corporations that have performed tremendous science with the help of public dollars. If they are not willing to relinquish control of a life-saving vaccine to allow for global production and distribution, then governments around the world must be pressured to wrest it from them.
Stephanie DeGooyer is co-author of The Right to Have Rights (Verso Books) and is completing Acts of Naturalization for Johns Hopkins University Press. She is visiting assistant professor of English at Harvard University.
Srinivas Murthy is Associate Professor of Infectious Diseases and Critical Care at the University of British Columbia.