Every Saturday, “Le Soir” publishes the chronicle of one or more members of Carta Academica. This week: we need to rethink the pharmaceutical ecosystem from a perspective of public health, medical innovation and production that is resolutely oriented towards the common good.
LThe endless and painful episode of “covid” seems to be moving away – at least in our countries – we are beginning to breathe and return to a normal life. The memory of those long months of waiting for a life-saving vaccine is fading. The innumerable victims who did not have access to these vaccines in time in the world are hardly thought of. Even today, only sixteen percent of people in low-income countries have been given at least one dose of vaccine. On the contrary, there is talk today of an overabundance of vaccines, at least in rich countries. There are too many vaccines, and many will soon be obsolete and will have to be destroyed. Indeed, the transfer of technology and the lifting of manufacturing monopolies demanded by more than a hundred countries has not taken place and still does not allow them to use their production capacity for their own needs. However, the benefit of vaccinating with the first generation of vaccines is more haphazard today because the virus has mutated. Definitely, the management of the epidemic based on the laws of the market and the supply and demand continues to produce its perverse effects.
Yet it is important to prepare for the times to come. New generations of vaccines may be needed against variants of the virus or even other forms of coronavirus. Pharmaceutical giants such as Moderna and Pfizer are also preparing for a new fall vaccination campaign. It is safe to say that through early purchase commitments, the United States, the European Union, and other rich countries are already in the ranks… As usual, the rest of the world will benefit. that his plan is worthwhile… and will no doubt benefit, at the end of the course, from the surpluses. In short, everything is in place so as not to draw lessons from the past.
Focus on public health or revenue?
We still have to hit the nail on the head: it is essential to change the model. It is no longer acceptable for a handful of pharmaceutical companies to have a monopoly on these critical technologies, knowledge and underlying technology platforms and monopolize supply. These companies compete with their proprietary technologies to be the first to enter the market and thus decide who to sell to, when and at what price. For the development and manufacture of vaccines, will they continue to deliver to these firms, whose ultimate goal is the enrichment of their shareholders, huge sums of money from taxpayers without putting any conditions to ensure a maximum benefit to public health? This approach has led to unequal access to vaccines, which has been described as a “catastrophic moral failure” by Dr. Tedros, Director-General of the World Health Organization. The problem can be turned in all directions, fair access to vaccines is incompatible with a monopolistic market. There are other perverse effects to this model. More discreet, they are no less formidable. Like any commercial firm, the pharmacy giants have a vested interest in producing a unique product, a vaccine that could sell for billions. It is much less cost-effective to refine research to obtain a vaccine that is more effective, or that would be more appropriate to regional specificities. By relying on its monopolies, the large pharmacy prevents public laboratories or smaller producers from seeking to adapt flexibly to the health needs of an epidemic. Or just to offer vaccinated people at a more affordable price.
Under the auspices of Oxfam, non-minority shareholders have submitted resolutions to Moderna, Pfizer or Johnson & Johnson calling for technology sharing with lesser countries, with the issuance of a license to produce vaccines for their populations. The impact of the move will remain symbolic because, unsurprisingly, it has been rejected.
Medical innovation? Yes, of course, but in the service of public health
One question deserves to be asked again. Who decides which drug, which disease, which virus is worth looking into and doing research on? Who sets the price at which new drugs or vaccines will be sold? In other words, who determines what public health requires, here and elsewhere? In fact, it is today pharmaceutical companies and even more so their shareholders, or even investment funds, who decide on research priorities, and who will have access to these new technologies and the drugs or vaccines that flow from them, when, and at what price. It is therefore the whole pharmaceutical ecosystem that must have the courage to revisit in a perspective of public health, medical innovation and production resolutely oriented towards the common good. Without the courage to correct the perverse effects of a market-only approach, will the scenario for access to the next generation of developing vaccines be as unequal as it is? have we lived so far?