The breakthrough in clinical research on the much-anticipated vaccine is a stroke of serendipity. Yet, accessibility remains the elephant in the room.
The race for a Covid-19 vaccine is in full swing. Barely a week after Pfizer and its German partner BioNTech announced that their vaccine was 90% effective, Moderna released its phase three trial data demonstrating 94.5% efficacy. The jostle to be at the forefront of developing a cutting-edge mRNA vaccine did not end there. Pfizer/BioNTech subsequently confirmed that a completed study of their experimental vaccine was 95% effective, even higher than previously thought.
In the coming months, the vaccines will be rolled out to the masses. In August, Moderna said it would be charging between $32 to $37 per dose for its vaccines, almost twice as much as what Pfizer/BioNTech intends.
One thing is clear – the vaccine will hardly be accessible to all. Because the health crisis has wrecked so much havoc globally, rich countries will especially be willing to purchase the cure at inflated prices in order to secure preferential access. This certainly dances to the tune of pharmaceutical companies that have traditionally vindicated lofty prices as necessary to fund and recoup the costs associated with research and development.
If the clarion call for companies to not profit from their Covid-19 vaccines constitutes “fanatic and radical”, it is safe to assume that establishments like Pfizer/BioNTech will stop at nothing to enforce their patent rights at every juncture. After all, why would they pass up the opportunity to create a strong monopoly and further cement their status quo? The AIDS epidemic is a perfect illustration of how deeply entrenched the mantra “profits before lives” is within the pharma industry. While millions of Africans were dying, big pharma attempted to block cash-strapped governments from importing cheaper versions of antiretroviral drugs in the name of protecting their patents.
This gloomy outlook is exacerbated by the stifling of universal access to Covid-19 vaccines that was first mooted by India and South Africa. The proposal for the World Trade Organisation (WTO) to waive certain obligations in the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement so that medical products can be more accessible to low-income nations was shot down by the US. Ironically, it had in the past threatened to issue compulsory licenses for Cipro when its manufacturer, Bayer, refused to lower the price for the drug that was used to treat anthrax in the wake of the September 11 attacks. The long for a cure looks set to remain elusive to those who will be driven into destitution as a result of the pandemic-induced economic hardships – estimated at up to 150 million people.
So where did the legal and economic threats emanate from? The short answer is the free market. It follows that capitalism advances the narrative of value-based pricing. For instance, Moderna is poised to generate $40bn in global sales from their Covid-19 vaccine while Pfizer/BioNTech stand to rake in $13bn.
Yet, the free market does not necessarily need to be perceived as the chief antagonist. Pharmaceutical companies will still be able to eke out substantial profits from vaccine sales simply because the global population, projected at approximately 7.8 billion inhabitants, will continue to sustain the demand for those vaccines. As the world population continues to expand, so will the revenue of pharmaceutical entities – at a precipitous rate.
The practicality of such an egalitarian arrangement is not in doubt. In 2015, the Australian government brokered a volume-based price agreement with pharmaceutical companies to treat Hepatitis C that cost AUS$1 billion over five years. It was a win-win situation that incentivised the pharma industry to diagnose and treat as many people as possible.
The ball is in the big pharma’s court. Should a vaccine prove too onerous to obtain, its concomitant patent will fall on deaf ears of cash-strapped nations, emboldened by the Doha Declaration on the TRIPS Agreement and Public Health that acknowledges genuine public health objectives and access to medicines should not be delegitimised at the expense of intellectual property rights enforcement.
If that happens, a long “private vs public” battle is guaranteed, and any minute advantage that whichever side gets over the other will be pyrrhic and short-lived.