Els Torreele Visiting Professor at the Institute for Innovation and Public Utility (IIPP) at University College London
The vaccines against the Covid-19 are coming, promise the multinationals one after the other, but you are not reassured. Why ?
Els Torreele In recent decades, biomedical research has been transferred to the market. We let go – in the most classic sense of capitalism – the big pharmaceutical companies, which must solve health problems with technological solutions. The public authorities do not set any conditions for them and simply wait for them to be the saviors of the world. This is exemplary in the race for vaccines against Covid-19. At this stage, communications on clinical trials do not provide all the elements: no one knows whether the products which make the headlines today cut the chain of transmission of the virus, while this is the essential dimension to determine the effectiveness of a vaccine. What we are told is that, two or three weeks after an injection, there is some protection against the disease … However, for public health, it is essential to know more about the effectiveness and the long-term security. The decision-making power has been abandoned by the States, which have delegated everything to large companies in a hyperfinancialized sector. Public investments in research, organization of clinical trials, direct subsidies for the development of vaccines, for production and logistics infrastructures, mechanism of advance purchase of vaccines at very high prices … In fact, through interventions public, we have already paid three or four times for vaccines without demanding anything from multinationals. States left the market to decide what was more convenient in the emergency, but that does not necessarily correspond to what would have facilitated access for all … The vaccine that won the race, that of Pfizer-BioNTech, must be stored at – 70 degrees. It is a huge challenge.
Technology sharing platform (C-TAP), joint clinical trials (Solidarity) allowing results to be compared with each other, definition of minimum conditions for the use of a vaccine (Target Product Profile), with storage at less exceptional temperatures than that of the Pfizer vaccine, with single dose packaging, etc. How could Big Pharma be allowed to snub all the initiatives taken by the World Health Organization (WHO) to coordinate efforts?
Els Torreele The institution does not have the possibility of imposing anything. WHO is States, and they did not want to face the challenge of a global public health strategy! But that’s not all: public health regulatory agencies are unwilling to exercise all their prerogatives. Designed as safeguards to protect the public interest, they have evolved over time and are content to support medical innovation for patients. It is screaming when reading the annual reports where they congratulate themselves on the number of products they have been able to approve. But they stand aside when it comes, as today, to imagine the necessary tools and their coordination to overcome the pandemic. General competition, to the detriment of global cooperation, leads to fragmentation that risks being catastrophic: instead of thinking about facing the pandemic on a global scale, the richest states have managed to acquire hundreds of millions of doses, and now they’re wondering what to do with it. It is not a health strategy!
How to get out of this dangerous impasse?
Els Torreele With the Covid-19, we put multinationals and their model based on financial profits back to the center of the game. In recent years, the pharmaceutical industry, which spends more on marketing than on research and development, has been rather on the defensive : under pressure from movements and civil society, the duration of patents, monopolies, the marketing of treatments without any therapeutic value, the exorbitant prices – sometimes exceeding hundreds of thousands of euros – of certain drugs with The costs of social security systems in Europe were called into question … And there, the pandemic occurs, governments are frightened and large companies take the opportunity to restore their image. It’s their hour of glory and they are enjoying it. The bosses talk directly with the heads of state, and civil society, the countries of the South are excluded from the discussions.
At the same time, with the exception of Donald Trump, the leaders of the great powers are competing in generous statements around the vaccine like “Global public good”…
Els Torreele Yes, it’s empty but we had never heard such words before. This demand by heads of state for access to vaccines, affordable, equitable, everywhere in the world, is still a first, and it must be emphasized. Everyone knows that, in the face of this pandemic, no one will be protected as long as everyone is not. Alas, for the moment, it is the opportunism and nationalism of the richest that is triumphing. And the pharmaceutical industry is taking advantage: while it constantly asked for pre-orders and subsidies for antibiotics, which it considers too unprofitable, it is taking advantage of the Covid to try to further consolidate this model as a benchmark for the future. : public money to cover all the risks and the profits in the pockets of the shareholders …
Any additional opacity in a context of mistrust of politicians, multinationals, but also of science, would be a big mistake.
Scientific results partially disclosed by the companies themselves, commercial contracts which keep prices secret but transfer responsibility to States in the event of undesirable effects … Against the backdrop of galloping conspiracy, this maintained opacity does not risk d fuel mistrust of vaccines?
Els Torreele With press releases from multinationals, transparency is not at all assured, indeed. Worse! It is the companies themselves that are developing the protocols to achieve the fastest and most attractive results for the markets, when they obviously have direct financial interests. The lack of transparency on the complete data, on the orders of the States, the distribution between them, the prices, the production centers, this risks adding to the crisis of confidence in the vaccines, with a conjunction of bad and bad. good reasons … On conspiracy, honestly, I don’t know how to thwart it. But on the rest, it is very relevant to ask for evidence, data, transparency. We absolutely have to open the discussion. Trade secrecy cannot be a screen to prevent it. Everyone must be able to form their own opinion. You have to know what is known with certainty, what remains to be verified in studies, etc. This transparency is essential. Any additional opacity in a context of mistrust of politicians, multinationals, but also of science, would be a big mistake.
Read also: Pauline Londeix: “The WTO must lift intellectual property rights on Covid-19 technologies”
How to put public utility back at the heart of the global health battle?
Els Torreele When we had the idea of sending a man to the Moon, the public powers set clear and precise criteria: it was not a question of going a little near the Moon; the order was to walk on the moon… We must not wait for the market to save the world, it is up to States to set ambitions and determine priorities. Putting science in a logic of competition, with patents emanating from public research then transferred to multinationals, this condemns us because what we put in competition, these are solutions which will inevitably be more mediocre than if they emanate from a cooperation general where everyone learns from the successes and failures of others. Today, all Western multinationals, but also laboratories in other great powers, like China, use roughly the same technologies for their vaccines, but they do not share anything. We had to go quickly, the market went to look in the same place – to immunize against the Spike protein, which allows the coronavirus to penetrate cells -, and no one is exploring other avenues that would enrich a global health strategy.
“Who are the populations that can benefit the most from a vaccine right now?” This is the question we should ask ourselves and which is completely evaded by States.
Effect of the current largely speculative frenzy, everything is now focused on the vaccine, and only him, in the fight against Covid-19. Why can’t this be enough, in your eyes?
Els Torreele More than 7 billion people, two doses of vaccine: the calculations are done. The tools of the market arrive, they are consumer goods, in a way, which are pushed forward for the logic of profits … But it is very binary to think that everything goes through a vaccine that should be administered to all inhabitants of the planet. A real global public health strategy should examine the characteristics of all the tools at our disposal, the evolution of the pandemic in the different regions, etc. “Who are the populations that can benefit the most from a vaccine right now?” This is the question we should ask ourselves and which is completely evaded by States. I was recently discussing with a colleague from Cameroon, where, until now, the epidemic has been rather controlled, but where, on the other hand, malaria and other diseases continue to take their toll and we would really need the money available … In Vietnam, Taiwan, Hong Kong, there has also been effective prevention. So it may not be worthwhile to vaccinate everyone with a product on which we still have little data. Of course, we will undoubtedly make less profit with masks or physical distancing, but the goal today is to stem the pandemic!