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China on the Horizon as ‘World’s Pharmacy’
M.K. Bhadrakumar
The World Health Organisation’s approval Friday for China’s COVID-19 vaccine known as Sinopharm dramatically transforms the ecosystem of the pandemic. In immediate terms, this has potential to boost global vaccine supply, as China’s overall yearly production capacity is approaching five billion doses.
The western pharmaceutical industry’s monopoly has been breached, as Sinopharm’s is the first COVID-19 vaccine developed by a developing country to be validated by the WHO and only the sixth approved for emergency use globally–in fact, the only non-western vaccine so far.
Literally, China has gatecrashed the aggressively-guarded orchard of powerful western pharmaceutical companies. In practical terms, the WHO approval allows China to enter the portals of the COVAX as a qualified supplier. The COVAX platform aims to provide two billion doses to developing countries and regions by the end of 2021. But as of Friday, only 54 million doses had been delivered to 121 participants of the program.
That is because, as New York Times wrote in the weekend, “Despite early vows, the developed world has done little to promote global vaccination, in what analysts call both a moral and epidemiological failure.” The anomaly creates a bizarre situation whereby in the western world, “vaccine orders are soaring into the billions of doses, COVID-19 cases are easing, economies are poised to roar to life, and people are busy lining up summer vacations,” while in the poor countries, the virus is raging on and vaccinations are happening far too slowly.
This wasn’t how COVAX was supposed to pan put when 192 countries joined hands and all agreed that vaccination is a universal human right. Plainly put, vaccine nationalism is as much a moral issue as of predatory capitalism.
The western pharmaceutical industry is prospering off sales to the world’s rich. Pfizer made $3.5 billion out of the vaccine in the first quarter of 2021. Moderna expects to make over $19 billion this year. The French President Emmanuel Macron lost patience, saying,
Today the Anglo-Saxons (read the U.S. and the UK) are blocking many of these ingredients and these vaccines. Today 100% of the vaccines produced in the U.S. go to the American market.
Jospeh Stiglitz–the Nobel laureate in economics at Columbia University, former chief economist of World Bank and chair of the U.S. President’s Council of Economic Advisers–co-authored an essay last week with a startling title Will Corporate Greed Prolong the Pandemic? He wrote:
The scarcity of COVID-19 vaccines across the developing world is largely the result of efforts by vaccine manufacturers to maintain their monopoly control and profits. Pfizer and Moderna, the makers of the extremely effective mRNA vaccines, have refused or failed to respond to numerous requests by qualified pharmaceutical manufacturers seeking to produce their vaccines.
Their goal is simple: to maintain as much market power as they can for as long as possible in order to maximise profits… The argument that developing countries lack the skills to manufacture COVID vaccines based on new technologies is bogus. When U.S. and European vaccine makers have agreed to partnerships with foreign producers, like the Serum Institute of India (the world’s largest vaccine producer) and Aspen Pharmacare in South Africa, these organisations have had no notable manufacturing problems. There are many more firms and organisations around the world with the same potential to help boost the vaccine supply; they just need access to the technology and know-how.
The western nations are inoculating their own citizens as priority and also keeping stockpiles and vaccine-making capacity as reserves to provide for booster doses that may be required against some new variants of the virus in future.
In effect, China’s Sinopharm is entering the COVAX platform just as it seemed to be floundering. The WHO said in a statement that the approval given to Sinopharm (which took over 5 months, actually) is a “milestone achievement” that will create an opening to significantly increase the global supply of vaccines.
The WHO is reportedly granting approval to a second Chinese vaccine, Sinovac, in the coming days. Last October, when China joined the COVAX global vaccine distribution campaign, it had made a modest commitment to provide 10 million vaccines. Now, the WHO approval to Sinopharm will speed up China’s supplies to COVAX, which aims to send vaccines for free to 92 lower-income countries and to help another 99 countries and territories procure them.
Indeed, the WHO approval is a defining moment for the Chinese vaccine. Many countries were hitherto hesitating to use the Chinese the vaccine as it did not have recognition from the WHO. Sri Lanka began using Sinopharm last weekend itself!
China has curbed the epidemic without the help of vaccines, while it has secured a place right at the forefront of vaccine research and development and has the capabilities today to expand vaccine production capacity explosively. To be sure, China is at the horizon as the ‘world’s pharmacy’.
The copyright for that compelling coinage belongs of course to India’s Prime Minister Narendra Modi who had patented it as far back October last year.
Modi was flaunting his government’s achievements in the rather surrealistic setting of an investment conference in New Delhi in the middle of a pandemic that was yet to rear its head in India. But, seriously, India’s ambitions to cater to the vaccine needs of world community lie in ruins today. And, with the virus mutating, new unforeseeable crisis situations of graver proportions still lie ahead for India.
Where China is scoring is on account of its high degree of national mobilisation. In comparison, the U.S. trails far behind. Its public health system is badly in need of revamp and is fragile. The Biden Administration is conscious of the vulnerabilities and deficiencies, which explains its refusal to export vaccines and raw materials.
The WHO statement added,
One vaccine (Sinopharm) has received EUL (Emergency Use Listing), but we know that there are over fifteen additional COVID-19 vaccines in advanced development in China. Today’s milestone achievement should spur other manufacturers to pursue this route and add to the global vaccine arsenal. It should also encourage an even greater contribution from China to global supply and vaccine equity.
Additionally, three Chinese biopharmaceutical companies have reportedly signed deals with Russian Direct Investment Fund (RDIF) in recent weeks for the production of over 260 million doses of Sputnik V vaccine that could fully vaccinate over 130 million people worldwide. The RDIF said,
China is one of the major production hubs for Sputnik V and we are ready for increasing the scope of partnership with local producers to meet the rising demand for the Russian vaccine.
China’s vaccine diplomacy has far-reaching consequences. Not only will China earn goodwill, but Sinopharm, Sinovac and the fifteen other vaccines rolling out in a near future (plus China-Russia cooperation in vaccine) bear testimony to the superiority of the Chinese model of development.
For the western world, this will be an intolerably rude reminder of the Asian Century. There are incipient western attempts already to resuscitate the moribund conspiracy theory over the ‘Wuhan virus’—that the pandemic is a grand export project of the Chinese Communist Party! Sour grapes?
(M.K. Bhadrakumar is a former Indian diplomat.)
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An article by Prabhat Patnaik, “People are More Important than Patents and Profiteering”, adds:
On October 2, 2020, even before any vaccines against COVID-19 had been approved, India and South Africa had proposed to the World Trade Organisation (WTO) that a temporary patent waiver should be granted on all such innovations. In the following months, 100 countries had supported this demand. And on May 5, the US, usually the most ardent defender of the patent system, agreed to a temporary patent waiver on anti-COVID vaccines, committing itself to “text-based negotiations at the WTO”.
There is, however, strong opposition to any such waiver not only among the drug multinationals but also among other advanced capitalist countries. Germany, in particular, has opposed it strongly as have others in the European Union. Because of this opposition, the prospects of such a waiver coming through in the near future appear bleak.
An alternative that must be resorted to, meanwhile, is compulsory licensing, which is permitted even by the existing WTO rules in situations of “national emergency”. And nobody can deny that the present situation in India qualifies to be called a “national emergency”.
Curiously, however, the Indian government has expressed itself against compulsory licensing, preferring instead to try “diplomatic channels” to persuade recalcitrant advanced countries to agree to a patent waiver. What it does not seem to care about is that even if some sort of agreement is reached on patent-waiver, it will be after months, by which time the country’s death toll could even have reached a million. But the Narendra Modi government’s inhumanity is boundless.
Leave aside issuing compulsory licenses on vaccines that are developed abroad. The Modi government has even refrained from taking out a compulsory license on Covaxin, which is developed within the country, and that too with government funding. Instead, it still allows Bharat Biotech to be a monopoly producer of this vaccine and even doles out public money to this private company (Rs 1,500 crore) to expand capacity so that its monopoly position remains intact! (It has similarly doled out Rs 3,000 crore to the Serum Institute of India to expand capacity while keeping its monopoly position as the producer of Covishield intact!)
It must be a totally unprecedented phenomenon for a government to be so solicitous of monopoly interests that it ignores the people who are facing the worst health crisis in over a century.
(Prabhat Patnaik is Professor Emeritus, Jawaharlal Nehru University, New Delhi.)
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How Corporate Greed Is Prolonging the Pandemic
The array of COVID-19 vaccines now being deployed is, as the situation in the United Kingdom demonstrates, a game-changing development in the midst of a once in a century pandemic that has taken more than 3.1 million lives. Despite some hiccups, those that have been approved for use in various Western countries—the Moderna, Pfizer, AstraZeneca and Johnson & Johnson vaccines—are reported to be preventing hospitalisation and death in 95 to 100 percent of cases for most of the coronavirus variants.
Yet, despite 12,000 deaths per day globally (likely a gross understatement because of under-counting in the underdeveloped world) and warnings that new, vaccine-resistant mutations are more likely to develop in places where the virus becomes endemic, the production and distribution of COVID-19 vaccines face obstacle after obstacle preventing billions of people getting vaccinated in a timely manner.
The first obstacle was in place well before COVID-19 even appeared. Today’s vaccine researchers built on the findings from previous deadly coronavirus outbreaks—severe acute respiratory syndrome (SARS) in China in 2003 and the Middle East respiratory syndrome (MERS) in 2012—which provided a blueprint from which to work. However, it was a blueprint only. Those who years ago had identified the need for coronavirus vaccines couldn’t obtain funding to take their research to the next level because pharmaceutical companies didn’t believe that they could make money out of them.
For example, scientists at the University of Texas developed a successful coronavirus vaccine in 2016—but it remains on ice. “We tried like heck to see if we could get investors or grants to move … into the [clinical trial stage]. But we just could not generate much interest”, Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, told NBC News in March last year. “We could have had this ready to go and been testing the vaccine’s efficacy at the start of this new outbreak in China. It’s tragic that we won’t have a vaccine ready for this epidemic. Practically speaking, we’ll be fighting these outbreaks with one hand tied behind our backs.”
Even when the COVID-19 outbreak began, obstacles remained. In February, Anthony Fauci, the US government’s chief medical adviser, said that pharmaceutical companies were refusing to “step up” to make a vaccine, creating a “very difficult and frustrating” situation. Hotez spoke to several “big pharma” companies the following month, “and literally one said, ‘Well, we’re holding back to see if this thing comes back year after year’”.
It took governments raining money on the private sector for the maths to add up for pharmaceutical companies. “In a business driven by profit, vaccines have a problem. They’re not very profitable—at least not without government subsidies”, Jay Hancock wrote in Forbes. “Pharma companies favor expensive medicines that must be taken repeatedly and generate revenue for years or decades.”
The Trump administration reportedly signed US$10 billion worth of deals with seven companies to provide them with a financial incentive to use their labs for the good of humanity. Among them was Moderna, a Massachusetts-based biotechnology company, which used the publicly funded research of the National Institutes of Health and received an additional $2.5 billion in government funding for research support. Pfizer, the world’s largest pharmaceutical company, received a half billion dollar German government grant and $6 billion in purchase commitments from the US and the EU.
And researchers from advocacy group Universities Allied for Essential Medicines UK estimate that public funding accounted for 97-99 percent of the development funding for the widely used AstraZeneca vaccine. As Achal Prabhala, Arjun Jayadev and Dean Baker wrote in the New York Times before the vaccine rollouts began last year:
“The vaccines developed by these companies were developed thanks wholly or partly to taxpayer money. Those vaccines essentially belong to the people—and yet the people are about to pay for them again, and with little prospect of getting as many as they need fast enough.”
Meanwhile, those trying to create alternatives that are easy to manufacture and store, and therefore can be made available more cheaply and to the greatest number of people, often have been frustrated. Hotez, working with a team in India, has just gained approval to begin Phase III clinical trials of a new vaccine. But it was a struggle to get funding—mainly because cheaper vaccines offer lower returns on investment. “We work on vaccines for diseases of the poor, that … no-one else will make”, he told Democracy Now!’s Nermeen Shaikh on 22 April.
“When we got the COVID-19 sequence in January [2020] … we turned that around really quickly. And then we couldn’t raise money for it, because everybody was so focused on innovation … I said, ‘That’s great, but what if you can’t scale it, or what if there’s a safety signal? Don’t you want a simple, low-cost vaccine as a backup?’ And we just couldn’t get anybody to move. So I wound up raising money privately from philanthropies.”
The obstacles didn’t end there. Next was the new scientific knowledge being kept secret. Oxford University initially promised to donate the rights to its coronavirus vaccine research. But soon after, it partnered exclusively with AstraZeneca. Now there is the ongoing World Trade Organization refusal to allow patent waivers, which would temporarily suspend the intellectual property rights over the new vaccines, allowing more manufacturers to produce them. The proposal, first made in October by India and South Africa, was, in their own words, “an urgent call for global solidarity, and the unhindered global sharing of technology and know-how”.
Today, labs across the world are still waiting for a green light to produce and distribute doses. For example, the chair of Bangladesh-based Incepta Pharmaceuticals, Abdul Muktadir, told the ABC in March that if the intellectual property waiver were granted, the company could manufacture up to 800 million vaccine doses annually—and could produce enough this year to vaccinate all of Bangladesh and Indonesia. And that’s just one manufacturer.
Oxfam’s health policy manager, Anna Marriott, last month called it “a massive missed opportunity”. It is beyond a scandal that a waiver was not granted immediately. But the opposition of a select group of wealthy countries, including the US, Australia, Canada and member states of the EU, has prevented it for more than half a year. (Most decisions at the 164-member WTO are made by consensus, so even a small opposition can scupper proposals.) As Marriott noted:
“Rich countries are vaccinating at a rate of one person per second yet are siding with a handful of pharmaceutical corporations in protecting their monopolies against the needs of the majority of developing countries who are struggling to administer a single dose. It is unforgivable that while people are literally fighting for breath, rich country governments continue to block what could be a vital breakthrough in ending this pandemic for everyone in rich and poor countries alike.”
Thomas Cueni, the director-general of the International Federation of Pharmaceutical Manufacturers and Associations, writing in the Financial Times on 26 April, argued that intellectual property protection is not at all a barrier to global vaccine access. Rather, it is the lack of capacity to increase production quickly enough to match the unprecedented demand. “What is keeping biotech chief executives up at night is the daunting task of scaling up production”, he wrote.
There are three counter-arguments that make this claim laughable. First is Peter Hotez’s testimony that pharmaceutical company funding simply did not flow to scientists who wanted to make a vaccine’s capacity for rapid mass production a precondition of its development. That is, from the beginning, scalability was subordinate to profitability—Big Pharma considered the former a liability if it meant that the vaccine would generate fewer revenues than a more innovative alternative.
Second is the testimony of pharmaceutical manufacturers, such as Bangladesh’s Incepta, that they could produce vaccines right now if a patent waiver were granted. Third is the situation facing the World Health Organization’s COVID-19 Technology Access Pool (C-TAP). Launched in May last year, C-TAP’s aim was to encourage companies to share knowledge, intellectual property and data with manufacturers in underdeveloped countries so that the world could indeed “scale up” vaccine production. Yet, “not a single vaccine company has signed up”, noted Selam Gebrekidan and Matt Apuzzo in the New York Times in March this year.
Maybe staying up all night worrying about scalability distracted the executives from taking concrete measures to increase global output. Whatever the reason—and it seems obvious that the reason is money—the companies that collectively received billions in public subsidies to develop vaccines have been at the forefront of preventing the sharing of information about how to produce them.
Another, related, obstacle to getting the world vaccinated is the Covax debacle. Covax, the COVID-19 Vaccines Global Access, is a dose-sharing facility that aims to get at least 20 percent of each country’s population vaccinated by the end of this year. It has thus far delivered just 40 million doses to 118 countries, well below what it intended. Its problems are several. Wealthy countries have signed private deals with the big pharmaceutical companies, taking the lion’s share of advance orders for vaccines (a confirmed 4.7 billion doses) while lower-income countries so far have procured orders for only a fraction of their populations. Nearly 900 million doses have been administered globally, but more than 80 percent have gone to wealthy and “upper middle-income” countries. Poorer countries have received just 0.3 percent, according to the World Health Organization.
Covax has secured agreements for more than 1.5 billion doses, depending on the Serum Institute of India to manufacture and export vaccines under licence from AstraZeneca. But Adar Poonawalla, the company CEO, complained last month that an “embargo of raw material exports out of the US” was hampering production. Now, with India in a devastating second wave, exports understandably have been halted—but that leaves many countries with no supply at all.
So, despite the threat of more outbreaks and epidemics, the belief that coronavirus vaccines were not profitable stymied their development in the last decade. It took a mountain of government subsidies to get them off the ground even when a once in a century pandemic emerged. Vaccines that might have been easier to produce and distribute were ignored. The pharmaceutical companies prevented the sharing of information that would allow more vaccines to be produced more quickly. And the wealthy states bought up the lion’s share of the limited supplies that have resulted.
All these obstacles mean that it won’t be until 2023, perhaps longer, that people in many parts of the world will be offered an inoculation. In the meantime, hundreds of thousands, perhaps millions, will die needlessly, and more variants will emerge that may be resistant to the first generation of vaccines.
Never forget the words that one unnamed pharmaceutical executive uttered to Peter Hotez: “We’re holding back to see if this thing comes back year after year”. In this murderous result—more than 3.1 million people dead and counting—those looking only for profits may have gotten just what they wanted.
(Courtesy: Red Flag, an Australian socialist publication.)
