Can EU wean itself off essential drugs from China, India?

The COVID pandemic has shown that public health in Europe relies massively on Asian supplies, from masks to antibiotics. EU attempts to reshore production seem to be going nowhere, and do they make sense, after all?


Insa Wrede

DW

Europe's pharma giants have relinquished the market for off-patent medications completely to cheaper Asian producers

Jan Woitas/dpa-Zentralbild/picture alliance

Ulrike Holzgrabe believes China wouldn't need an atomic bomb to deal a fatal blow to Europe. Just stopping its supplies of antibiotics would also do the trick, the professor for pharmaceutical and medicinal chemistry at Würzburg University in southern Germany told DW.

Europe's huge shortage of medical masks during the coronavirus pandemic has laid bare the continent's vulnerability to ensuring a steady supply of basic medicinal products. In 2020, the European Parliament stated in a report that public health could be a "geopolitical weapon that can bring down an entire continent."

Big pharma, made in China  04:55

The European Union has since attempted to identify the types of medicines it can only source from outside the bloc, notably from China. Holzgrabe said this effort needs to be intensified with a database on which company produces what and who provides the precursor chemicals for drug production.

Cut-throat competition and trade secrets

Establishing a precise pharmaceutical database is where the problem already begins, says Jasmina Kirchhoff from the German Economic Institute (IW) in Cologne, Germany. Information on the manufacturers of chemicals and other downstream ingredients are "well-kept trade secrets," the pharma business expert told DW.

It's critical for manufacturers to keep market advantages secret from competitors, especially in the generics sector. Generics are pharmaceutical drugs that contain the same chemical substance as a drug that was formerly protected by chemical patents.

India is known as the "pharmacy of the world" as its vast generics market supplies medicines to more than 200 countries

Manjunath Kiran/AFP/GettyImages

The success of generic drugmakers depends on low prices, which means that supply chains are often "very complex, and making it unclear how many companies in which countries are involved," Kirchhoff said.

Regarding antibiotics, the IW researcher noted that China recognized "as early as the 1980s" how important it is to have its own antibiotic production. "There was massive investment in those factories that could produce at the lowest costs — first for the domestic market, and then the surplus output was exported," Kirchhoff added.

In addition to China, which has also become the largest producer of chemical precursor products for the global pharmaceutical market, India has emerged as a major supplier of pharmaceutical products.

National Pharma Strategy: Germany's reshoring initiative

As part of efforts to boost the domestic pharmaceutical industry, the German government adopted a strategy paper in December 2023 identifying three key areas to be strengthened. The goals include, first of all, unbureaucratic approvals for clinical trials with medicinal products. Secondly, easier access to health data for research purposes. And finally, incentives for setting up more manufacturing sites in the country.

For vaccine maker BioNTech the action plan came too late. In January 2023, it decided to move its mRNA research to the UK

BioNTech SE 2020/dpa/picture alliance

Germany is still a major player in the global pharma market and home to leading companies such as Bayer, Boehringer Ingelheim and Merck Group. However, they are strong in the market for innovative, patented medications but weak in the generics market, said Holzgrabe, adding that generics production in Europe is hardly profitable due to low profit margins.

But generics are crucial for public health care in general, as they cover about 80% of basic medication needs, including many antibiotics.

Bork Bretthauer criticizes the government's strategy to boost domestic investments with subsidies. The CEO of Pro Generika — a German nonprofit that regularly commissions scientific studies into health policy and the pharma sector — told DW that Germany needs "a different pricing system" for drugs.

"We don't need zombie factories in Europe that need to be permanently subsidized," he said, adding that Europeans must be willing to pay higher drug prices.
Big Pharma needs big incentives

In the summer of last year, the German parliament adopted legislation aimed at incentivizing the German pharma industry to reshore production or at least stop relocating abroad, with higher drug prices. The law was also a result of drug shortages and supply bottlenecks that had emerged during the global pandemic and the Russian invasion of Ukraine.

German drugmaker Bayer is currently investing about €1 billion in its production facilities in Germany

Image: Bayer AG

It is a major healthcare policy change because Germany had sought to keep public health costs as low as possible until last year.

Previously, drugmakers were forced to offer statutory health insurance companies their medications at capped prices. So prices were fixed for about 80% of medications, including generic drugs, meaning that only the most cost-effective drug firms could make a profit.

Under the new legislation, insurance companies' drug tenders for specific active ingredients and off-patent medications must also award contracts to a European company.

Ulrike Holzgrabe believes the legislation is a step in the right direction, but fears it will come to nothing because there is "simply no European production left," especially in the generics sector. Jasmina Kirchhoff says the law has at least helped prevent more production from moving abroad.

China's unassailable dominance

Wolfgang Große Entrup, managing director of the Association of the German Chemical Industry (VCI), thinks higher drug prices are inevitable if Europe wants more security. But production in Europe will never be as cheap as in Asia, he said in April. The German pharma industry, in particular, would suffer from "excessive bureaucracy, skilled labor shortages, high energy costs, and crumbling infrastructure."

Holzgrabe shares this view, adding that Chinese drugmakers, by contrast, benefit from lower labor and energy costs and cost-free land allowances from the government when they establish production facilities. Moreover, they don't have to comply with environmental regulations as strict as those in Europe.

All of this, she said, would make it difficult to bring pharmaceutical production back to Europe so that "independence from China won't be achieved."

This article was originally written in German.

Bill Gates Almost Single-Handedly Derailed the Plan That Could Have Led to a 'People's Vaccine'

For all his philanthropy, Gates is deeply committed to protecting the rights of patent holders.

by Linda McQuaig 

 Published on Thursday, June 03, 2021 

by

Toronto Star

Billionaire Bill Gates on Sunday argued against a temporary patent waiver for Covid-19 vaccines at the World Trade Organization during an interview with Sky News. (Photo: Screenshot/Sky News)


Hard to believe now, but in the first few months of the pandemic it looked like the world was going to act together to develop a "people's vaccine."

Given the scope and urgency of the looming crisis in February 2020, hundreds of global health experts and researchers converged for two intense days at the Geneva headquarters of the World Health Organization (WHO) where they drew up extensive plans for pooling global scientific knowledge in order to expedite the quest for a vaccine.

Their plan amounted to a bold rejection of the usual pharmaceutical model where drug companies carry out research behind proprietary walls, jealously guarding their "intellectual property" as they race to get a patent, which will give them a monopoly on their new product.

Instead, the urgent plan drawn up at WHO headquarters by some of the world's top infectious disease experts was based on a concept rarely seen in the ultra-lucrative world of pharmaceutical drugs—co-operation in the interests of creating a public good.

The Gates-Big Pharma model has been a disaster, with pharmaceutical companies making astronomical profits as they dole out scarce supplies of their patented COVID vaccines to the highest bidders, leaving poor countries with little chance of vaccinating their people before 2024.

But, in the grim winter and early spring of 2020, governments around the world were sufficiently scared of the deadly new virus that they seemed willing to embrace such a radical scheme—even over the objections of Big Pharma.

"The early days featured tantalizing glimpses of an open-science, co-operative pandemic response," notes Alexander Zaitchik, author of the forthcoming book "Owning the Sun: A People's History of Monopoly Medicine, from Aspirin to COVID-19."

But the inspiring plan devised by the scientists—which promised to create a vaccine essentially belonging to the world's people, not to corporate shareholders—was crushed fairly decisively when Bill Gates ventured into the fray.

The multibillionaire, often described as the "global health czar," has achieved an exulted, almost revered status for giving away tens of billions of his fortune in a seemingly selfless effort to help the world.

Unlike other billionaire philanthropists, who lavish money on their alma maters or prestigious cultural institutions, Gates has focused on helping the world's poor.

Long before the pandemic struck, Gates was channelling billions from his foundation to support vaccine programs in the developing world.

And yet, as Zaitchik documents, Gates almost single-handedly derailed the plan that could have led to a "people's vaccine."

That's because, for all his philanthropy, Gates is deeply committed to protecting the rights of patent holders. He made his own mega-fortune through patents on his computer innovations and has long supported the pharmaceutical industry's claim that patents are necessary to encourage investment.

Big Pharma has been only too happy to let the selfless billionaire be the frontman for their cause, seemingly providing evidence of its moral validity.

So, even before the scientific community had a chance to launch its co-operative public initiative in May 2020, Gates had put forward his own COVID initiative based on protecting drug patents and encouraging vaccine philanthropy.

Of course, the Gates-Big Pharma model has been a disaster, with pharmaceutical companies making astronomical profits as they dole out scarce supplies of their patented COVID vaccines to the highest bidders, leaving poor countries with little chance of vaccinating their people before 2024.

This abject failure prompted an alliance of developing nations, led by South Africa and India, to demand that patents be waived for COVID vaccines and drugs until the end of the pandemic.

For months, rich countries rejected the patent-waiver demand. But a surprise recent endorsement by the Biden administration has changed the dynamics somewhat, pushing even the Bill and Melinda Gates Foundation to support the poor countries' initiative, although Gates himself has not changed his tune.

Among other things, the vaccine tragedy highlights the danger posed by the extreme concentration of wealth and power that Bill Gates represents.

It turns out that his mega-philanthropy comes with a hitch: it enables Gates to develop extraordinary influence over crucial matters, such as whether or not the world's poor will have a chance to survive the pandemic.

Dr. Jonas Salk, developer of the polio vaccine, famously dismissed a question about ownership of his discovery with the question: "Could you patent the sun?"

To which Bill Gates would presumably reply: "Absolutely. How else can we encourage investment?"

Linda McQuaig is an author, journalist, and former NDP candidate for Toronto Centre in the Canadian federal election. She is also the author of "The Sport and Prey of Capitalists: How the Rich Are Stealing Canada's Public Wealth" (2019), "War, Big Oil and the Fight for the Planet: It's the Crude, Dude" (2006) and (with Neil Brooks) of "Billionaires’ Ball: Gluttony and Hubris in an Age of Epic Inequality" (2012).
© 2021 TheStar.com

 

Big Pharma business model 'serious obstacle to wiping out Covid-19'

By agency reporter

DECEMBER 20, 2020

New research by Global Justice Now examines the history of some of the leading corporations producing coronavirus medicines, warning that their business model is likely to make controlling the pandemic more difficult, despite the rapid production of vaccines.

The report, The horrible history of Big Pharma: Why we can’t leave pharmaceutical corporations in the driving seat of the Covid-19 response, finds that six of the biggest corporations in the coronavirus market generated $266 billion last year, with profits totalling $46 billion. Judged by revenue, Johnson & Johnson is more wealthy than rich countries like New Zealand and Hungary. Pfizer’s revenues are bigger than oil-rich Kuwait or Malaysia. 

Yet these same corporations have taken billions of dollars from governments like the UK in research and manufacturing funding, as well as presales of medicines, campaigners point out. 

While this vast mobilisation of public money has been effective in producing vaccines in record time, the Big Pharma model means that these vaccines and treatments have essentially been privatised. That matters, campaigners claim, because it means rich countries being prioritised in terms of distribution, and it leaves governments with no leverage over the pricing of these drugs, making it harder to control coronavirus.

The report examines the history of some of the corporations producing these medicines:

• Pfizer and its UK distributor hiked the price of on anti-epilepsy drug which 48,000 NHS patients relied upon. As a result, NHS annual expenditure on their capsules rose from about £2 million to £50 million in a year. UK wholesalers and pharmacies faced price hikes of 2,300  to 2,600 per cent. 
• GlaxoSmithKlein was handed a $3 billion fine after it admitted to giving kickbacks to doctors in the US and encouraging the prescription of unsuitable antidepressants to children. Doctors and their spouses were flown to five-star resorts, given $750, and access to snorkelling, golf and deep-sea fishing.
• Gilead introduced a Hepatitis C drug to the US market at $84,000 per course. A US Senate investigation concluded: “it was always Gilead’s plan to max out revenue, and that accessibility and affordability were pretty much an afterthought." Gilead corporate profits increased fivefold to $21.7 billion after the release of this and another very highly priced Hep-C drug.  
• Pfizer and GSK produce a vitally important pneumonia vaccine, which health NGO MSF claim has earned the companies over $50 billion while 55 million children are unable to access to the pneumonia vaccine, largely due to high prices.  

Campaigners claim these examples are inherent in a model driven by the need for very high returns, and that these trends are already at play during the pandemic: 

• Pfizer has made no promise to limit profits, and has pre-sold over 1 billion doses to rich governments, representing just 14 per cent of the world’s population.
• Moderna’s corporate executive have made tens of millions of dollars this year in automated share sales which former US regulators have called "highly problematic" and worthy of investigation. Moderna’s vaccine has been made with public money, yet the company is expected to charge between $64 and $74 per person for immunisation.
• Gilead made an extraordinary application for ‘orphan status’ on its drug remdesivir, which would have given it special protection owing to the fact the drug would be useful to a tiny number of patients – the very opposite of a pandemic. A public outcry led to withdrawal of the request.  
• The vaccine being developed by Oxford University was to be produced on a nonexclusive, royalty-free basis. However, on entering a deal with AstraZeneca, the situation changed. The deal is now exclusive and while the company maintains it will not profit during the pandemic, it has failed to release details of its contract and how it calculates research costs.

Nick Dearden, director of Global Justice Now, said: “What’s been achieved during this pandemic by dedicated scientists and researchers is incredible. It’s amazing that they’ve discovered these potential vaccines in just under a year. That’s thanks to unprecedented amounts of government money poured into research. But given the public has paid for most of this research, any vaccines that come out should be owned by the public – true people’s vaccines. That would mean we could get vaccines out to those who need them in a fair way, prioritising the most vulnerable wherever they live.

“It’s beyond disgusting that a group of wealthy corporate executives and hedge funds are using this opportunity to further enrich themselves. Sadly, coronavirus has shown, once again, that the way we research and develop new medicines is not fit for purpose. We have a bunch of companies more interested in raking in massive profits than they are in providing for the needs of people around the UK and around the world. We must change that.”

* Read The horrible history of Big Pharma: Why we can’t leave pharmaceutical corporations in the driving seat of the Covid-19 response here

* Global Justice Now https://www.globaljustice.org.uk/

If You Think Coronavirus Profiteering Is Bad, Wait Till the Climate Heats Up


From testing for coronavirus to treating the health impacts of climate change, universal healthcare and publicly owned medicine production are critical components for adapting to the coming crisis.
by Josue De Luna Navarro




Rich or poor, Americans already spend more on medicine than any other people in the world. (Photo: Elvert Barnes/flickr/cc)


COVID-19 is testing the U.S. public health system. And, unfortunately, things don’t look so good — especially if you’re one of the 87 million underinsured people in this country.

The Centers for Disease Control and Prevention (CDC) has promised that coronavirus tests would be free. But that doesn’t mean that you can expect a free trip to the hospital. The New York Times recently reported that hospital trips for even a “free” test can cost thousands of dollars — which could be devastating for a family that doesn’t have insurance.

Hospitals aren’t the only winners here — Big Pharma and biotech companies are cashing in, too. Take Novacyt PLC, a French biotech company that developed a test for COVID-19. The day they released the tests to the public, their stock surged more than 30 percent.

But if you think companies profiting off the coronavirus is bad, wait until the climate crisis worsens. Beyond even novel outbreaks like COVID-19, more familiar health threats are set to spread like wildfire.

A sick planet, in short, means a sick public.

Already, hotter temperatures are increasing the rate of heat strokes and heat exhaustion, while expanding the range of diseases like malaria or West Nile virus. Droughts spread food insecurity, wildfires cause respiratory illnesses, and floods expose people to unsanitary conditions.

A sick planet, in short, means a sick public. And, as Naomi Klein and other journalists have reported, corporations have devised a number of ways to profit off our planet’s sickness — from companies patenting “climate-ready” crops to property insurance companies contracting private firefighters for rich clients in the path of wildfires.

One of the biggest beneficiaries, again, is Big Pharma. According to the European Pharmaceutical Review (EPR), the pharmaceutical industry expects to “benefit from a warming planet, as the spread of disease will become more prevalent, revealing opportunities for medicine markets.”




Even before coronavirus was a household name, the EPR estimated that between 385 and 725 million people worldwide will be exposed to infectious diseases as the climate crisis worsens. No wonder they find that “almost 70 percent of biotech, healthcare and pharma companies have climate change integrated into their business strategy.”

According to Morgan Stanley, $50 to $100 billion will be needed to produce vaccines alone in the coming years. Unfortunately, many pharmaceutical giants are investing in reducing access to these medications. Pfizer, J&J, and Merck Co. together spent over $19 billion in 2019 alone on lobbying efforts to keep prescription drug and health care costs high — and thus inaccessible to many vulnerable communities.

Indeed, like everything else in the U.S., the climate crisis doesn’t impact everyone equally. The Lancet, a peer-reviewed medical journal, concludes that the poor, people of color, the elderly, and children are most at risk from the health effects of pollution and climate change. And communities of color, the Kaiser Family Foundation reports, are most likely to be uninsured.

Rich or poor, Americans already spend more on medicine than any other people in the world. Numerous studies show that Medicare for All could reduce these costs while expanding coverage. So could investing in a “public option” for prescription drugs.

After all, taxpayers already heavily subsidize pharmaceutical development. One study published last year found that National Institute of Health (NIH) funding — that is, taxpayer money — “was associated directly or indirectly with every drug approved from 2010–2016.” If it’s our own tax money funding this business, why not make medicine production benefit the people who need those medicines the most?

Another recent study by the Democracy Collaborative imagines a publicly owned supply chain to produce needed medications — a “public option” for drugs. Publicly owned drug production, they find, would “combat the increasingly harmful impacts of Big Pharma which decades of regulation have failed to counteract,” from skyrocketing drug prices to the opioid epidemic.

It would also ensure that all communities get the medicine they need as the climate crisis worsens — especially communities disadvantaged by the health care system today. From testing for coronavirus to treating the health impacts of climate change, universal healthcare and publicly owned medicine production are critical components for adapting to the coming crisis.

Josue De Luna Navarro is the New Mexico Fellow at the Institute for Policy Studies. Find him on Twitter at @Josue_DeLuna.

Vaccines boost Big Pharma’s image,

 but won’t change its ways

SAAD HASAN

6 DAYS AGO



The development of Covid-19 vaccines in record time will not be enough to fix big pharma’s tarnished image.

In 1955, Jonas Salk, the inventor of the polio vaccine, was asked a question about who owned the patent to the drug. “Well, the people I would say,” he told a journalist. “There is no patent. Could you patent the Sun?”

The widespread availability of an affordable polio vaccine in subsequent years has almost eliminated the disease from the world, saving millions of children from paralysis and death.

A few months back, large American and European pharmaceutical companies in the race to make Covid-19 vaccines were being pushed to follow Salk’s path and keep their research in the public domain.

That would have helped generic manufacturers in countries such as India to ramp up production and deliver vaccines, even in poorer countries.

Yet none of the pharma bigwigs including Pfizer, AstraZeneca, GSK or Johnson and Johnson (J&J) participated in the patent sharing pool created by the World Health Organisation (WHO).

Experts say the Covid-19 pandemic afforded an opportunity to the industry to rebuild its image tarnished by recent scandals involving price-gouging practices and the opioid crisis.

By luck or by design, the industry seemed to have redeemed some of its reputation with vaccines produced in record time.

“Covid-19 gives a handful of companies a chance to come forward with a vaccine that may help us return to the pre-Covid normal faster than we would have otherwise,” Gerald Posner, the author of Pharma, a book that takes a deep dive into how the industry works, told TRT World.

“As a result, this will have a temporary good effect for them. But the question is: will that fundamentally change the business? — no I don't believe so. They will go back to their ways very quickly which is putting profits ahead of patients.”

Jonas Salk could have made hundreds of millions of dollars but decided not to patent the polio vaccine. (AP Archive)

With governments under public pressure for their handling of the pandemic, politicians desperately sought a magic pill that would make lockdowns disappear. The virus has killed more than 1.7 million people and millions more have lost their jobs.

The urgency to deal with a global health emergency means the scrutiny that was directed at the pharma industry until very recently will have to take a back seat, says Posner.

In 2018, a US court ordered J&J to pay $4.1 billion in damages for the talc products that caused ovarian cancer. The story of Martin Shkreli, aka the Pharma Bro, who raised the price of a drug used to treat a life-threatening infection by 5000 percent overnight, continues to rile people.

Those stories are a distant memory. Moderna and BioNtech, the startups that pioneered mRNA technology, which prep human cells to make a protein that kicks in an immune response to the virus, are enjoying overwhelmingly positive media coverage.

Though the vaccines have gone through the necessary three-tier trial process, America’s Food and Drug Administration and its counterpart in the UK have been unusually quick with approvals. For a medicine maker, an FDA nod is as good as cash — it's an official stamp of authenticity for the drug.

The industry itself has been betting on the coronavirus vaccine to rescue its image as executives have indicated in multiple interviews, hoping that it will deflect negative publicity.

“We went from having been a political piñata in January to a recognition, at least in the minds of many policymakers, that this is an industry that we must support,” Jeremy Levin, chairman of the industry association BIO, told the Financial Times, in July.

And the governments have indeed come out in full support. They have not just allowed the companies to use publicly-funded research and paid them money to accelerate vaccine development — they also spent billions of dollars to buy the vaccines.

A numbers game

Posner says it goes to the pharma industry’s credit that it hasn’t put a steep price tag on the Covid-19 vaccines.

Prices range between $3 a dose to $50 a dose with AstraZeneca’s the cheapest and Moderna’s the most expensive.

But there’s a catch here. What the industry gives up on price, it makes up in volume. Also, instead of selling the vaccine at pharmacies, the companies have struck deals directly with governments which have taken the responsibility to administer them to the public.

“They are going to vaccinate the entire population and you have to do it twice. That is a huge, huge, volume of vaccines. So even a very small profit for each dose means billions of dollars of income even at a modest price,” John Rother, the President of National Coalition on Health Care, which lobbies for health reforms in the US, told TRT World.

Rother said pharma companies in the US spend as much as 40 percent of their revenue on advertising and marketing. With Covid-19 vaccines, they don’t need to spend a dime on convincing people to buy their products.

Wealthy nations have mopped up almost all the Pfizer-BioNtech and Moderna vaccine supplies. (AP)

If the virus mutates, as is evident from different strains that have already emerged, then the Covid-19 jabs could become an annual feature, bringing in additional cash in the coming years.

Pfizer and Moderna alone are expected to generate $32 billion in revenue from vaccine sales in 2021 alone.

Two giants — AstraZeneca and J&J — say they don’t intend to make immediate profits. The caveat here is that their commitment to keep the price near cost of production lasts only till mid 2021.

AstraZeneca is also among a handful of companies which are part of the Gavi vaccine alliance that aims to distribute the shots to more than a hundred developing and low-income countries. But the distribution of its vaccine has lagged behind others.

The most publicised vaccines to be approved up until now are mRNA-based BNT162b2 and mRNA-1273 developed by the Pfizer-BioNtech duo and Moderna, respectively. China and Russia have also reported that their vaccines are effective and many countries are preparing to roll them out.

But most Pfizer and Moderna jabs have gone to wealthy nations which have mopped up the supplies months before production even started. The European Union just bought 100 million doses of the Pfizer vaccine, taking its total to 300 million. But that doesn’t compare to Canada's stockpile - enough to vaccinate all its citizens five times over.

Activists have severely criticised the practice and warned that “vaccine nationalism” can hinder efforts to stop the pandemic.

That money is at the heart of vaccine distribution was evident as Saudi Arabia and the UAE, which have not helped develop the vaccines, got a share of the precious drugs coming off manufacturing plants of Pfizer.

“I guarantee you that it is only about one thing — price,” said Posner about how the oil-rich Arab countries struck deals with pharma companies and rapidly built a cold supply chain.

“I would be flabbergasted — if we ever saw the documents — to find if those were not the highest prices paid for the vaccine.”

Former pharmaceutical CEO Martin Shkreli who raised the price of a life-saving drug by 5000 percent has come to symbolize industry's greed. (AP Archive)

Your money, their choice

Many more countries could have benefited from the first wave of vaccine distribution if patent rights and manufacturing know-how had been shared, says Dr Enrico Bonadio, an intellectual property (IP) law expert who is a Reader at the City Law School, London.

“This was an unprecedented situation. But still what we witness was that the governments in the US, UK and EU supported their pharmaceutical lobbies. Even a pandemic didn’t change their perspective,” he told TRT World.

In October, India and South Africa mounted a challenge at the World Trade Organisation (WTO), arguing that patent rights, confidential information and trademarks should be shared with the rest of the world. The West balked at the proposal.

The Wall Street Journal (WSJ) carried an editorial backing the pharma industry’s long held argument that intellectual property is to be protected because it’s their money that has gone into the expensive research.

Bonadio said he’s not surprised by the decision of pharma corporations to vigorously defend their patents. “It’s like a sacred belief for them. They need IP protection to recoup their investments.”

But that’s just part of the story. Starting from the first antibiotic, penicillin, many drugs have been funded by governments in the US and Europe through public funding.

The messenger RNA or mRNA technology behind Moderna’s vaccine comes from Washington-funded National Institutes of Health (NIH).

“From the late 1930s to 2018, the US government spent $930 billion on the NIH to fund public research that was then taken by the pharmaceutical industry. They put a patent on it, made it their own intellectual property and then charged high prices, in some cases making billions of dollars,” said Posner.

Pfizer repeatedly said that it didn’t receive anything from the $10 billion Operation Warp Speed, which was created by US President Donald Trump to hasten vaccine development.

But the vaccine was not an American multinational’s own creation. Instead, it struck a deal with Germany’s BioNtech which did the R&D for the drug partly funded by $445 million it received from Berlin.

In the past there have been cases where governments in developing countries have stepped in to forcibly take over the patents, said Bonadio.

Public pressure forced pharma companies in the late 1990s to drop opposition of cheaper generic HIV Aids drugs. (AP Archive)

One high profile case involved South Africa, which in the late 1990s decided to introduce generic drugs to treat HIV/Aids in a bid to counter the high-priced treatments sold by multinational companies.

Despite Aids killing millions of people in sub-Saharan Africa, 39 companies took South Africa to court. “That legal action was later abandoned because the companies realised their position had a kind of boomerang effect as they were being seen as greedy pharma companies,” said Bonadio.

This time the pharma companies have evaded similar scrutiny by keeping the Covid-19 vaccine price low and striking deals with governments, which are desperate to revitalise their economies.

But there’s no consolation for hundreds of millions of people in the developing world who have to wait years to get the jabs.

And there’s no Jonas Salk around to help them. 

Source: TRT World

Big pharma and GOP allies aim to sabotage Medicare drug price reforms

Jake Johnson, Common Dreams
December 29, 2022

Senator Marco Rubio speaks to the American Enterprise Institute (AFP)


The pharmaceutical industry and its Republican allies in Congress are openly signaling their plans obstruct at every turn as the Biden administration looks to begin implementing a recently passed law that will allow Medicare to negotiate drug prices for the first time in its history.

In November, Sen. Marco Rubio (R-Fla.) and several other Republican senators introduced legislation that would repeal the new prescription drug pricing reforms, which Congress approved earlier this year as part of the Inflation Reduction Act—a measure that Republicans unanimously opposed.


"Though chances of this repeal effort succeeding are vanishingly slim with Democrats holding the Senate and White House, conservative lawmakers and their outside allies want to impede the law's progress before its expansion becomes inevitable," Politicoreported Thursday.

Big Pharma lobbied aggressively against the Medicare drug pricing provisions, hysterically claiming the modest and extremely popular changes could send the U.S. "back into the dark ages of biomedical research."

Speaking to Politico, Rubio echoed the pharmaceutical industry's talking points.

"I want drug prices to be lower but we have to do it in a way that doesn't undermine the creation of new drugs," Rubio said. "Companies are not going to invest in developing new treatments unless they believe they have a chance to make back their money with a profit."

While the drug price reforms are far less ambitious than what progressives wanted—and the specific provision requiring Medicare to negotiate prices for a small number of drugs doesn't take full effect until 2026—the changes could still have a significant impact on costs, given that a small number of medicines make up a sizeable chunk of Medicare's prescription drug spending.

Beginning next year, the law will also require drug companies to pay Medicare a rebate if they raise their drug prices at a faster rate than inflation. Additionally, the law will limit monthly insulin cost-sharing to $35 for people with Medicare Part D starting in 2023.

Politico noted Thursday that the deep-pocketed drug industry—which boasts nearly three registered lobbyists for every member of Congress—is "gearing up to fight the law's implementation, using whatever legal and regulatory tools are available."

Sarah Ryan, a spokesperson for Pharmaceutical Research and Manufacturers of America (PhRMA), told the outlet that the industry will "keep working to mitigate the law's harm and continue to push for real solutions that will bring financial relief for patients."'

NPRreported in September that pharma lobbyists are likely to take aim at "seemingly technical details" that "could have major implications" for the law, which advocates and Democratic lawmakers hope to build on in the coming years.

According to NPR:

One area ripe for gaming is the formula known as average manufacturer price that Medicaid uses to determine whether companies owe money for hiking prices faster than inflation. The law gives companies ample discretion in how they calculate that average, and firms have used that discretion to include or exclude certain sales to avoid triggering rebate payments. Just one loophole in that formula, which Congress closed in 2019, had cost Medicaid at least $595 million per year in lost rebates.
The Inflation Reduction Act essentially duplicates the language of Medicaid's inflation rebate law, making Medicare now vulnerable to the same loopholes.

Rep. Peter Welch (D-Vt.), who is set to be sworn in as a senator next month, told Politico that "it's going to be really hard to reverse" the drug price reforms once they take effect and begin having a material impact.

"If [negotiation] works in Medicare, it can work in the private market," said Welch, who cautioned that the drug industry is still a strong influence that must be overcome.

“All the contributions they make and all their lobbying money gives them a lot of power," Welch said. "But I think what gives them the most power is that everybody can imagine themselves in a position where someday, somebody they really love is going to need a pharmaceutical drug and won't be able to get it. They play on the fear we all have by basically saying, 'If you make us charge reasonable prices, that'll happen.'"

Welch stressed that he views such fearmongering as "bogus."

Patient advocates have similarly decried the pharmaceutical industry's scare tactics, which are often used to shield companies' power to drive up prices as they please.

"Patients like me and those who live with hemophilia need innovative medicine. But what use is there in developing groundbreaking new drugs if we can’t afford them?" Utah-based advocate Meg Jackson-Drage wrote in a letter to Deseret News earlier this month. "The drug price provisions in the Inflation Reduction Act aren't a political 'sound bite'—they are historic legislation that allow for the innovation we need at prices we can afford."

"Patients fought hard for the reforms in the Inflation Reduction Act—and we won't let Big Pharma and its allies' fearmongering scare us," Jackson-Drage added.

Politico reported Thursday that "Senate Finance Chair Ron Wyden (D-Ore.) said his committee will be on the lookout for any political or corporate meddling" with regard to the drug price reforms.

Sen. Bernie Sanders (I-Vt.), who is set to take charge of the Senate's Health, Education, Labor, and Pensions Committee, has vowed to use his position to challenge the "incredible greed in the pharmaceutical industry."

One Democratic pharmaceutical lobbyist lamented anonymously to The Washington Post last month that Sanders will "go after [the drug companies] at every turn, and they only have a couple friends left in the caucus anymore, so it's going to be tough."

WELL OF COURSE HE DID

Rep. Matt Gaetz Votes Against Capping Insulin Prices, Says People Should Just Lose Weight

The Florida congressman said “the price of insulin increases as waistlines increase.”

STEPHANIE MENCIMER

Senior Reporter

Mother Jones


Rep. Matt Gaetz (R-Fla.) and one of the few obese people he seems to like. 

Megan Varner/Getty Images

On Thursday, the House passed a Democratic-sponsored bill to cap the price of insulin at $35 a month for most Americans, an effort to crack down on price-gouging by drug makers who have raised the price of a lifesaving product used by millions of Americans by almost 500 percent in recent years. Some people now pay more than $1,000 a month for insulin to treat diabetes, even with insurance. Democrats had been seeking a way to rein in drugs prices overall in a broader policy proposal, but it had little chance of passing the Senate. Hoping for bipartisan compromise, they siloed the insulin price control as its own measure. Still, only 12 House Republicans voted in favor of a bill that’s wildly popular with the American public.

Among those voting “no” was Rep. Matt Gaetz (R-Fla.), the GOP’s leading troll, who has come up with perhaps one of the most offensive justifications for GOP opposition to the popular bill. In his newsletter Friday, Gaetz told his constituents that he opposed the bill because fat people, not Big Pharma, are responsible for driving up the cost of insulin. He suggested that Type 2 diabetes, which is often linked to obesity, could be cured if only people would workout more and lose weight, at which point they wouldn’t need insulin anymore and the drug costs would fall without government intervention. Gaetz wrote:

While Democrat posturing of H.R. 6833 victimizes insulin payees as people with an uncontrollable disease that are being taken advantage of and need Big Brother to throw them a raft, lifestyle changes en masse would expeditiously lower demand and the subsequent prices of insulin. 90-95% of people with diabetes have type 2 diabetes, which “can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active.” Arbitrary price controls are no substitute for individual weight control. Since 2000, the number of diabetes cases in the U.S. has nearly doubled. The demand for insulin has increased and the requisite price increase has followed suit. In other words, the price of insulin increases as waistlines increase.

More than a quarter of Florida residents are obese, including Gaetz’s favorite Palm Beach resident, former president Donald Trump. And more than 10 percent of the state’s population suffers from diabetes, not all of which is caused by lifestyle factors. Gaetz’s attempt to sympathize with then was probably not very convincing. “While I empathize with all Americans suffering from disease and will continue to fight Big Pharma, I voted against H.R. 6833,” he wrote. “I will not see a reemergence of FDR price controls and join the Democrats in their attempt to pave the Road to Serfdom.”

This isn’t the first time Gaetz has shown real scorn for overweight people. In January, on his podcast “Firebrand,” he decried Twitter’s banning of Rep. Marjorie Taylor Greene (R-Ga.) for “telling the truth” about the relationship between Covid and obesity. After a segment about his advocacy for medical marijuana, he warned that legal weed was “not an excuse for America to sit home fat and high.” He decried “woke” culture for “cheerleading for the chubbies.”

“I’m not here to fat shame anyone,” he said. “I’d have no room to talk. I know personally how challenging issues of weight can be. I’m frequently way behind in my own goals. But society has now gotten to the point where it’s considered verboten to consider that a daily salad might make you more resilient to all kinds of disease than the vax of the month pushed by Big Pharma. Where’s Michelle Obama when you need her?” He expressed nostalgia for the former First Lady’s “Let’s Move!” campaign and puzzled over how the country had gone from her push for a better diet to the current “obesity-embracing woketopia,” where people are accusing “the Body Mass Index of being a tool of white supremacy.”

Even his own colleagues are not immune from Gaetz’s obesity scorn. He once took a potshot at Rep. Jerry Nadler (D-NY), who has openly discussed his struggle with obesity and went through weight-loss surgery in August, suggesting that Nadler should be put in charge of the “congressional weight loss program.”

While Gaetz may claim to empathize with people struggling with weight issues, he clearly doesn’t think he’s one of them. In August, he declared that he didn’t “fit in” with other members of Congress because most of them are old, obese people.

 

The cancer of money in our politics gives a 'thumbs-up' for corporations to kill more of America

Thom Hartmann
September 18, 2021

Facebook.

Want to know who owns your member of Congress? Just look at how they vote.

For example, this week Representatives Kurt Schrader (D-OR), Scott Peters (D-CA), Kathleen Rice (D-NY) and, on another committee, Stephanie Murphy (D-Fla.) all voted with 100% of their Republican colleagues to kill the ability of Medicare to negotiate drug prices.

To put this into context, the VA and every insurance company and hospital group in America negotiates prescription drug prices. Only Medicare is forced to pay around $60 billion a year more than they should. Which echoes as higher retail drug prices through our entire healthcare system.

And this time it isn't just about pharmaceuticals. As Rep. Schrader's hometown newspaper, The Oregonian, noted in their headline: "Rep. Kurt Schrader of Oregon Helps Kill Drug Pricing Bill, Endangering Biden Infrastructure Plan."

It's a safe bet that none of them did it because they were representing the interest of the people in their districts who helped put them in office. A national poll published just last week found:

An 87% majority of voters over age 65 favor allowing Medicare to negotiate drug prices... Among Democratic seniors, 89% are in favor, as are 87% of Republican seniors and 81% of independent seniors.

Instead, these Democrats are enthusiastically and publicly representing the interest of the pharmaceutical industry, which, Senator Bernie Sanders notes, "[H]as spent over $4.5 billion on lobbying and campaign contributions over the past 20 years and has hired some 1,200 lobbyists to get Congress to do its bidding."

Americans pay an average of $1500 a year more for prescription drugs than citizens of any other nation. But the crisis isn't just the rip-off that's making Big Pharma executives rich: it's quite literally killing us.

Dr. Nicky J. Mehtani, a resident physician at Johns Hopkins Hospital, writes about the pain of having to tell a family that their mother and grandmother has died when the most likely reason was because her patient couldn't afford the heart medication she'd been prescribed.

"[I]n this patient's case, there was no truer underlying cause of death than the blatant unaffordability of her prescription medications," writes Dr. Mehtani.

This is an everyday story all across America. Last year 2.3 million seniors (and 15.5 million people under 65) couldn't afford to pay for doctor-prescribed medication. One in four Americans say they "have difficulty" paying for pharmaceuticals, and one-in-eight "ration" their own pills.

Dr. Mehtani notes that the patient who died in her hospital had a prescription for the heart medications she needed.

"But upon arrival to her pharmacy," Dr. Mehtani writes, "she learned that, despite being insured, one of her heart medications would cost over $200 per month. Though she had $200 in her bank account, she also had eight grandchildren to care for and feed. She figured she could skip a few days of medication and fill the prescription two days later, when she was due to receive her Social Security check.

"But two days without these expensive medications was enough to cause her to have a second heart attack — one that would ultimately take her life and drastically change those of her eight grandchildren, some of whom would later enter the foster care system."

Meanwhile, members of Congress rake in the Big Pharma cash, laughing all the way to the bank as people in their districts cut pills in half and die.

It's easy to dismiss Reps Schrader, Peters, Rice and Murphy as corrupt sellouts and, certainly in this case, the label fits. And it's frankly surprising that they were the only ones who publicly sold out their constituents' grandparents: Big Pharma is throwing money around Congress and on TV ads like a kid with a Super Soaker at the beach.

You've probably by now seen the dueling TV ads from AARP and the pharmaceutical lobby about negotiating Medicare drug prices; the industry is trying to provide cover for the members of Congress who said, "How high?" when the big drug companies said, "Jump!"

But the cancer of money in our politics is much deeper than these four corrupted Democrats (and 100% of the Republicans), and it goes back to a corrupted and sold-out US Supreme Court.

In their 5-4 split 2010 Citizens United decision, they concluded not only that corporations are persons and thus able to exercise their Constitutional right to "free speech" by owning pet politicians but that, because corporations don't have mouths, the form of speech they (and the morbidly rich) can use is money.

That's right: that stuff you have in your pocket is "free speech."

At the time there were five Republican appointees on the Court and four Democratic appointees. Justice John Paul Stevens, a Democratic appointee, wrote the main dissent, noting:

"The fact that corporations are different from human beings might seem to need no elaboration, except that the majority opinion almost completely elides it… corporations have no consciences, no beliefs, no feelings, no thoughts, no desires. … They are not themselves members of 'We the People' by whom and for whom our Constitution was established."


Writing as if he were seeing the "swamp" the Roberts Court's decision left us with today, he added:

"Politicians who fear that a certain corporation can make or break their reelection chances may be cowed into silence about that corporation. On a variety of levels, unregulated corporate electioneering might diminish the ability of citizens to 'hold officials accountable to the people,' and disserve the goal of a public debate that is 'uninhibited, robust, and wide-open.'"


Our problem isn't just a few corrupt, for-sale Democrats; it's pervasive across our political system and mostly because five conservatives on the US Supreme Court chose to corrupt the system to benefit that corporations and billionaires who helped put them on the Court in the first place.

It's why our politics are more polarized than ever before in living memory; corporations and rightwing billionaires are pouring money down the throats of increasingly radicalized Republicans and a few sellout Democrats across the country.
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As I document at length in my book The Hidden History of the Supreme Court and the Betrayal of America, until we overturn these corrupt Court decisions and get money out of politics, every effort to save lives and move this nation forward will face often-insurmountable resistance.

U$A

Manufacturers of 10 Drugs Slated for Medicare Price

Negotiation Spent Billions More on Buybacks, Dividends and Executive Compensation than R&D

WASHINGTON - While the pharmaceutical industry says that the drug price negotiation provisions under the Inflation Reduction Act will harm research and development, a new report by Public Citizen and Protect our Care reveals that the manufacturers of the first 10 drugs selected for Medicare price negotiation spent $10 billion more on stock buybacks, dividends to shareholders, and executive compensation than they spent on research and development in 2022. According to the report, which analyzes SEC filings and company annual reports, manufacturers spent $107 billion on these activities compared to $97 billion on R&D in 2022. What’s more, executive compensation for these companies was approximately half a billion dollars in 2022.

“The industry tells us that Medicare price negotiations will make it hard to research and develop new drugs. What they leave out is that many are already spending far more to make their executives and shareholders rich than on R&D,” said Peter Maybarduk, Access to Medicines program director at Public Citizen. “When these corporations complain about the impact of price negotiations on innovation, we should be deeply skeptical.”

Additionally, the report notes that researchers and the Congressional Budget Office conclude there is no connection between a drug’s research and development cost and its future price, and that the current price of drugs reflects what companies believe the market will bear in response to their monopolistic pricing power. Additionally, the United States is an outlier that does little to protect its residents from the unfair pricing power of drug companies – and bringing American policy into alignment with those of other countries, including its high-income peers, would not destroy the incentive to innovate new medicines.

“These findings undermine industry claims that reducing corporate profits in Medicare price negotiation will impact capacity to invest in research and developing new drugs,” said Jishian Ravinthiran, researcher with Public Citizen and lead author of the report. “These companies are not strapped for resources, as they spend massive amounts of money on self-enriching activities.”

The report also reveals that manufacturers of the 10 drugs with the highest annual expenditures by payers in Maryland spent $9 billion more on stock buybacks, dividends, and executive compensation than on research and development expenses in 2022. Seven states, starting with Maryland in 2019, have established Prescription Drug Affordability Boards charged with analyzing the excessive costs of prescription drugs and identifying solutions to medicine inaccessibility. As other states consider creating their own Boards with the authority to limit the price of drug transactions, or consider expanding these Boards’ authority to deliver relief to more residents, they can rely on this report’s finding that industry has ample resources to invest in drug innovation.

At a press conference today, Maryland Healthcare for all will kick off a campaign to pass major legislation in 2024 to expand the authority of the Maryland Prescription Drug Affordability Board and continue the work of bringing down high costs for medications.

Senator Sanders’ HELP Committee Subpoenas Merck, Johnson & Johnson CEOs

“Time’s Up” For Big Pharma Abuses, Says Public Citizen

WASHINGTON - Today, the U.S. Senate Committee on Health, Education, Labor and Pensions subpoenaed the CEOs of Merck and Johnson & Johnson to testify before a committee hearing on “outrageously high drug prices”. The companies are among the 10 manufacturers of drugs chosen for Medicare price negotiations under the provisions of the Inflation Reduction Act.

While the pharmaceutical industry claims that negotiating with Medicare will harm research and development, a new report by Public Citizen and Protect our Care reveals that the manufacturers of the drugs selected for Medicare price negotiation spent $10 billion more on stock buybacks, dividends to shareholders, and executive compensation than they spent on research and development in 2022.

In response, Robert Weissman, president of Public Citizen, released the following statement.

“Time’s up for the prescription drug price gougers.

“For too long, Big Pharma executives have behaved as if they are immune from accountability. They take publicly funded research; skyrocket prices to the moon, forcing patients to ration or skip medications they need; and then laugh as the very government that paid for the original research accepts without negotiation their outrageous prices, paying multiples of what other countries pay.

“Merck charges 30 times more for a diabetes drug in the United States than it does in France. Johnson & Johnson charges almost five times more for a blood cancer drug in the United States than it does in Germany.

“Meanwhile, Johnson & Johnson is paying out more in stock buybacks, dividends and executive compensation than they are spending on research and development, even though R&D is the only claimed rationale for high prices.

“The pharma profiteers know exactly what they are doing. They know how they are forcing rationing. They know they are ripping off the government and taxpayers. And they know they are getting rich.

“What’s different now is that they can no longer escape public accountability. The Merck and Johnson & Johnson CEOs thought they could simply ignore the Senate health committee demand that they testify and justify their practices. Think again.

“The hearings at which they will be forced to testify are another key marker in the process of rationalizing prescription drug pricing policy in the United States. The price negotiation provisions of the Inflation Reduction Act were a start. The Biden administration’s announcement of a framework to use its authority to override patent monopolies is another. It’s a new day, Big Pharma. Get used to it.”

Chairman Sanders Announces HELP Committee Votes on Subpoenas for Johnson & Johnson and Merck CEOs

WASHINGTON - At a time when the United States pays, by far, the highest prices in the world for prescription drugs, Sen. Bernie Sanders (I-Vt.), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), announced today that the committee will, on Wednesday, January 31, hold votes to issue subpoenas for Johnson & Johnson CEO Joaquin Duato and Merck CEO Robert Davis to provide testimony about why their companies charge substantially higher prices for medicne in the U.S. compared to other countries. If authorized, these would be the first subpoenas issued by the HELP Committee since 1981.

Sanders was pleased that Chris Boerner, the CEO of Bristol Myers Squibb, has agreed to testify in the HELP Committee alongside at least one of the other pharmaceutical CEOs.

This follows a majority of senators on the HELP Committee, on November 21, 2023, inviting all three of the pharmaceutical CEOs to a committee hearing to explain why it is that one out of four Americans cannot afford to take the medicine their doctors prescribe while prescription drug companies make billions in profits and pay their CEOs exorbitant compensation packages.

Sanders said: “It is absolutely unacceptable that the CEOs of Johnson & Johnson and Merck have refused an invitation by a majority of members on the HELP Committee to appear before Congress about the outrageously high price of prescription drugs. These CEOs may make tens of millions of dollars in compensation. The pharmaceutical companies they run may make billions in profits. But that does not give them a right to evade congressional oversight. It is time to hold these pharmaceutical companies accountable for charging the American people the highest prices in the world for the medicine they need. As the HELP Committee considers legislation to lower prescription drug prices, it is critical that these CEOs explain how they determine the price of medicine in the United States.”

Johnson & Johnson, Merck, and Bristol Myers Squibb sell some of the most expensive and widely prescribed drugs in the U.S. relative to the price of those drugs in other countries. For example:Merck sells Januvia, a drug for diabetes, for $6,000 in the U.S. compared to just $900 in Canada and $200 in France. Merck also sells Keytruda, a cancer treatment, for $191,000 in the U.S., but just $89,000 in Germany.

Johnson & Johnson sells Imbruvica, a drug for blood cancer, for $204,000 in the U.S. compared to just $46,000 in the U.K. and $43,000 in Germany. Johnson & Johnson also sells Symtuza, an HIV drug, for $56,000 in the U.S. but just $14,000 in Canada.

Bristol Myers Squibb sells Eliquis, a blood thinner, for $6,700 in the U.S. compared to just $900 in Canada and $650 in France.In 2022, Johnson & Johnson made $17.9 billion in profit and its CEO, Joaquin Duato, received $27.6 million in compensation. That same year, Merck made $14.5 billion in profit and its CEO, Robert Davis, made $52.5 million in compensation; while Bristol Myers Squibb made $6.3 billion in profits and its former CEO, Giovanni Caforio, made $41.4 million in compensation.


This Congress, five CEOs have agreed to voluntarily testify in the HELP Committee. Four out of the five were pharmaceutical CEOs including the CEOs of Moderna, Eli Lilly, Novo Nordisk, and Sanofi. Last year, the CEO of Moderna committed to Chairman Sanders during a HELP Committee hearing that Moderna would set up a patient assistance program so that no one in America would have to pay for their vaccine out of pocket. In a separate HELP Committee hearing last year, the CEO of Eli Lilly committed to Chairman Sanders that his company would not raise prices on existing insulin products.

Cuba's Homegrown Covid-19 Vaccines Poised to Protect Millions in Poor Nations

As rich countries hoard doses and Big Pharma refuses to share the knowledge required to ramp up manufacturing, Cuba's public biotech sector could play a key role in defeating vaccine apartheid.


A nurse vaccinates an elderly woman against Covid-19 with Cuban vaccine Abdala in Havana on August 2, 2021.

 (Photo: Yamil Lage/AFP via Getty Images)

KENNY STANCIL

COMMONDREAMS

November 24, 2021

Despite the added challenges created by a six decade-long U.S. blockade, Cuba's public biotech sector has developed two highly effective vaccines and its universal healthcare system has inoculated four-fifths of its population.

Additionally, the island has begun exporting its homegrown doses and is on the verge of sharing its recipes with impoverished nations abandoned by Big Pharma and wealthy countries.

"Cuba knew it would be hard to obtain Covid vaccines, so it made its own... and they could be key to vaccinating the world."

"Cuba is now one of the few lower-income countries to have not only vaccinated a majority of its population," Jacobin's Branko Marcetic wrote Tuesday, "but the only one to have done so with a vaccine it developed on its own."

According to Our World in Data, Cuba has fully vaccinated 80% of its population against Covid-19, putting it in the top 10 globally, and well ahead of several wealthy nations. Nearly 90% of Cubans have received at least one dose, again outpacing most of the world—even as the Biden administration has intensified Washington's embargo on the island, stifling its economy and depriving its residents of food and medical supplies, including syringes.

"Cuba," wrote Marcetic, "has been able to do the unthinkable, developing its own vaccine and outdoing much of the developed world in overcoming the pandemic, despite its size and level of wealth, and despite a policy of concerted economic strangulation from a hostile government off its shores."

He added that "international solidarity efforts have been vital, too. When the U.S. blockade meant a shortage of syringes on the island, jeopardizing its vaccination campaign, solidarity groups from the United States alone sent 6 million syringes to Cuba, with the Mexican government sending 800,000 more, and more than 100,000 on top of that coming from Cubans in China."

Since a late-August peak of nearly 10,000 cases and almost 100 deaths per day, Cuba's successful vaccination effort has coincided with a major decline in coronavirus infections and mortality. While Covid-19 has claimed the lives of 8,295 Cubans since the pandemic began, the country recorded zero deaths from the disease on Tuesday.

Moreover, "the country reopened its borders on November 15 to tourism, roughly a tenth of its economy, and has reopened schools," Marcetic noted. "This makes Cuba an outlier among low-income countries, which have vaccinated only 2.8% of their combined populations."

The glaring gap in vaccination rates between rich and poor countries is the result of vaccine hoarding by wealthy governments—which have gobbled up most of the world's doses, occasionally wasting excess supplies even as they tout their insufficient donations—and pharmaceutical corporations' refusal to share vaccine formulas, even though the underlying technology is publicly funded.

While health justice advocates continue to push for a temporary suspension of deadly intellectual property barriers at the World Trade Organization—a widely supported move that would enable qualified manufacturers to produce generic Covid-19 vaccines, treatments, and tests—Big Pharma has lobbied to maintain its extremely profitable monopoly control over lifesaving knowledge, and the industry continues to be backed by the United Kingdom, Germany, and a few other opponents of the patent waiver.

As that struggle continues ahead of the WTO's biannual Ministerial Conference that begins on November 30, Marcetic argued that Cuba's domestic vaccine production "suggests a path forward for the developing world as it continues struggling with the pandemic in the face of ongoing corporate-driven vaccine apartheid, and points more broadly to what's possible when medical science is decoupled from private profit."

Marcetic attributed Cuba's successful inoculation drive to the country's "decision to develop its own vaccines, two of which—Abdala, named for a poem penned by an independence hero, and Soberana 02, Spanish for 'sovereign'—were finally given official regulatory approval in July and August."

He continued:

In the words of Vicente Vérez Bencomo, the internationally acclaimed head of the country's Finlay Vaccine Institute, the country was "betting it safe" by waiting longer to manufacture its own vaccines. This way, it would avoid dependence on bigger allies like Russia and China while adding a new commercial export at a time of ongoing economic hardship.

These efforts are already underway. Vietnam, with only 39% of its population fully vaccinated, inked a deal to buy 5 million vaccine doses, with Cuba recently shipping more than 1 million of them to its communist ally, 150,000 of which were donated. Venezuela (32% fully vaccinated) also agreed to buy $12 million worth of the three-dose vaccine and has already started administering it, while Iran (51%) and Nigeria (1.6%) have agreed to partner with the country to develop their own homegrown vaccines. Syria (4.2%) has recently discussed with Cuban officials the prospect of doing the same.

The two vaccines are part of a suite of five Covid vaccines Cuba is developing. That includes a vaccine delivered nasally that's progressed to Phase II of clinical studies, one of only five vaccines in the entire world that have a nasal application, according to one of its top scientists, that could be particularly useful if proven to be safe and effective, given the virus's entry through the nasal cavity. It also includes a booster shot specially designed to work for those already inoculated with other vaccines, and which was recently trialed on Italian tourists. Since September, Cuba's been in the process of getting World Health Organization approval for its vaccines, which would open the door to its widespread adoption.

Unlike the mRNA vaccines produced by Pfizer and Moderna, Cuba opted to develop a more traditional vaccine, as Nature explained Tuesday:

In developing Soberana 02, Vérez Bencomo's group drew on its existing "conjugate" vaccine technology. Finlay's conjugate vaccines take a protein or a sugar from a bacterium or virus and chemically link it to a harmless fragment of a neurotoxin protein from the tetanus bacterium... Conjugate vaccines against meningitis and typhoid are used around the world, and Cuba has been immunizing children with a vaccine of this type for years.

[...]

[The Center for Genetic Engineering and Biotechnology's] Abdala vaccine is also making major strides. As with Soberana 02, the technology behind it is adapted from an existing vaccine—one for hepatitis B—that Cuba developed and has used for many years.

Protein-based vaccines like Soberana 02 and Abdala come with multiple advantages.

For one thing, Marcetic wrote, they "can be kept in a fridge or even at room temperature, as opposed to the subpolar temperatures the Pfizer vaccine has to be stored at or the freezer temperatures Moderna's vaccine requires," making distribution easier, especially in developing countries and remote areas.

"Cuba has decommodified a vital human resource—the exact opposite policy direction that we've seen in these last four decades of neoliberalism."

Alluding to other vaccines' extreme cold storage requirements, Helen Yaffe, senior lecturer in economic and social history at the University of Glasgow, told Marcetic that "in the Global South, where huge amounts of the population have no access to electricity, it's just another technological obstacle."

Moreover, because Cuba has relied on conjugate vaccines for years to protect people, including children, from meningitis and typhoid, Bencomo told Nature he is confident that Soberana 02—which has been used to inoculate nearly two million Cuban children so far—is safe across age groups.

As Marcetic noted, "the mRNA technology, which has never been used on kids before, has meant a lag between adult and child vaccination in the developed world—and means vaccines for kids under five are still being developed."

Cuba, by contrast, "aimed from the outset to create a vaccine that kids could take," he added. "As of this month, it's fully vaccinated more than four-fifths of all kids aged two to eighteen."

Arguably the most important aspect of Cuba's vaccines, proponents say, is that their development demonstrates the existence of an alternative model for scientific research that puts people over profits.

"The Cuban vaccine," Yaffe told Marcetic, "is 100% entirely a product of a public biotech sector."

Marcetic explained:

While in the United States and other developed countries, lifesaving medicines are developed thanks largely to public funding before their profits and distribution are ruthlessly privatized for corporate enrichment, Cuba's biotech sector is wholly publicly owned and funded. That means Cuba has decommodified a vital human resource—the exact opposite policy direction that we've seen in these last four decades of neoliberalism.

Cuba has poured billions of dollars into creating a domestic biotech industry since the 1980s, when a combination of an outbreak of dengue fever and new economic sanctions from then-president Ronald Reagan forced its hand. Despite a crushing blockade by the United States, responsible for a third of the world's pharmaceutical production, Cuba's biotech sector has thrived: it makes nearly 70% of the roughly eight hundred medicines that Cubans consume and eight of the eleven vaccines in the country's national immunization program, and it exports hundreds of millions of vaccines a year. The revenues are then reinvested into the sector.

Journalist Paris Marx marveled at Cuba's recent accomplishment. "Under U.S. embargo for 60 years," they tweeted, "Cuba knew it would be hard to obtain Covid vaccines, so it made its own... and they could be key to vaccinating the world."

"The Cuban vaccine is 100% entirely a product of a public biotech sector."

"Being in Canada, it's such a stark contrast," Marx added. "Canada hasn't even manufactured Covid vaccines, let alone developed them, after privatizing the public pharma company. Meanwhile, Cuba is not only measuring up to the top global pharma giants, it's producing vaccines for export."

Marcetic wrote that "while Cuba's rebound from the pandemic suggests [Bencomo's] and the Cuban government's confidence in the vaccines isn't misplaced, it may take some more time for them to get the international scientific community's official imprimatur."

"Should it come," he continued, "it would prove a powerful refutation of the corporate-driven vaccine model that has so far dominated, which holds that, in line with the talking points of Big Pharma, only profit-driven competition can produce the kind of lifesaving innovation the world is desperate for."

Ongoing opposition to the WTO patent waiver threatens to prolong vaccine apartheid and with it, the Covid-19 pandemic—potentially endangering everyone should a vaccine-resistant variant emerge, as epidemiologists have repeatedly warned is a growing possibility.

In light of that, Marcetic added, "we should all hope that Cuba's vaccines are proven as successful as its scientists are sure they are."

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