How to ensure vaccines are designed for people over profits
Recent announcements of demonstrated efficacy in coronavirus (COVID-19) vaccine trials have brought hope that a return to normality is in sight. The preliminary data for Pfizer/ BioNTech and Moderna’s novel messenger RNA vaccines are highly encouraging, with the first approval for emergency use of the former coming in the UK on Wednesday. And more recent news of effectiveness (albeit at a slightly lower rate) in a vaccine from AstraZeneca and the University of Oxford has fueled optimism that even more breakthroughs are on their way.
In theory, the arrival of a safe and effective vaccine would represent the beginning of the end of the COVID-19 pandemic. In reality, we are not even at the end of the beginning of delivering what is needed: A “people’s vaccine” that is equitably distributed and made freely available to all who need it.
For technological advances to translate into “Health for All,” innovations that are created collectively should be governed in the public interest, not for private profit. This is especially true when it comes to developing, manufacturing, and distributing a vaccine in the context of a pandemic.
No country acting alone can resolve this crisis. That is why we need vaccines that are universally and freely available. However, the current innovation system prioritizes the interests of high-income countries over those of everyone else, and profits over public health. Responding to political and economic pressure in high-income countries, pharmaceutical companies are rushing their vaccine candidates across the finish line. Accordingly, they have designed their Phase 3
Mariana Mazzucato, Professor of the Economics of Innovation and Public Value at University College London, is Founding Director of the UCL Institute for Innovation and Public Purpose and the author of “The Value of Everything: Making and Taking in the Global Economy” and “The Entrepreneurial State: Debunking Public vs. Private
Sector Myths.”.
Henry Lishi Li is a research fellow in health innovation at the UCL Institute for Innovation and Public
Purpose.
Els Torreele is a visiting policy fellow at the UCL Institute for Innovation and Public
Purpose.
©Project Syndicate clinical trials to deliver the quickest possible positive read-out, rather than addressing more relevant questions, such as whether the vaccine prevents infection or just protects against the disease.
Moreover, national interests — especially those of developed countries — remain the dominant factor in vaccine rollout. While the international purchase and distribution platform COVAX represents a momentous step forward, its impact is being offset by massive bilateral advance-purchase agreements by rich countries.
Beyond national interest lurks the problem of even narrower private interests, which stem from an over-financialized biopharmaceutical innovation model.
The COVID-19 crisis is a perfect test of whether a more public health-oriented approach to innovation and production will prevail in the years ahead. While Pfizer is sticking with the model of maximizing shareholder value, AstraZeneca has at least pledged not to profit from its vaccine “during the pandemic.” However, despite all the public investment that underwrote these innovations, the process will remain opaque, leaving one to wonder if AstraZeneca is actually ready to prioritize public health over profit and offer its vaccine at cost.
While the recent vaccine news has brought hope, it has also exposed the pharmaceutical industry’s broken business model, casting doubt on the prospect of delivering a people’s vaccine. Business as usual may allow us to scrape by in this crisis, but there is a better way to do things. Before the next pandemic arrives, we must recognize vaccines as global health commons, and start to reorient the innovation system toward symbiotic public-private partnerships governed in the public interest.