Home > Uncategorized > The quant case for open-access COVID vaccines

The quant case for open-access COVID vaccines

from Blair Fix

Around the world, rich countries are celebrating as their COVID numbers fall. Their success is no mystery — it’s because of a massive rollout of COVID vaccines. While we should celebrate the development of these vaccines, their deployment highlights the tyrannies of capitalism.

Most of the basic research for COVID vaccines was funded by the public. Yet their manufacture is controlled by Big Pharma. The predictable result is that vaccines flow to the highest bidder and Big Pharma reaps the profit. Thus, the world is now ‘blessed’ with 9 new pharma billionaires.

Since we’re stuck with COVID for the long haul, we need to end the privatized vaccine model. The alternative is surprisingly simple. Let governments continue to fund basic science. And let private companies continue to manufacture vaccines. Just don’t let these companies have a monopoly on property rights. Instead, put vaccines in the Creative Commons. The result will be cheap vaccines, available to all.

To make the case for open-access vaccines, it helps to run the numbers. To date, the vast majority of COVID vaccines have gone to rich nations. It’s plutocratic healthcare in action: more money = more vaccines.

Let the data speak.

The global distribution of COVID cases

We’ll start by looking at how the global distribution of COVID cases has played out since the beginning of the pandemic. Figure 1 shows the global share of cases by continent since February 2020.

Figure 1: Share of world’s COVID cases by continent. [Sources and methods].

When the pandemic started in late 2019, Asia had 100% of all COVID cases — obviously because the virus arose in China. In March 2020, Donald Trump bemoaned the spread of the ‘Chinese virus’. But by then the vast majority of cases were in Europe, which had refused to lock down until it was too late.

After the early European (and then American) debacle, the spread of the virus slowed in these regions, but sped up in Asia and South America. By September 2020, the majority of cases were in the ‘Global South’. Then in the fall of 2020, the US and Europe brashly reopened and cases there skyrocketed. And so at the start of 2021, most COVID cases were again in the ‘Global North’.

Figure 2 shows this ‘North-South’ dynamic. I’ve plotted here the Global North’s share of world COVID cases since February 2020. (Remember that ‘North’ is code for ‘rich countries’. Here it consists of North America, Europe and Oceania.)

Figure 2: Share of world’s COVID cases in the ‘Global North’. [Sources and methods].

I’ve marked in Figure 2 the approval dates of the 4 major COVID vaccines. Shortly after these vaccines went on the market, COVID numbers in the Global North plummeted. Today, COVID is overwhelmingly a disease of the Global South. In other words, the pandemic is now a poor-country problem.

The global distribution of COVID vaccines

Let’s switch gears now and look at the global rollout of COVID vaccines. The most ethical way to distribute vaccines would be to send them where they are needed most. If we followed this principle, regions with the most cases would get the most vaccines. In other words, the vaccine rollout would mirror the COVID case load.

That’s not how things have played out.

COVID vaccines haven’t chased cases … they’ve chased dollars. As Figure 3 shows, vaccines have gone overwhelmingly to rich buyers in Europe and North America.

Figure 3: Share of the world’s fully vaccinated people by continent. [Sources and methods].

Figure 4 simplifies things by looking at the vaccine rollout in terms of a North-South dynamic. I’ve plotted here the share of fully vaccinated people who live in the Global North. In January 2021, when vaccines first rolled out in the UK and the US, this share was 100%. Thankfully, it declined thereafter, meaning some vaccines did make it to the Global South. But outside rich countries, the pace of vaccine distribution has been slow. As of June 4, 2021, 65% of all fully vaccinated people live in the Global North.

Figure 4: Share of the world’s fully vaccinated people who live in the Global North. [Sources and methods].

The truth is that the rollout of COVID vaccines has followed a simple plutocratic formula:

more money = more vaccines

My guess is that you can see this formula at many different scales. For instance, in Toronto (where I live) the vaccine rollout has been slower in low income neighbourhoods. And as we’ve seen above, at the global level vaccines have gone overwhelmingly to rich regions.

The same formula also holds at the national level, as shown in Figure 5 and 6. Across countries, the portion of people who are fully vaccinated is proportional to GDP per capita. In other words, the greater your income, the more vaccines you get.

Figure 5: COVID vaccination rates vs. GDP per capita. Each point shows the most recent data for vaccination rates by country, plotted against GDP per capita in 2019. [Sources and methods].
Figure 6: COVID vaccination rates vs. GDP per capita, January 2021 to June 2021. [Sources and methods].

If you’re familiar with global health statistics, the above trend won’t surprise you. Pick any health indicator (including other vaccination rates) and you’ll find that it gets better as per capita income grows. That’s because we live in a plutocratic world where money buys healthcare.

The truth about intellectual property

The unequal rollout of COVID vaccines brings me back to intellectual property. When drug patents expire, the drugs tend to become cheaper. Why? According to drugs.com, it’s because generic manufacturers have lower costs:

Generics are less expensive because the drug manufacturer does not have to duplicate the original clinical trials for effectiveness and safety, which lowers the cost to bring the drug to market.

Of course, it is true that generic manufacturers don’t do drug trials. But that’s not why drugs get cheaper when patents expire. The reality is that patented drugs are expensive precisely because they are patented. Drug patents are a government-sanctioned monopoly that gives the power to set prices. That’s the secret to Big Pharma’s thick profit margins (which tend to exceed the margins of most other companies on the S&P 500). Let the public fund the dirty work. Then get a monopoly on the final product.

Speaking of thick profit margins earned through intellectual property, perhaps the only firms that can compete with Big Pharma’s margins are academic publishers. In 2018, for instance, the publisher Elsevier reaped a profit margin of 37%. The reason academic publishers can compete with Big Pharma is because they’ve adopted the same business model:

  1. Let the public sector do the expensive basic science;
  2. In the last mile, put IP around the final product;
  3. Earn monopoly profits.

The key to these profits is intellectual property. It is the institutional fence that sanctions monopoly power. Without IP, Big Pharma’s hefty profits would vanish. That is the dirty truth that pharma execs dare not speak publicly. Instead, they’ll call their IP an ‘intangible asset’ that ‘generates value’. But inside the boardroom, Cory Doctorow notes, the doublespeak gets dropped. In the halls of power, ‘IP’ has a crisp meaning:

When you attune yourself to how businesses use “IP,” it has a very crisp meaning: “IP is anything that lets me control the conduct of my competitors, customers and critics.”

In other words, intellectual property is all about power. IP grants Big Pharma the power to restrict access to drugs. It’s no wonder that this power leads to unjust results. That’s what it’s designed to do.

Back to COVID vaccines. Big Pharma has been wielding IP for a long time, so there’s nothing new or surprising about the inequities of the COVID vaccine rollout. It’s just that the brutality of the pandemic makes these inequities more visceral. As a result, skepticism of drug IP is probably at an all-time high. A recent poll found that 85% of Americans oppose letting private companies have monopoly rights to vaccines.

Let’s put that skepticism to good use and end IP on all COVID vaccines. And when we’re done, let’s do the same for every other life-saving drug.

  1. Ken Zimmerman
    June 11, 2021 at 8:43 am

    Plutocracy and plutocrats are a heavy, maybe terminal burden on the world. They must end. Even if it means war to achieve that result.

  2. Meta Capitalism
    June 11, 2021 at 10:14 am

    Plutocracy and plutocrats are a heavy, maybe terminal burden on the world. They must end. Even if it means war to achieve that result. ~ Ken Zimmerman, RWER’s Keyboard Warrior

    Spoken like a true keyboard warriors. KMAGA!

    • Ikonoclast
      June 11, 2021 at 9:24 pm

      Let’s be honest, we all act like keyboard warriors here. “First take the beam of wood out of your eye, and then you will see clearly to take the splinter out of your brother’s eye.” ;)

      • Meta Capitalism
        June 19, 2021 at 5:37 am

        We clearly have different definitions of the meaning of keyboard warriors (KW)*. Gerald Holtham is not KW in my view. Nor Lars and authors, or Dave Taylor, etc.

        * I use it with a very narrow view, e.g., calls for violent revolution.

  3. Ikonoclast
    June 11, 2021 at 10:01 pm

    If history follows the path Thomas PIketty noted, it will take a major war or revolution to change matters. Each time profit rises faster than the overall rate of growth we get a war, like WW1 or WW2 or a great depression like most of the 1930s. Sometimes we get the depression, then the war. Piketty noted that under capitalism’s axioms:

    If R (rate of return on capital) is Greater Than G (growth in inflation adjusted dollars) then inequality increases.

    There are real limits to the increase in inequality. People reach the point where they will not tolerate greater inequality. They will rebel against the system and elites enforcing the inequality or be diverted by elite misdirection into attacking others.

    Piketty’s “Conditional Law of Approach to an Asymptote” (my clumsy title for it) is fully compatible with Capital as Power theory. There is no need to assume that R and G are measuring real wealth. They are simply the ratios of nominal capital being assigned to each variable by the calculations and operations of the capitalist financial system. Since money does not measure value but rather implements creorder power, then the relative power of the owners of capital axiomatically increases and the relative power of the rest of society axiomatically decreases. However, the decrease in the relative power of the bulk of the people has a lower real limit (more a band than a precise point) this being the physiological or psychological limits beyond which people find life intolerable or impossible. The rise in real inequality will be found to have real limits.

    The elites seem determined to push matters to those real limits just as they appear determined to push the biosphere to and beyond the environment’s real limits. We are already in environmental overshoot. We also may not be far away from inequality limits. Rapid evnvironmental recoil or snap-back coming the other way will meet increasing inequality: two asymptotes interfering and compounding. The system will rapidly destabilize without timely preemptive action on both fronts.

    That’s me being a keyboard warrior. ;)

  4. Ken Zimmerman
    June 12, 2021 at 9:30 am

    Or in the more direct and powerful words of the French Revolution, “Liberté, égalité, fraternité, ou la mort!” (“Liberty, equality, fraternity, or death!”)

  5. Ken Zimmerman
    June 21, 2021 at 7:22 am

    “The people cannot be all, and always, well informed. The part which is wrong will be discontented, in proportion to the importance of the facts they misconceive. If they remain quiet under such misconceptions, it is lethargy, the forerunner of death to the public liberty. … What country before ever existed a century and half without a rebellion? And what country can preserve its liberties if their rulers are not warned from time to time that their people preserve the spirit of resistance? Let them take arms. The remedy is to set them right as to facts, pardon and pacify them. What signify a few lives lost in a century or two? The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants. It is its natural manure.”
    ― Thomas Jefferson, Letters of Thomas Jefferson

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