Home > Uncategorized > The drug companies are killing people

The drug companies are killing people

from Dean Baker

I get to say this about the drug companies, now that President Biden has said that Facebook is killing people because it was allowing people to use its system to spread lies about the vaccines. There is actually a better case against the drug companies.

After all, they are using their government-granted patent monopolies, and their control over technical information about the production of vaccines, to limit the supply of vaccines available to the world. As a result, most of the population in the developing world is not yet vaccinated. And, unlike the followers of Donald Trump, people in developing countries are not vaccinated because they can’t get vaccines.

The TRIPS Waiver Charade

The central item in the story about speeding vaccine distribution in the developing world is the proposal put forward at the WTO last October (yes, that would be nine months ago), by India and South Africa, to suspend patents and other intellectual property rules related to vaccines, tests, and treatments for the duration of the pandemic. Since that time, the rich countries have been engaged in a massive filibuster, continually delaying any WTO action on the measure, presumably with the hope that it will become largely irrelevant at some point.

The Biden administration breathed new life into the proposal when it endorsed suspending patent rights, albeit just for vaccines. This is the easiest sell for people in the United States and other rich countries, since it is not just about humanitarian concerns for the developing world. If the pandemic is allowed to spread unchecked in the developing world it is likely only a matter of time before a vaccine resistant strain develops. This could mean a whole new round of disease, death, and shutdowns in the rich countries, until a new vaccine can be developed and widely distributed.

After the Biden administration indicated its support for this limited waiver, many other rich countries signed on as well. Germany, under longtime chancellor Angela Merkel, has been largely left alone to carry water for the pharmaceutical industry in opposing the vaccine waiver.

I had the chance to confront the industry arguments directly last week in a web panel sponsored by the International Association for the Protection of Intellectual Property (link included when it becomes available). It’s always educational to see these arguments up close and real people actually making them.

The first line of defense is that the waiver of patent rights by itself does not lead to any increase in vaccine production. This is of course true. Vaccines have to be manufactured, eliminating patent rights is not the same thing as manufacturing vaccines.

But once we get serious, the point is that many potential manufacturers of vaccines are being prevented from getting into the business by the threat of patent infringement suits. In some cases, this might mean reverse engineering the process, something that might be more feasible with the adenovirus vaccines produced by Johnson and Johnson and AstraZeneca, than with the mRNA vaccines. The manufacturing process for these vaccines is similar to ones already used by manufacturers in several countries in the developing world, as well as several in the rich countries that are not currently producing vaccines against the pandemic.

Another possible outcome from eliminating patent rights is that the drug companies may opt to do more voluntary licensing agreements under the logic that it is better to get something than nothing. If manufacturers are using reverse engineering to produce vaccines, the patent holders get nothing. They would be much better off with a limited royalty on a licensing agreement, even if it is less than they could have expected if they had been able to maintain an unchecked patent monopoly.

The other route that suspending patent monopolies may open is one where former employees of the pharmaceutical companies may choose to share their expertise with vaccine manufacturers around the world. In almost all cases these employees would be bound by non-disclosure agreements. This means that sharing their knowledge would subject them to substantial legal liability. But some of them may be willing to take this risk. From the standpoint of potential manufacturers, the patent waiver would mean that they would not face direct liability if they were to go this route, and the countries in which they are based would not face trade sanctions.

Open-Sourcing Technology

While suspending patent rights by itself could lead to a substantial increase in vaccine production, if we took the pandemic seriously, we would want to go much further. We would want to see the technology for producing vaccines fully open-sourced. This would mean posting the details of the manufacturing process on the web, so that engineers all over the world could benefit from them. Ideally, the engineers from the pharmaceutical companies would also be available to do webinars and even in-person visits to factories around the world, with the goal of assisting them in getting their facilities up-to-speed as quickly as possible.

The industry person on my panel didn’t seem to understand how governments could even arrange to have this technology open-sourced. He asked rhetorically whether governments can force a company to disclose information.

As a legal matter, governments probably cannot force a company to disclose information that it chooses to keep secret. However, governments can offer to pay companies to share this information. This could mean, for example, that the U.S. government (or some set of rich country governments) offer Pfizer $1-$2 billion to fully open-source its manufacturing technology.

Suppose Pfizer and the other manufacturers refuse reasonable offers. There is another recourse. The governments can make their offers directly to the company’s engineers who have developed the technology. They can offer the engineers say $1-$2 million a month for making their knowledge available to the world.

This sharing would almost certainly violate non-disclosure agreements these engineers have signed with their employers. The companies would almost certainly sue engineers for making public disclosures of protected information. Governments can offer to cover all legal expenses and any settlements or penalties that they faced as a result of the disclosure.

The key point is that we want the information available as soon as possible. We can worry about the proper level of compensation later. This again gets back to whether we see the pandemic as a real emergency.

Suppose that during World War II Lockheed, General Electric, or some other military contractor developed a new sonar system that made it easier to detect the presence of German submarines. What would we do if this company refused to share the technology with the U.S. government so that it was better able to defend its military and merchant vessels against German attacks?

While that scenario would have been almost unimaginable – no U.S. corporation would have withheld valuable military technology from the government during the war – it is also almost inconceivable that the government would have just shrugged and said “oh well, I guess there is nothing we can do.”  (That’s especially hard to imagine since so much public money went into developing the technology.) The point is that the war was seen as a national emergency and the belief that we had to do everything possible to win the war as quickly as possible was widely shared. If we see the pandemic as a similar emergency it would be reasonable to treat it in the same way as World War II.

Perhaps the most interesting part of this story is what the industry representative saw as the downside of making their technology widely available. The argument was that the mRNA technology was not actually developed to be used against Covid. Its value against the pandemic was just a fortunate coincidence. The technology was actually intended to be used for vaccines against cancer and other diseases.

From the industry perspective, the downside is that if they made their technology more widely available, then other companies may be able to step in and use it to develop their own vaccines against cancer and other diseases. In other words, the big fear is that we will see more advances in health care if the technology is widely available, pretty much the exact opposite of the story about how this would impede further innovation.

I gather most of us do not share the industry’s concerns that open-sourcing technology could lead to a proliferation of new vaccines against deadly diseases, but it is worth taking a moment to think about the innovation process. The industry has long pushed the line that the way to promote more innovation is to make patent and related monopolies longer and stronger. The idea is that by increasing potential profits, we will see more investment in developing new vaccines, cures, and treatments.

But these monopolies are only one way to provide incentives, and even now they are not the only mechanism we use. We also spend over $40 billion a year in the United States alone on supporting biomedical research, primarily through the National Institutes of Health. Most of this money goes to more basic research, but many drugs and vaccines have been developed largely on the government dime, most notably the Moderna vaccine, which was paid for entirely through Operation Warp Speed.

If we put up more public money, then we need less private money. I have argued that we would be best off relying pretty much entirely on public money.[1] This would take away the perverse incentives created by patent monopoly pricing, like the pushing of opioids that was a major factor in the country’s opioid crisis. It would also allow for the open-sourcing of research, which should be a condition of public funding. This could create the world the industry fears, as many companies could jump ahead and take advantage of developments in mRNA technology to develop vaccines against a variety of diseases.

But even if we don’t go the full public funding route, it is pretty much definitional that more public funding reduces the need for strong patent monopolies to provide incentives. If we put up more dollars for research, clinical testing, or other aspects of the development process, then we can provide the same incentive to the pharmaceutical industry with shorter and/or weaker monopoly protections.

In the vaccine context, open-source means not only sharing existing technology, but creating the opportunity for improving it by allowing engineers all of the world to inspect production techniques. While the industry would like to pretend that it has perfected the production process and possibilities for improvement do not exist, this is hardly plausible based on what is publicly known.

To take a few examples, Pfizer announced back in February that it found that changing its production techniques could cut production time in half. It also discovered that its vaccine did not require super-cold storage. Rather, it could be kept in a normal freezer for up to two weeks. In fact, Pfizer did not even realize that its standard vial contained six doses of the vaccine rather than five. This meant that one sixth of its vaccines were being thrown into the toilet at a time when they were in very short supply.

Given this history, it is hard to believe that Pfizer and the other pharmaceutical companies now have an optimal production system that will allow for no further improvements. As the saying goes, when did the drug companies stop making mistakes about their production technology?

Has Anyone Heard of China?

It is remarkable how discussions of vaccinating the world so often leave out the Chinese vaccines. They are clearly not as effective as the mRNA vaccines, but they are nonetheless hugely more effective in preventing death and serious illness than no vaccines.[2] And, in a context where our drug companies insist that they couldn’t possible produce enough vaccines to cover the developing world this year, and possibly not even next year, we should be looking to the Chinese vaccines to fill the gap.

China was able to distribute more than 560 million vaccines internally, in the month of June, in addition to the doses it supplied to other countries. Unless the country had a truly massive stockpile at the start of the month, this presumably reflects capacity in the range of 500 million vaccines a month. The Chinese vaccines account for close to 50 percent of the doses given around the world to date.

It would be bizarre not to try to take advantage of China’s capacity. There obviously are political issues in dealing with China, but the U.S. and other Western countries should try to put these aside, if we are going to be serious about vaccinating the world as quickly as possible.

“Mistakes Were Made,” Should not be Our National Motto

If a vaccine resistant strain of the coronavirus develops, and we have to go through a whole new round of disease, deaths, and shutdowns, it will be an enormous disaster from any perspective. The worst part of the story is that it is a fully avoidable disaster.

We could have had the whole world vaccinated by now, if the United States and other major powers had made it a priority. Unfortunately, we were too concerned about pharmaceutical industry profits and scoring points against China to go this route.

Nonetheless, we may get lucky. Current infection rates worldwide are down sharply from the peaks hit in April, but they are rising again due to the Delta variant. It is essential to do everything possible to accelerate the distribution of vaccines. It is long past time that we started taking the pandemic seriously.

[1] I discuss a mechanism for public funding of drug development in chapter of 5 of Rigged (it’s free).

[2] The NYT had a peculiar article last month celebrating Covid illnesses and death in Seychelles, where most of the population has been vaccinated with one of the Chinese vaccines. Seychelles largely avoided the pandemic until the point where it began large-scale vaccinations. If we take the whole period since the pandemic began, the percent of the population that has died from Covid in Seychelles is 0.08 percent, less than half the 0.19 percent in the United States.

  1. Benjamin
    July 20, 2021 at 10:24 am

    There are still many of those who believe that for profit only corporations are out there to do good. They are not and so it is absolutely legitimate to take back what they have taken by law, by force, by sheer might, by corruption from civil societies before… not only vaccines. Think about all other aspects of our daily lifes which have become a mere pawn on a corporate chessboard

  2. Ikonoclast
    July 21, 2021 at 12:53 am

    Intro.

    Don’t imagine that only the people in undeveloped nations can’t get vaccinations. Here in supposedly developed and enlightened Australia, our fully vaccinated rate is woefully low due to government bungling and penny-pinching. We can afford flash new weapons for our military but apparently we can’t afford enough mRNA vaccines, now that AstraZeneca has a few clouds, erm blood clots, hanging over it. Even our AstraZeneca supplies are not that great and the logistics of the vaccination rollout here have been a complete mess.

    Australia is at a meager 12% to 13% fully vaccinated. It is hard to get precise and fully updated figures. This means places like The World, Russia, Peru, Colombia, Peru, Malaysia and Morocco are all ahead of us. Bet you thought Australia was a developed and enlightened country. Actually, not quite. We have avoided the COVID-19 waves mainly due to luck, isolation and our state governments taking better action while our Federal Government did next to nothing. But now an outbreak of delta variant has started here and we are scarcely protected at all. This has occurred because we have a completely incompetent Federal Govt who are neoliberal (market fundamentalist) through and through. They are rapidly destroying everything that was good about Australia.

    On the world front, the news on SARSCov-2 (which causes COVID-19 disease) just gets worse and worse and worse. This all stems back to the issue of the world egregiously failing to world quarantine and eradicate the virus as should have been done. Big Pharma actually has a vested interest in curing not preventing. I am not actually alleging conspiracy but it makes one wonder. Nobody except the China and a few other countries seemed interested in eradication early on. I think we can draw a line between that phenomenon and neoliberalism.

    Evolutionary and Emergent Phenomena re COVID-19.

    However, lets look at some emerging specifics.

    First, a stem cell biology letter sent to the editor of nature dot com.

    “An evidence that SARS-Cov-2/COVID-19 spike protein (SP) damages hematopoietic stem/progenitor cells in the mechanism of pyroptosis in Nlrp3 inflammasome-dependent manner”

    https://www.nature.com/articles/s41375-021-01332-z

    I do not know the status of this letter in terms of peer review and attempts to replicate tests and outcomes. However, there is enough of concern in it for any person facing major surgery in the near future and/or recovering from recent major surgery. Should or should not a person in such a situation have a COVID-19 vaccination or vaccinations? My GP and my specialist both dodged answering this question or even offering an opinion. One can understand why. They know that they don’t know, at least not for certain yet. This is because the science and empirical facts are far from fully known yet. It’s a new virus and a new area of research.

    The issue relates firstly to blood clots: more common after surgery anyway and also produced by some COVID-19 vaccines albeit at a very low incidence. But how would the incidence change when affected by these factors combined? For example, might the risks be additive or multiplicative? The second set of issue relates to the generation process for new blood cells in the body and the signs that the spike protein (SP) coded for by the vaccines is itself an “agent” which attacks (stem) blood cells in this process and also has inflammatory ramifications. A third set of issues, not alluded to in this paper, relate to SARSCoV2’s propensity (reported early) to promote abnormal blood vessel and capillary growth / re-growth: certainly likely to be an issue after both extensive and fine surgery. Whether spike protein plays a role in this phenomenon I do not know. I do not even know if this early reported phenomenon has been confirmed, though I could look it up again.

    I write the above, to add a note to the many ways that SARSCoV2 can affect the lives and decisions of vulnerable people or people who suddenly become vulnerable because of a nascent medical condition which surprises and/or shocks them. Ignoring SARSCoV2 and letting it rip through populations sooner or later or over and over again is a recipe for playing dice with any and everybody’s lives at odds which are dangerously unknown and rightly unacceptable to all likely or even possibly vulnerable persons, the world over. The so-called developed world has plenty of poor and vulnerable people due to rampant and extreme in equality. Indeed, in many respects the so-called developed neoliberal capitalist world now has many huge undeveloped enclaves embedded in it now like so many untreated cysts and cancers. These undeveloped and de-developed enclaves are metastasizing through the whole system as the developed world itself heads towards relative collapse from a high base, as we could term the process. People in the so-called world are going to greivously shocked within as little as ten years as to how far their whole nations have fallen, unless they take radical action.

    Further Thoughts.

    I continue on to say (and it’s not unrelated) that we face in the nearly immediate future a phenomenon which we might call the “vaccination paradox” in relation to COVID-19. This in my definition will be the paradox that vaccination of an inadequate percentage of the population for so-called “herd immunity” may perhaps paradoxically make the remaining unvaccinated persons less safe, not more safe. Let us bear in mind that the unvaccinated now and for quite a while into Australia’s future, for example, will consist of far more than just antivaxers and the vaccine hesitant. They will also consist of people who cannot advisedly get vaccinated now or perhaps ever, due to;

    (a) A lagging vaccine rollout; or
    (b) Other medical conditions of temporary or permanent duration; or
    (c) Other reasons (like “no vaccine yet approved for cohort”).

    The “vaccination paradox” could arise basically because of the rapid mutation of SARSCov2 and what that means in terms of the rapidly evolving situation. First, some terms;

    (1) vaccine efficacy means how well it works in trials.
    (2) vaccine effectiveness means how well it works in the real world.

    Vaccine effectiveness as a term is used in two senses, at least since the arrival of this pandemic. We could call them “total vaccine effectiveness” and “partial vaccine effectiveness”. To make more precise definitions in relation to COVID-19 we can say:

    (i) Total vaccine effectiveness means it totally prevents infection for life or for a significant duration of years after which it can be re-activated by a booster. If a vaccine is totally effective on you, you cannot catch the disease and you cannot transmit the disease. Such a vaccine if very good may be totally effective on say 95% of the population. That fact along with just a few other likely very temporary measures would confer herd immunity, squash an epidemic and maybe even lead to effective eradication.

    (ii) Partial vaccine effectiveness means it prevents serious disease or death of the person vaccinated. This is the kind of effectiveness the Astrazenca and Pfizer vaccines are demonstrating in practice and even then only for 60% to 90% of the population, depending on the vaccine and the variant. You can still get sick, you can still test positive, and quite likely, can still be able to infect someone else.

    All this means that if people get effective protection in the second sense only (which is what is happening in the real world) then it is very likely, if the society fully opens up, like the renewed idiocy we are now seeing in the UK, lots of the unvaccinated may still get sick and die. They, as a cohort could be made less safe, not more safe, unless people still behave very circumspectly and considerately. Behave circumspectly and considerately? Who am I kidding? That won’t happen in a neoliberalised society which means a “selfish-ized” society! I personally will have to totally lock down for another half a year at least and maybe even for the term of my natural life, to stay safe. I don’t particularly mind that. I am a misanthropic hermit and I have the resources.

    But one unlucky essential outing, like to the hospital for surgery, could still kill or maim me. I am 67. I am not happy with all the people who minimized this disease and still minimize it in the face of all evidence. They have been proven egregiously and shamefully wrong. And they were warned early by the best economists, virologists and epidemiologists to “Lock down early to full eradication. They would not listen. Now there is hell to pay for many tens of millions of people (at least) world wide. Indeed, the final disaster could be a magnitude larger than that. We are not even half way through this global pandemic, probably not even a quarter of the way through. Vaccination is semi-effective at best, just like flu vacs and needing boosters every 12 months and maybe even every 6 months.

    This, combined with climate change and its knock-on and ramping up feed-back effects is potentially civlization ns species ending stuff. We need to declare a planetary emergency. But if you are not intelligent enough to absorb all this, go and drink a beer, preferably in a very crowded pub just to make your point. Good luck, you’ll need it.

  3. Edward Ross
    July 21, 2021 at 1:01 am

    I totally agree with you and as i have said before many ordinary citizens i speak with also agree with you. However the from my observations these people lack the leadership to come together to demand change. Also i am not involved in social media and the problem there seems to be much of the social media is dominated by those who unquestionably accept the popular rubbish .As my fish man said once there was only one nut in the village, now there are many nuts in the village all on there keyboards or phones. Thus the challenge is to form socially active informed groups as a nucleolus to demand equality and justice for all in a peaceful democratic way.Ted

  4. Ken Zimmerman
    July 21, 2021 at 8:23 am

    In  a confessional  in  the  New  York  Times  in  2014,  former  Wall  Street  trader Sam Polk  outed  himself  as  a  recovering  wealth  addict. He said his childhood was toxic with an abusive parent (a common part of the biographies of addicts). He revealed the exhilaration of dopamine release at the power  that money provided  him. He admitted that he abused money like he abused alcohol and cocaine —  to  feel  better  about himself. In the powerful control of his all consuming addiction, his  ‘fixes,’  including  cash  bonuses,  were  never big  enough.  Like the ‘users’ on Wall Street who fly into addiction-fueled rages,  he  would  do anything,  including  bringing  harm  to  others, any number of others to  amass  more  cash.  As an addict, he didn’t care as long as  he  could  have  more. Scientists are beginning to see the addictive link between dopamine and money, but  we  don’t need to wait  for  them  to  catch  up.  Except for the addicts, it is widely known this is a problem.

    Money is the most highly addictive substance  on  the  planet: It  is  a  powerful  addiction,  unrivalled  in  its  ability  to  trigger  good  feelings,  and  what’s  most frightening  about  it  is  that  you  can’t  ever  physically  overdose. Cocaine, heroin and crack  will  kill  you  if  you  do  too  much,  but  not  money.  Money won’t harm you,  physically  anyway.  The cash addict can madly  mainline  money from  the  trading  floor, the  Senate  floor  or,  with  smart  phone  in  hand,  the  bathroom  floor  without  ever  risking  a deadly  OD.  It  would  be  comical  if  it  wasn’t  so  tragic. For the  addict, their  families  and  society  at  large. Like  all junkies,  cash  junkies  will  do  anything  to  service  their  need.  They  will certainly  neglect  their own families  while  they  work  long  hours  to  make  more. To  the  outside  world,  everything  will  seem  fine.  They  will  ‘keep  it  in  the  family’ as  they dissemble,  distract  and  confuse.  They  will  buy  nannies  and  ponies  and  cars.  They  will  snort cocaine  and  go  shopping  and  jet  off  to  exclusive  resorts  to  hobnob  with  other  wealthy  people. They  will  present  their  wealth  fashionably,  but  as  Sam  Polk  one  day  realized,  the  pain  and anguish  are  real.

    And it’s not just the neglected family that suffers. There are no boundaries. Like a fentanyl addiction, it takes over and distorts everything. Cash addicts in the U.S. government (in any government, really), their campaigns funded by the wealthy, will steal from the poor, destroy the environment, rip off sick children, engage in colonial exploitation, start wars and even sacrifice kids in yet another school shooting, if it means they can make some more bucks. And that’s not even the worst of it. The addicts will hijack human spirituality, exploit hatred, brainwash the masses, derail democratic politics and tinker with fascism in their desire to have more. So, what to do?

    Well, as strange as this is going to sound, there might be a pill for all this. In an experiment in the journal Current Biology, tolcapone, a drug that prolongs dopamine feelings, made participants who took it rather than a placebo become more egalitarian about money. A magical cure seemed okay to Sam. But even if you can’t get access to tolcapone, there are immediate things you can do.

    1.       Stop neglecting and abusing children. The research is coming in on this one: Abuse and neglect in childhood cause copious mental and emotional problems, and lead, via damage to neurochemical systems and cultural supports, to addictions in adult life. If we don’t want to raise another generation of addicts, speak up when you see children being mistreated by their parents, teachers, priests or anyone else given access.

    2.       As clichéd as this may sound, do something about the addict in your life. Stop avoiding the situation. Quit enabling the addiction. Stop suffering in silence. Don’t lie to yourself. We all have experiences with addiction and we all know, if we don’t do something, it only gets worse. So do something.

    3.       To make sure we don’t fall victim to a money addiction, get out and get active. Most important, get involved politically. At the very least, get out and vote. Democracy may be under global attack and fascism may soon come a knocking, but we still have the power to vote. Sure, they’d like you to believe it is a ‘good versus evil,’ left versus right, Darth versus Luke sort of thing, but there are addicts on both sides, and even Princess Leia may struggle with addiction.

    See this problem for what it is: A loosely organized group of global addicts getting together to figure out ways to enrich each other financially. If you think this is about “draining the swamp” and jobs for the people, you are mistaken. It is about sidling up to the trough and gobbling as much as they can, no matter how obscene it gets. It is about the ‘you scratch my back, I’ll scratch back’ service of globalized addiction. It is a serious problem, and we should all be concerned, because to the enabled addicts, everything, even a holocaust, is merely an ‘opportunity’ for amassing more wealth. Like any addict in the throes of their addiction, there’s no limit to how far this can go. While there is still time, gently, carefully, take their big sticks and red buttons away. Don’t hurt them and punish them, because that’s what made these people sick to begin with. Instead, remind them of the illness that binds them, and get them the help that they need. Don’t let yourself or the ones you love become like Sam Polk, ‘a giant fireball of greed.’ See the truth. Take some action. If you need it, get help.

  5. Ken Zimmerman
    July 21, 2021 at 10:11 am

    ,

  1. No trackbacks yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.