The US virologist Jonas Salk, who developed the first successful polio vaccine in the mid-1950s, had a ready answer to anyone who asked if his invention would be patented: “There is no patent. Could you patent the sun?” This decision, as much as the vaccine itself, has saved many millions of lives, but altruism like Salk’s is unheard of in today’s pharmaceutical industry. Now, it seems, how much you – and your country’s health system – can afford to pay will determine which medicines you can access. The noble impulse of harnessing scientific ingenuity to relieve human suffering has been subsumed into just another way of making shedloads of money.
Nick Dearden is the director of the campaign group Global Justice Now, which focuses on issues of economic justice affecting the Global South. His new book, Pharmanomics, published by Verso in October 2023, describes the evolution of globalised ‘Big Pharma’ companies into, he explains, little more than “hedge funds with pharmaceutical firms attached”.
The book is authoritative, detailed, practical and written with passion. Dearden describes the area I know best, the scientific basis of drug and vaccine action, accurately; I know less about intellectual property and much less about economics, but I am confident that these sections will be as accurate.
The profit motive in pharmaceutical production
If a disease is to attract Big Pharma’s interest, it must have certain characteristics. It must be chronic, so any drug must be taken for years, and it must affect millions of patients in countries with health systems able to pay inflated drug prices. It is not surprising, therefore, that more new drugs are being developed for unpleasant but trivial conditions such as hay fever than for so-called ‘neglected tropical’ (almost always infectious) diseases.
And stark inequalities remain even when companies are driven to invest in drugs for infectious disease. Many years after antiviral drugs had turned HIV infection from a killer disease into a liveable chronic one for patients in the Global North, the same drugs were priced way beyond the means of their counterparts in southern Africa. It was only after years of dedicated campaigning that any became affordable there.
Nine new covid vaccine billionaires
The most egregious example of ‘Big Pharma’ greed, however, is found in the Covid-19 pandemic. During the last few years, the names of companies Pfizer and Moderna have become synonymous with life-saving vaccines but, as Dearden explains, that public approval conceals a more sinister truth. Essentially, these companies took the public know-how behind the vaccines, including their ground-breaking mRNA technology, and provided vaccine for the Global North but essentially turned that know-how into cash.
During only one year – the first of the pandemic – Big Pharma’s Covid products made nine new billionaires. Despite the best efforts of the People’s Vaccine campaign, many countries have not yet been able to vaccinate their populations, and the risk of new variants emerging remains. If, to quote the truism, “nobody is safe until everyone is safe”, nobody will be safe from this pandemic – or from the next one – until the behemoth of Big Pharma has been tamed.
There is hope for universally accessible vaccines
Perhaps surprisingly, Dearden ends on a hopeful note, devoting the final two chapters to strategies for doing just that. And here, too, the Covid pandemic is inspiring solutions. Governments in the Global North, including centrist ones like Biden’s USA, are waking up to the importance of the “entrepreneurial state” in drug discovery and the need for tighter regulation of companies.
Furthermore, one particularly inspiring Southern-led initiative suggests a completely new way of doing drug research. Scientists in the WHO mRNA Vaccine Hub in Cape Town, South Africa, are reverse-engineering Moderna’s Covid vaccine and sharing the technology, as well as the vaccine, throughout Southern countries. This technology – and this paradigm – can be adapted for many of the diseases that Big Pharma ignores, and it shows that these companies can be bypassed, and drugs produced at scale.
Dearden ends his inspiring book with a quote from a radical US lawyer, Tahir Amin: “Do governments have the courage to really take this to where it needs to go? How can we pressure them to make sure they do?”
Nick Dearden will discuss the arguments in his book in more detail when he presents the annual lecture of the Nottingham University-based Centre for the Study of Social and Global Justice (CSSGJ) via Zoom on Thursday 7 December, 6–7:30 pm. Tickets and further information are available here.