JOIN USCoronavirus: The vaccine race is on
A global race is on to develop the first vaccine to counteract the coronavirus. Multinational pharmaceutical companies (‘Big Pharma’), publicly and privately funded research labs, hospitals and universities from the US, UK, China, Israel and elsewhere are in the race. Indian drug companies will not be competing in the race in any meaningful way since their primary focus is on being the world’s chief supplier of generic drugs. Generic drugs can be sold only after the patents on the original drugs have expired. While some patented drugs are also manufactured in India under licence from the patent-holders to be primarily sold in the US or elsewhere -- India accounted for 24% of drugs imported into the US in 2018, according to the US Food and Drug Administration -- these same drugs when sold in India typically turn out to be very unaffordable, even for the middle class.
Huge amounts of money and instant fame await the winner(s), who will instantly patent the vaccine. The more prescient ones have been busy since last December. Given America’s vast pool of resources, it is more than likely that the winner will be from the US. Of the top 15 biotechnology companies in the world, nine are from the US, the rest from Europe. Likewise, of the top five pharmaceutical companies selling prescription drugs, four are from the US, the other from France.
To give you an idea of the profits that a successful coronavirus vaccine can generate, I have done a comparative cost study of several drugs sold in the US and used in the treatment of a variety of ailments such as malaria, HIV, diabetes, obesity, and leukemia. The data shown in the table below has been obtained from publicly available web sources and copies of pharmacy receipts sent to me by patients.
There have been recent press reports that it costs only 12 cents to manufacture one dose of BCG vaccine; it retails for $142 in the US and around $8 in India. The most expensive item in the table below is the generic drug Exjade (see last row) which even in India sells for $700. The drug has been around for 40 years, but the price has yet to come down.
In the US where laissez-faire economics is the norm, drug companies, hospitals and doctors set their own prices. Unlike in many other countries, most hospitals in the US are for-profit entities, as are ancillary health services such as ambulances and diagnostic testing companies. Quite often, a single umbrella organisation owns a set of hospitals, specialty doctors, pharmacies and labs, thereby exerting monopoly power.
As of June 5, more than 6.7 million people have been infected worldwide and there have been nearly 400,000 fatalities. And infections are just beginning to rise in many countries, including India.
Let us hope that the winner does not subscribe to US President Donald Trump’s perspective on money, immigration and race, or his handling of the pandemic. Also, the winner may wish to take note of the sentiments expressed in two well-known quotes. Gandhi said, “There is enough in this world to satisfy everyone’s need, but there will never be enough to satisfy even one man’s greed.” And then there is former US Ambassador to India Daniel Patrick Moynihan: “What has India exported other than communicable diseases?”
Moynihan’s quote and Trump’s derogatory “shit hole countries in Africa” hide an ugly truth born of racism: that significant amount of testing of experimental drugs is conducted by multinational pharmaceutical companies on uninformed or under-informed citizens of developing and under-developed countries in Asia and Africa.
Given such attitudes among world leaders, when a successful vaccine is developed, it is imperative that all rights associated with the vaccine should be given to the World Health Organisation (WHO) for country-specific pricing and distribution in a non-discriminatory manner. Factors such as income disparity, racism, xenophobia, political or religious leaning, etc., would not then enter the picture. After all, genome data, patient health data, and bodily fluids have been provided by different countries from a globally infected populace. Of course, in all fairness, apart from the WHO’s administrative costs, all revenues accruing from the worldwide sale of the vaccine should be given to the entity that created the vaccine.
The WHO is a repository of worldwide health data, especially as it pertains to epidemics and vaccines. The WHO has 196 member countries and it is divided into six regions of equal-size populations. The smallest region has 11 countries while the largest region has 52. There are WHO offices in every region of the world and in some cases, every country in that region has a WHO office. The staff of WHO is mostly comprised of medical professionals, many of whom are top epidemiologists in their own countries. The existing infrastructure of WHO is uniquely capable of pricing, distribution and administering vaccines in every country in the world. Also, WHO has a wealth of experience dealing with diseases such as HIV, SARS and malaria.
Of course, if WHO is given possession of the Covid-19 vaccine, it will need to set prices based on country-specific affordability. For example, using WHO data for 2014, the yearly per capita expenditure on health in Burundi was $58 compared to $9,403 in the US.
How likely is my suggestion to be taken up? Not very, but one can always hope. India currently chairs the Executive Board of WHO.
(The writer is a computer scientist based in the US)