The COVID-19 vaccines slowly entering circulation offer a glimmer of hope for millions of ordinary people who have spent the best part of a year trapped in the seemingly endless nightmare of this pandemic. For the pharmaceutical capitalists, these essential resources (whose development has been funded largely by public money) are a goldmine to be plundered. Meanwhile, stockpiling by the imperialist powers, and Big Pharma’s bottom line put a working vaccine out of reach for the poorest parts of the world.
A number of vaccines have now passed phase three trials and been approved for public use, including an mRNA-based product from US pharmaceutical giant Pfizer and its German partner BioNTech; and an inactivated coronavirus vaccine by the Chinese company Sinovac. Drugs by the Boston-based biotech firm Moderna and the University of Oxford/AstraZeneca have posted good results in phase three and are nearing approval.
The rapid turnaround reflects the urgent need for a working vaccine. The political leaders of almost every country on earth have catastrophically failed to contain this pandemic. We are well on the way to two million deaths, and the capitalist system is facing the deepest crisis in its history, with many parts of the world seeing new lockdowns during the critical holiday season, particularly in Britain, where a more transmissible strain of the virus has been reported.
Given the fact that natural herd immunity (in addition to causing millions of unnecessary deaths) is unlikely to stop the virus, mass vaccination is the only realistic option. As a result, the ruling classes of the world’s biggest economies have thrown all their weight behind getting a working vaccine over the line, in order to resume normal production and get profits flowing again.
Despite the colossal public health emergency, Big Pharma was initially slow off the mark. Historically, developing vaccines – especially for active pandemics – has seldom been profitable. The discovery process is slow, results are not guaranteed, and poor countries often require high supplies which they cannot afford. By contrast, churning out generic and lifestyle drugs (like Viagra) that are popular in wealthy countries provides a much more reliable source of income.
The pharmaceutical capitalists don’t weigh lives in the balance when deciding where to invest their capital, only profits. This is why no vaccine has been developed for Zika, while an Ebola vaccine was only approved in December 2019, for example – these diseases mostly affect poor parts of the world. Meanwhile, abandonment of research on Sars CoV-1 due to lack of profits considerably set back research into a vaccine for COVID-19.
Socialising the risk, privatising the profits
But as the scale of the crisis triggered by the novel coronavirus became apparent, capitalist governments began throwing billions at Big Pharma in order to facilitate vaccine development. It was only then that it entered the vaccine race in earnest. Moderna received $2.5 billion in US government public funds as part of Donald Trump’s ‘Operation Warp Speed’ initiative, while Pfizer/BioNTech was supported by a $443 million from the German government, along with a $118 million loan from the European Investment Bank. This is despite Pfizer’s extremely selective claim to have “never taken any federal money” from the US government. Furthermore, the UK government contributed £84 million to the development of the Oxford/AstraZeneca vaccine.
In total, various states have put £6.5bn towards creating a COVID-19 vaccine, with an additional £1.5bn coming from not-for-profit organisations. On top of benefiting from massive sums of public money, many of these vaccines were made using university or state-funded research. The mRNA technology behind the Pfizer and Moderna vaccines, for example, originated in US and German government labs.
By rights, given that these life-saving drugs have been largely funded by the tax-payer, and rely on the discoveries of publicly-funded science, surely they ought to be made available to the public at no additional cost? AstraZeneca, who will be manufacturing and supplying the vaccine developed by Oxford University – which was entirely funded by the state and not-for-profit organisations – will only seek to cover production costs. Although this only applies to "the duration of the pandemic", leaving the door open to make a profit in future. As for the biggest players: they fully expect a handsome return on their capital investment.
Although they have refused to open their books to scrutiny (meaning we don’t know the exact costs of R&D, clinical trials, and manufacture), it is estimated that Pfizer and Moderna will generate $32 billion in COVID-19 vaccine revenue in 2021 alone. Aside from their shareholders, this will delight British Chancellor Rishi Sunak, whose former hedgefund Theleme Partners has invested heavily in Moderna.
Moderna initially proposed a price of $50-74 per person (for the necessary two doses) for high-income countries, while Pfizer was aiming for $40 per person. Not only are these vaccines being sold for a profit, but they are also being sold back to the states that funded them in the first place – with the US, British and EU governments securing hundreds of millions of doses. This means that, when these vaccines get as far as the public, they will have effectively been paid for twice. Belgium’s Budget State Secretary Eva De Bleeker caused an embarrassment by tweeting a table with the price of each vaccine purchased by the EU, along with how much Brussels will spend on them in total.
Pfizer CEO Albert Bourla (who personally sold his stock of shares to the tune of $5.6m after his company posted its phase three trial results) scoffed at the “radical” idea that companies should not expect to profit from a COVID-19 vaccine. “Who is finding the solution? The private sector,” he said. Another corporate spokesperson added: “From the beginning, we have been investing at risk,” because Pfizer will only be paid for delivering a working vaccine.
But in fact, the risk has largely been borne by the public purse. This is the nature of private pharmaceutical production under capitalism: it is not innovative, but parasitic. Big Pharma swoops in to secure patents on new medicines and technologies that are mostly developed by the state, claims government funding to manufacture saleable commodities, and prices its products so as to secure a hefty profit.
A report published in 2017 by the National Academy of Sciences of the USA found that all of the 210 new drugs approved by the FDA between 2010 and 2016 were supported by National Institute of Health funding, collectively totalling more than $100 billion. But none of the money accrued from these drugs was funnelled back into state research. Rather, it went straight into the hands of the Big Pharma companies that secured patents to sell them, sometimes with 1000-times mark-ups. While some of the resulting funds go to private R&D, a healthy proportion go to executive bonuses, political lobbying and the manufacture of existing drugs.
It is the height of cynicism for these fatcats to talk about ‘risk’, while ordinary people are risking their health at work or facing destitution during a pandemic. Big Pharma’s profiteering off a public health catastrophe that has left over a million people dead and thrown tens of millions more into poverty and unemployment is the strongest possible evidence for the need to expropriate this rotten sector under democratic workers’ control.
The poor denied access
We are often told that the COVID-19 pandemic is a common enemy of the world: that it knows no borders, and we are all in it together. But the dual fetters of private property and the nation-state mean that these desperately needed drugs will be denied to millions of people in poor countries.
The stacks of cash handed over by the advanced capitalist countries to pharmaceutical companies came with conditions attached: including priority access. The US secured 300 million doses from Pfizer and Moderna, with the option of buying 800 million more. Additionally, it has preordered 810 million doses from AstraZeneca, Johnson & Johnson, Novavax and Sanofi, with expansion deals could push the number to 1.5 billion. Britain claimed 357 million doses from the above companies, in addition to the smaller Valneva, with the option to buy 152 million more. And the EU has secured 1.3 billion from the same companies, in addition to the German company CureVac, with the option to purchase 660 million more doses.
One consequence of the anarchic nature of free-market production is that a number of different pharmaceutical companies worked separately and secretly on producing a working COVID-19 vaccine. Because there was no guarantee that any one of these candidate drugs would be effective, the rich countries hedged their bets by buying up a swathe of different vaccines. Aside from depriving billions of poorer people of working vaccines, this ‘pick-and-mix’ approach is exceptionally inefficient, especially as some of these drugs (like those based on mRNA technology) have to be stored in specialised, super-cold fridges, at great expense. There is also a question mark over how fast Big Pharma can even fulfil these orders, as vaccine manufacture and distribution is a fraught process.
All told, the richest countries in the world have on average bought enough doses to vaccinate their populations three times over. In the case of Canada, the population could be vaccinated five times over. This absurd level of stockpiling potentially spells disaster for the poorer countries (which are poor because they have been exploited by imperialist countries in the first place), who have been pushed to the very back of the queue. The People's Vaccine Alliance – a network of organisations including Amnesty International, Oxfam and Global Justice Now – has estimated that 70 lower-income countries will only be able to vaccinate one in 10 people.
A handful of wealthy ‘philanthropists’ have pushed for access in poor countries. For example, Adar Poonawalla (head of the Serum Institute of India) secured large quantities of the AstraZeneca and Novavax vaccines, stating “India gets priority because it’s my home country.” Similarly, Mexican billionaire Carlos Slim helped fund a deal for 150 million doses of the AstraZeneca vaccine in Latin America. And the Bill Gates Foundation has launched an effort to secure a billion doses for 92 poor countries. It is total madness that vaccine provision to billions of people depends on the caprice of a few capitalists, who ultimately are driven by a desire to rescue the decrepit capitalist system. Moreover, their ‘charity’ is not nearly enough to plug the gap – whereas expropriating their massive fortunes would have a much greater impact.
Dr Sidney Wong, Executive Co-Director of Médecins Sans Frontières (MSF)'s Access Campaign stated: “Right now, we're in a situation where a lion's share of the limited number of first doses have already been snatched up by a handful of countries like the US and UK, as well as the EU, leaving very little for other countries in the short term. What we really want to see is a rapid expansion of the overall global supply, so there are more vaccines to go around and doses can be allocated according to WHO's public health criteria, not a country's ability to pay.”
But under capitalism, a country’s ability to pay tops all other considerations. Attempts to get around this on a capitalist basis are futile. The World Health Organisation (WHO) has set up the COVAX programme: a global scheme to vaccinate people in low-and-middle-income countries against COVID-19. It has a goal of delivering 2 billion vaccine doses by the end of 2021 to 20 percent of the most-vulnerable people in 91 countries, mainly in Africa, Asia and Latin America. But internal documents suggest the scheme faces a “very high risk” of failure, with billions of people potentially being left with no access to vaccines until as late as 2024.
This is partly because the world’s two biggest economies, the USA and China, have made no financial commitments to COVAX, and nor have they allocated any of the doses they have secured. China is running its own initiatives to make some of its vaccines available to poorer countries in its sphere of influence, which will of course serve its geopolitical interests in challenging the US on the world stage. Unsurprisingly, President Donald Trump has extended his ‘America First’ maxim to vaccine development, making no commitments to addressing vaccine inequalities, in addition to withdrawing from the WHO.
With President-Elect Joe Biden due to take office in January, some commentators are hoping for a change in policy. Biden has already pledged to rejoin the WHO for instance. However, a change at the top will not alter the fact that the biggest countries maintain a stranglehold on the global supply of vaccines. There is some hope that, when vaccination efforts begin to take effect next year, demand will decrease and prices will start to drop. However, if it turns out that the COVID-19 vaccine is required on an annual basis, like a flu jab, then, as Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center, states: “all bets are off.” Big Pharma, which privately owns the means of pharmaceutical production, will keep its prices high for as long as its products remain an essential commodity. This will see rich western countries continuing to jump the queue, while the poorest nations are left wanting. What this means in effect is that millions of lives will be sacrificed on the altar of profit.
Private property and the nation state
There is much talk in the COVAX internal documents about the problem of “risk”, which euphemistically means the financial outlay of private companies supplying vaccines to low-income markets. The WHO scheme relies on cheaper vaccines from companies like AstraZeneca, which also don’t need to be stored at super-low temperatures, making distribution easier. By contrast, Pfizer and Moderna have no intention of lowering the costs of their products (which have posted better results in trials) for poorer countries.
Recently, Pfizer’s submission of documentation about its vaccine to the European Medicines Agency was hacked, causing the company to scramble to protect its intellectual property. This incident raises a salient point. Given that this drug was funded in large part by the state and based on research from state labs, why shouldn’t this documentation be freely available? Making this information public would allow poorer countries to develop cheaper generic versions of the Pfizer vaccine domestically, rather than having to import expensive products from elsewhere.
MSF have warned that this kind of data sharing is in fact a necessity for solving the global pandemic, calling on the sharing of all necessary intellectual property and data so that as many companies as possible can produce these vaccines. Facilities like the WHO’s COVID-19 Technology Access Pool exist for precisely this purpose. And the 2001 Doha Declaration on the 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) – agreed by all WTO Member States – affirms that public health must always take precedence over the enforcement of intellectual property rights.
But private property is sacrosanct under capitalism. Big Pharma has been flouting the Doha Declaration for years, and has instead (according to a 2019 Oxfam report) “pursued an aggressive agenda to subject the developing world to even stricter IP protection, through free-trade agreements and unilateral pressure”. Not even this unparalleled public health emergency trumps the IP rights of pharmaceutical companies. Recently, attempts by the governments of India and South Africa to prevent pharmaceutical companies from enforcing intellectual property rights until global immunity is reached were stonewalled by the Big Pharma lobby.
Under a global, planned economy, all of humanity’s ingenuity and resources would have been pooled into producing a working vaccine, irrespective of outmoded national borders. This process would be expedited by the open and free sharing of data and expertise. Once a breakthrough was reached, this critical resource would be prioritised for production as quickly and affordably as possible, to ensure it reached everyone on earth freely at the point of use. But private property and the nation state place a colossal brake on this process, to the detriment of the human race.
And even in countries where vaccines become available, we have the problem of public hesitancy. A recent survey by Kantar found that the number of people willing to be vaccinated against COVID-19 in western countries has rapidly declined. Currently, only 43 per cent of British people said they would “definitely” get vaccinated if eligible. This is compared to 30 percent of people in the US, 38 percent of Italians, 35 percent of Germans and a mere 21 percent of French people.
Historically, ‘anti-vax’ conspiracies have been a fringe concern affecting the more backward layers of society. But this more widespread scepticism has a different character. Many respondents in the survey expressed doubt in “the safety of vaccines because of the speed with which they are produced”. Indeed, many of the companies behind the vaccines lobbied to have regulatory processes relaxed in order to facilitate a quick turnaround. Although given the urgent need for a vaccine, this isn't too surprising, and we should emphasise that clinical trial results for the headline COVID-19 vaccines seem robust. More tellingly, the same survey found that: “The countries with the least trust in government – France (18 per cent trust) and the US (14 per cent trust) also see the lowest numbers willing to be vaccinated.”
The catastrophic mishandling of this pandemic, the constantly shifting rules, the mixed messaging, and the endless lockdowns to little apparent effect, combined with a pre-existing collapse in support for the establishment following a decade of attacks and austerity, mean that millions of people no longer trust a word coming out of politicians’ mouths. For many, this distrust also extends to the ‘scientific establishment'.
This mood, which reflects understandable class anger in a distorted way, has been demagogically fanned by right-wing figures like Donald Trump, Nigel Farage and Jair Bolsonaro, who have exploited the despair and anger of the population by sowing doubts in the dangers (or even the existence) of the pandemic. This is despite none other than Trump ally Mike Pence recently publicly taking the Pfizer vaccine on live television.
That this mood has penetrated significant layers of society, despite millions of cases and over a million deaths, is evidence of the depth of the crisis of the capitalist system, which has lost all trust from the population. It is also evidence of the pathetic failure of the leaders of the labour movement to channel this anger at the elite in a progressive, class-based direction. If this scepticism translates into low vaccination rates, then we might not reach the 70 percent immunity necessary to end the pandemic. All of the money and effort spent on producing a vaccine in the first place could be for nothing.
It is therefore critical for the left to point their finger at the real source of this crisis: the capitalist system and its hapless political representatives. If the vaccination process had been managed by a socialist state, which had carried out effective lockdowns with provided adequate financial support to people prevented from working, this current of resentment and mistrust would not exist. With Big Pharma expropriated under workers’ control, its books could be opened and the whole process of vaccine development made fully transparent, to ensure public confidence. People would gratefully receive a vaccine to put an end to the dark night of this pandemic. Instead, the remarkable accomplishments of science could be undermined by a senile economic system. The experience of this crisis has exposed the grave sickness of capitalist society, the only cure for which is a socialist revolution.