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Within weeks, President Donald Trump is expected to announce a short list of promising Covid-19 vaccine candidates. As part of its Operation Warp Speed program, the Trump administration has given Big Pharma billions of dollars to expedite vaccine development, but provided little assurance that corporations will not profiteer. This raises a crucial question: If we get a safe and effective vaccine, will everyone be able to afford it?
The idea that some people would not receive a vaccine was once unthinkable. In a now legendary story, Jonas Salk developed the polio vaccine in 1955—and then gave it away for free. An interviewer once asked Salk who owned the patent for his polio vaccine. He responded, “Well, the people, I would say. There is no patent.” Salk was incredulous. “Could you patent the sun?”
Since then, pharmaceutical corporations have patented the medical equivalent of the moon and the stars. Patent monopolies have fueled the current drug pricing crisis, and they may block access to any future Covid-19 vaccine.
Consider the case of Moderna, the biotechnology company developing a short-listed vaccine with the National Institutes of Health. Moderna brags about its “broad and deep patent estate” on its website. The company has been granted over a hundred patent monopolies globally. If its vaccine proves safe and effective, Moderna’s monopolies will allow the corporation to set an exorbitant price. Monopolies will also allow Moderna to block other manufacturers from supplying the vaccine. It could throttle supply. The decision would rest with Stéphane Bancel, the CEO of Moderna.
Will Bancel be a hero like Salk? Salk refused a monopoly and trained scientists around the world to shore up supply. Bancel, on the other hand, has watched as Wall Street investors pumped his corporation’s stock price and made him a billionaire. Bancel has vaguely pledged to set a price in line with other respiratory vaccines—which cost up to $800—and flatly said, “We won’t have enough supply at the global level.” Despite this, Bancel has refused to relinquish his corporation’s monopolies.
The public should get a say. Like Salk, Bancel has benefited greatly from public dollars. His corporation received millions in funding as early as 2013 to help develop its new way of making vaccines. Federal scientists helped design the new Covid-19 vaccine and are now running the critical human tests. The government also just gave $483 million to scale manufacturing. The public is paying at every stage for this potential vaccine—and so many others. All five candidates Trump is expected to short-list have benefited from public funding.
Fortunately, we do not have to wait for Big Pharma to find it in its heart to be benevolent. We can force executives to be like Salk. The US government has the authority, under existing law, to break patent monopolies. In exchange for a modest royalty, the government can and should allow any manufacturer to produce promising Covid-19 medicines. The government threatened to use the approach to lower prices for a critical antibiotic when letters containing anthrax spores were sent to media outlets and the offices of Democratic Senators Tom Daschle and Patrick Leahy in 2001. The government should also require companies to share know-how, and ramp up public production for promising medicines. All contracts should safeguard affordability and availability for all.
The pharmaceutical industry’s principal objection to this approach would be its potential impact on innovation. We understand the need for medical innovation more than most. One of us was diagnosed at age 32 with ALS, a debilitating disease with a life expectancy of three to four years after diagnosis. The industry claims that without extravagant rewards, there would be no extravagant effort. But that story ignores just how deeply corporations like Moderna rely on public science. The National Institutes of Health alone spends $41 billion annually advancing medical research. Congress has appropriated billions more for Covid-19 work. Yet the corporations who benefit from this investment will be under no obligation to act in the public interest.
When Salk developed the polio vaccine, President Dwight Eisenhower said he was a “benefactor to mankind.” His work was “in the highest tradition of selfless and dedicated medical research.” Salk taught us that vaccines belong to the people.
It is time we claim them as ours.