What does the European Alliance for Responsible R&D and Affordable Medicines do?
We demand that governments attach public interest conditions to publicly funded medical research and development.
What are your challenges?
It is very difficult to track how much public funding has gone into a certain vaccine. Nobody really knows, except maybe for the companies that develops it, as the funds are not tracked in one coherent way. This and other pieces of information – such as the total cost of research – are not known by governments: this means they are blindfolded when they negotiate prices with the companies.
The industry claims that the public investment in medical research and development is very little. Yet, a lot of the basic research that will be taken up by the pharma industry comes from public universities, and there are other forms of public support from grants to tax credits. Even if the investment is minimal: if the public is an investor, it should act like one and demand something in return. Governments should demand companies to disclose all public funds that have gone into the development of any concrete medication over the years.
The EU’s Horizon 2020 research program has a public-private partnership with the pharmaceutical industry called Innovative Medicines Initiative. How do you describe this structure?
The industry is on equal foot with the EU Commission, with 50-50 representation on the governing board.For every euro invested by the Commission, the industry needs to match their contribution “in-kind” – for example with their expertise. If some priorities are not interesting for the industry, they will not be picked up.
In addition, the EU Commission never owns the intellectual property, not for IMI results nor within Horizon 2020. IP management is decided by the consortia internally.
The World Health Assembly, consisting of the 194 countries who are members of the World Health Organisation (WHO), last year passed a resolution to support greater public disclosure of medicine prices. What is the value of this agreement?
It was proposed by the Italians and went through with opposition from Germany, the UK and other countries. It might be a coincidence, but there is a strong pharmaceutical industry in those countries. The adopted version of the resolution was watered down a bit, but is still a very good starting point to bring the issue of transparency on the table.
It is up to each country to adopt measures to implement it. Italy started with a decree. But then the government changed, and the process stalled.
How does Covid-19 influence all this?
In this situation, let us not throw accountability out of the window just because of the urgency.
Covid changes the perspective. Everyone is looking at the pharmaceutical companies to find solutions. For them, this is a good chance to improve their reputation. Whoever will come up with the vaccine, will be seen as the saviour.
Some companies have already announced that they will sell it at a low price. They are trying to be good, knowing this will benefit them in the long term. And when Johnson & Johnson says it will sell a vaccine at 10 USD a dose, this is maybe reasonable in Germany but not in Congo. I am sure they will make some profit out of that: I doubt that they will lose money on a Covid vaccine. The demand is global. It is more likely that there will be a production capacity problem.
To what extent might this situation be an opportunity to break with structures that often result in profits trumping public health interests?
It’s early to say. It will very much depend from the political will of the funders (be it governments, CEPI, EC, Gates, Wellcome…) to keep some of the practices improved for the emergency, as standard. We will definitely push for it.
What are the geopolitical issues that could affect everybody’s access to a vaccine?
Politicians of course want to show that they do their utmost to save their countries. I don’t know what is true in the story of Donald Trump and Curevac. But it is true that every country scrambles their resources to save their own people.