It was another time, and a different world. In 1955, after it was announced that the US virologist Jonas Salk had developed the first safe and effective vaccine against polio, he was interviewed on CBS television, when he was asked “Who owns the patent on this vaccine?” Salk replied: “Well, the people I would say. There is no patent,” adding “Could you patent the sun?”
In April 1980 he was interviewed by The New York Times. “I think of biological knowledge as providing useful analogies for understanding human nature,” Salk said. “People think of biology in terms of such practical matters as drugs, but its contribution to knowledge about living systems and ourselves will in the future be equally important. […] It's much more important to cooperate and collaborate. We are the co-authors with nature of our destiny.”
The great gulf that now separates us from the old values of medicine and medical research was illustrated earlier this week by Paul Hudson, the British CEO of Sanofi, the giant French pharma group. In an interview with Bloomberg he announced that the US would be first in line to receive the vaccine against the Covid-19 virus currently under development by his company, should it succeed. Hudson explained that because the US had funded Sanofi’s research into a possible vaccine, “The US government has the right to the largest pre-order because it’s invested in taking the risk”. Gone were notions of sharing knowledge with the world and acting for the common good.
Enlargement : Illustration 1
Since several decades now, the health sector has become a commercial market. It is a business in which the “Big Pharma”, the huge multinational drugs firms who dominate the sector, have no scruples in patenting the living world, all that nature has created. If it had indeed been possible, they might even have patented the sun and demanded royalties.
With Covid-19, this development has taken an even more chilling aspect. At the end of April, the general assembly of the United Nations adopted a motion calling for the largest possible international cooperation in face of the virus pandemic, and notably the universal availability of a vaccine across the globe. But China and the US have decided otherwise; vaccines, tests, medicines – all that can help fight the crisis – have become a commercial war, a battle between world powers.
As of the very beginning of the pandemic, US President Donald Trump announced that the discovery of a vaccine should be an American success story. Wall Street applauded, such as it is that the financial world considers the health sector, like the agribusiness, as one of the most solid in these uncertain times, a domain where, whatever happens, there are still billions to be made.
In this struggle for supremacy, the US president has proved himself ready to try anything. At the beginning of February, the press in Germany reported that the White House had made a substantial financial offer to CureVac, a relatively small German medical research company working on a vaccine for Covid-19, to supply it “only for the United States”. The reports caused outrage in Germany, prompting the country’s economy minister Peter Altmaier to declare “Germany is not for sale”.
In face of the anger, the US backed off, but it did not for as much give up on its strategy, tempting non-US pharma firms with the promise of billions in research funding. Several have been won over, not just by the initial offer but also sure in the knowledge that they would be able to impose their prices on vaccine sales given the freer regulations on this in the US, opening the prospect of vast future profits.
It was in this context that Sanofi joined up with its British competitor GlaxoSmithKline in a US-funded project to develop a vaccine for the coronavirus and, if successfull, initially produce a yearly 600 million doses.
“That’s how it will be because they’ve invested to try and protect their population, to restart their economy,” Hudson told Bloomberg in the interview published on Wednesday.
In France, his statements caused an uproar. “The engagement of the French people to develop a champion in the healthcare sector cannot [be allowed to] result in seeing it prefer other markets for the launch of its vaccine,” said France’s Parti socialiste in a statement this week, referring to the state aid, notably in tax breaks for research, that has for years been handed to Sanofi. “There cannot be gains that are systematically privatised, and losses or investments systematically passed on to the French collective effort.”
On Thursday, South African President Cyril Ramaphosa joined with a number of heads of state and medical experts in publishing an open letter, issued by UNAIDS and Oxfam, calling for “a people’s vaccine” against Covid-19, available on an equal basis for all world populations. “Nobody should be pushed to the back of the vaccine queue because of where they live or what they earn,” wrote Ramaphosa in alarm at the medical nationalism of a commercial war which runs contrary to principles adopted by the UN.
The French government, meanwhile, had no option but to also step into the Sanofi controversy. President Emmanuel Macron said he was “disturbed” by Hudson’s comments, adding that “the vaccine against Covid-19 should be a worldwide common good” that was “outside of market rules”, while his prime minister, Edouard Philippe, declared that Sanofi had given him “every assurance that the vaccine would indeed be distributed in France”.
The episode has been a new demonstration of the French executive’s amateurism and double-talk. Contrary to the governments of Germany and Britain, which have provided important sums to fund vaccine research by their pharma companies, that in France chose not to do so. French research projects into producing a vaccine were excluded from the first tender for funding issued under the “Flash Covid-19” action programme launched by the national research agency, the ANR.
Except by admitting that it is unaware of what is going on, how could the French government pretend to have suddenly discovered Sanofi’s collaboration with the US? Had Paul Hudson not detailed the matter publicly, would the government have spoken out?
Engulfed by the controversy, Sanofi on Thursday sought to play down Hudson’s comments, when the head of the group’s French arm, Olivier Bogillot, told BFMTV that "the goal is to have this vaccine available to the US as well as France and Europe at the same time", adding that this would only be possible "if Europeans work as quickly as the Americans".
"The Americans have been effective in this period. The EU must be just as effective in helping us make this vaccine available quickly," he said.
On May 4th, Macron and German Chancellor Angela Merkel joined other heads of government from around the world in a European Union-organised fundraising video-conference in which they pledged sums for research into developing a Covid-19 virus vaccine. Around 7.3 billion euros were raised, in vastly different amounts, but its concrete use is still to be defined.
Sanofi, meanwhile, said on Thursday that regarding its vaccine research activities in Europe, "We are having very constructive conversations with the EU institutions and the French and German government among others”. That raises the question of whether the company will have open access to public funds to finance its research.
'We will only halt Covid-19 through solidarity'
Successive governments in France have handed medical research to the private sector, abandoning almost all ambitions for public-funded research. From year to year, public laboratories have seen their budgets reduced, leading them to go cap in hand to private groups.
Sanofi, like others in the sector, give funding to the French national health and medical research institute, INSERM, to the health research branch of country’s atomic and alternative energies agency, the CEA, and to the research activities of a number of French teaching hospitals. But the research involved is that of frameworks and themes chosen by the private sector, which of course benefits from the commercial rights and future sales revenue of the fruit of that public research.
For France’s high administrations, the value of public sector-led medical research is held in low esteem, where there is no place for its own ambition, ideas or success. It is allowed to be plundered without causing any concern from the ministry in charge of research policy, the universities and the healthcare institutions.
In France’s yearly Téléthon, a televised fundraising event for medical research, the scientific discoveries that may result from that public research, financed by donations from the public, are subsequently bought up by the private sector, which obtains the commercial windfalls.
This plundering of public research has become a general practice that is acceptable at all levels of the state, a state which for years has been content to distribute funds from the public purse in aid, including tax breaks, without demanding anything in return. That is particularly the case regarding the major French corporations, so-called economic “champions” of the nation, in the cause of meeting international competition.
Sanofi, the third-largest pharma group worldwide and a global leader in vaccine production, is in fact the sum of a merger of public groups – a branch of Elf Aquitaine and Rhône-Poulenc. It also owes part of its development to the French social security system and the national drug agency via which a significant part of its annual turnover from drugs sales is assured.
On top of this come various state aid grants. In its statement on the controversy this week, France’s Parti socialiste noted that Sanofi receives a yearly 150 million euros in tax breaks for research, and in 2018 was given 24 million euros in tax breaks from a now-defunct measure to encourage companies to maintain staff numbers.
The Observatory for transparency in medicine policy-making (l’Observatoire de la transparence dans les politiques du medicament), an independent French pressure group, said this week that while Sanofi has received a total of 1.5 billion euros in tax breaks on research over the past ten years, it had “over this same period axed more than 2,800 research posts and abandoned entire fields, like Alzheimer’s [disease]”.
This general laisser-faire and absence of control has spread to the security of healthcare provisions. It took the Covid-19 pandemic and the halting of medicine production in China for the French government to recognise that 80% of the active principles of drugs are produced there, and that their supply was no longer ensured.
In the interests of turning in the greatest profit, Sanofi decided many years ago to relocate outside France, to India and China, the production of drugs that it no longer has exclusive rights to, or which generate low returns. A move which caused no concern to anyone at a governmental level.
There is every reason to fear that once the current controversy has passed the bad old habits will return. That, in the name of defending France’s national economic “champions”, the pharma giant will again be exempt of any control, of any reciprocity, in the name of its performance amid international competition.
Now involved in a worldwide commercial battle, France is even in danger of becoming embroiled in vaccine “nationalism” while hiding behind the European banner. Yet the Covid-19 crisis has taught us that it is urgent that issues of healthcare are removed from commercial considerations, and that medicines are returned to serve the common good.
“We will only halt Covid-19 through solidarity,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization in a statement issued on April 24th. “Countries, health partners, manufacturers, and the private sector must act together and ensure that the fruits of science and research can benefit everybody.” Ghebreyesus warned that the virus would likely remain a worldwide threat for some time, notably if numerous countries and people were excluded from access to vaccines and medicines for want of being able to pay for them.
It is thanks to massive campaigns of freely available treatment that smallpox was eradicated, and that the devastating spread of polio was significantly reduced. However, measles, for which vaccine patents remain in private-sector hands, is still rife.
What is at stake is that without international solidarity, without a sharing of knowledge and medicines, the worldwide battle against the coronavirus is at risk of suffering years of defeat.
-------------------------
- The French version of this article can be found here.