Factually! with Adam Conover - Does Pfizer Have Too Much Power? with Hannah Kuchler

Episode Date: December 22, 2021

Even though the COVID-19 vaccines were born of publicly-funded research, our privatized medical system has left them to for-profit companies like Pfizer to distribute, giving these private companies massive power in a time of great need. On the show this week to dive into the ways Pfizer has used and abuse its power is Financial Times global pharmaceutical correspondent Hannah Kuchler. Learn more about your ad choices. Visit megaphone.fm/adchoices See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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So if all of that sounds good, if you want a big box of delicious snacks like this for yourself, use the code factually for $15 off your first order at Bokksu.com. That's code factually for $15 off your first order on Bokksu.com. I don't know the way I don't know what to think I don't know what to say Yeah, but that's alright Yeah, that's okay I don't know anything Hello and welcome to Factually, I'm Adam Conover.

I can't thank you enough for being here. This is going to be our last episode of the year, our last new episode of the year. Next week, we'll take a break and run a rerun. So, you know, you'll have something to listen to if you need something while you're puttering around the house with your family. You got nothing to do. You know, you got to do the dishes for the fourth time in a day because you've all been cooking and eating so much. We'll have an episode here for you to listen to, but it's going to be a rerun of one of our outstanding episodes of the past. I hope, though, that during the next couple of weeks, you're able to take some time off. You're able to relax and recharge in the way you need to. I hope you're

able to keep your family and your friends safe from the Omicron surge that's happening now across the United States and many parts of the world. Please, you know, keep those masks on and get your boosties, everybody, if you can. Let's talk about the show this week. You know, speaking of boosties, we've got these incredible miraculous vaccines, right? They are true marvels of modern science, as we have talked about on this show before. They represent a quantum leap in our understanding of the body and our ability to cure disease. And they only happen because the federal government spent billions of dollars to make them happen. At every step along the way, from developing the basic science to preclinical

and clinical trials, and then procurement contracts to ensure there'd be a supply here, the federal government was essential. This is the moon landing of medicine, except if instead of just, you know, sending a couple dudes to a lifeless rock, we managed to cure a disease we had just heard about barely a year earlier. It is mind-blowing, greatest achievement of humanity level stuff. But despite the integral role that the federal government played, you know, the giant not-for-profit enterprise that we all pool our money into in order to do things that support the public good, hopefully, you know, in addition to that thing, we also have a healthcare system that is based around private companies who are there to make a private profit. We might not like that system, but that is the system that we have.

And, you know, in the context of a global public health emergency where, you know, the public good needs to come first, throwing those for-profit companies in the mix, you know, it does tend to make things kind of fucking screwy. For example, take Pfizer, you know, the massive pharmaceutical company whose logos you see on the Viagra ads before baseball games. Well, this company partnered with a small German company called BioNTech to earn the contract to manufacture one of the mRNA vaccines. And in so doing, they achieved one of the greatest windfalls in all of pharmaceutical history. Because let's get this straight.

Pfizer did not invent the vaccine. They didn't do the foundational Pfizer did not invent the vaccine. They didn't do the foundational research that led to the vaccine. All that they do now is manufacture the vaccine. And that has given them an incredible amount of power in the world. I mean, sure, they've cornered the market and they have saved untold lives by manufacturing the vaccine at scale. But they have also kind of been dicks about it. For instance, they've pushed around lower income countries demanding egregious concessions just in order to get this life-saving vaccine. And they have tried to extract as much

money as humanly possible from rich countries like the United States. Basically, they have been playing corporate fucking hardball in the middle of a cataclysmic global emergency all so that they could earn themselves more money. And wouldn't you guess, there's actually an even darker side to this because, you know, these vaccines are safe and they do work, but a lot of people are skeptical of them.

A lot of people are questioning. They're hesitant about the vaccines. And the question a lot of them ask is, hey, hold on a second. Why should I trust the drug companies to keep me safe when they're in it for themselves? Why exactly should I believe that they have my best interests at heart? And even though, once again, these vaccines were by and large created by the federal government, by scientists around the world, even though they are safe and they work, when they're being manufactured and

distributed by companies that are looking out for their own profits instead of the public good, well, it's a lot harder for us to answer that skepticism with confidence, isn't it? It muddles the whole issue. This is what happens when we take a public necessity, not even a public good, but a necessity like this, and deliver it in a little basket with a bow on it to a private, undemocratic, for-profit entity and say, hey, do whatever you want with this. Well, on the show today to talk more about the immense power that Pfizer has been wielding, our guest today is Financial Times global pharmaceutical correspondent Hannah Kuchler, an author of the fantastic recent piece, The Inside Story of the Pfizer Vaccine, A Once in an Epic Windfall. Please welcome Hannah Kuchler.

Hannah, thank you so much for being on the show. Thank you for having me. So you've written extensively about Pfizer's role in the pandemic. First of all, how are they situated among all the different companies that are making vaccines? Are they more successful? They are by far more successful, which is why I was so interested in them. So the facts that I think really stand out are Pfizer is due to make $36 billion in revenue this year, which is more than twice as much as the nearest company vaccine maker. So that's Moderna. And in October alone,

in the big markets where you make money, so the US and Europe, they had 80% and 74% market share. So while a lot of what I want to talk about is perhaps criticisms that could be leveled at other companies, they are so big and so dominant, I think they have to be the focus. So why are they so dominant? I mean, here, at least where I am in LA, everyone's like, oh, did you get Pfizer? Did you get Moderna? Did you get Johnson & Johnson? There's jokes about Johnson & Johnson because of the slightly lower efficacy. I'm triple Moderna myself, and I'm very proud to be because I don't know. I don't really have any allegiance, but these are the kind of conversations people have. Right.

But we don't really have this awareness that that Pfizer is running away with the game. Why were they able to do that? Yeah, that's really interesting. I was in the States for the beginning of the pandemic, and I certainly remember there being two big camps. They were able to do it, really, because they are the only big pharma company that is making mRNA vaccine. It's a big vaccine maker before the pandemic. So you will see, like J&J is obviously a huge pharma company. They're the world's largest healthcare company, but they huge pharma company. They're the world's largest healthcare company, but they barely had any vaccines. They were just starting to get into vaccines. AstraZeneca, which is big in Europe, but not obviously in the US. Again, pharma company,

not a big vaccine maker. Pfizer was a big vaccine maker and it made a big bet. And, you know, we can thank it for it in many ways because it said, we're going to spend a lot of money, not even government money. And we're going to use it to speed up the process, but also, most importantly, expand production. So they have taken this vaccine that they didn't even create. We can talk about that later. But they have expanded production on this massively. So we're going to get like 4 billion doses from Pfizer next year. And that is, you know, that's a tricky thing to do. But once you expand production, you've got people queuing around the block, countries desperate for these vaccines, then you become very dominant.

Of course, the efficacy rate does have an impact, but it's quite similar to Moderna. Yeah, I mean, well, first of all, it's, you know, we're obviously in this position where, you know, a big company like this is the only sort of organization that has capacity to make all that. I mean, like maybe the U.S. government is large enough that it could have done it all by itself, but I think it probably would have taken longer simply because they wouldn't have the infrastructure ready to go in the way a company like Pfizer would. Is that right? Well, yeah, certainly. And Pfizer didn't have the infrastructure ready to go in the way a company like Pfizer would. Is that right? Well, yeah, certainly.

And Pfizer didn't have the infrastructure completely ready to go. They did have to hire a lot of people. And this is a new type of vaccine. Obviously, mRNA, so no one had made some of the parts that go into these vaccines at scale before, but they had some expertise. They had a lot of capital ready to deploy. And yes, the U.S. government, you know, you could argue that it's almost what they did do with Moderna because Moderna was very heavily financed by the U.S. government. But that meant that Moderna is quite dominant in the U.S., but not in the rest of the world. Well, so, look, I mean, we've talked about the vaccines on this show before.

We've talked about the incredible scientific breakthrough that mRNA vaccines represent. If you want to go back to listen to our episode with Derek Lowe, for folks who are listening and want to hear how they work, why they work so effectively, what sort of like, one of the great modern miracles of our time, I think, is the invention of these vaccines right when we needed them. And so there's a lot of positive aspects to this story. However, you've written a lot that I think one could take as being critical of Pfizer's, let's say, not the vaccines themselves, but the business practices around the vaccines. And so tell me more of those. Let's start with, you said they didn't invent the vaccine. Who did and why are we all now calling it the Pfizer vaccine if they didn't? Well, there is a small but growing company in Germany that really wishes that we weren't calling it the Pfizer vaccine.

That's BioNTech. They're this company that, you know, huge pioneers in mRNA. And, you know, their founder was one of the early people like Moderna to spot the pandemic coming in January 2020 and say, we need to get on this. And this is we have a technology that's super adaptable and we could test it out on this. So he started making a vaccine actually the first time he chose Pfizer to approach as a partner because they didn't have the money to do something like this in because they had already got a deal with them on flu. So they hadn't actually made it yet, but they were working on a flu vaccine since 2018. And then the first time they approached, actually, Pfizer said, no, no, not sure that this is going to be the one, you know, that we need to jump on. And they continued to finance it themselves.

And then in March, they signed this deal with Pfizer, March 2020, of course. And so they worked together since then. But all the sort of research part of it really comes from BioNTech. And what Pfizer did is they put it through the trials and they expanded production. Wow. So this, again, look, I mean, it's almost difficult for me to express how cool mRNA vaccines are as an idea and as like a product of research. And so this is basically the people who invented this technique, who had it ready to go, who said, oh, my God, there's a pandemic coming. Wait, we think we have a way to get a vaccine out before, you know, in record time, that's going to be far more effective than previous forms of vaccines, as has been proven out. They end up being like second fiddle to just

basically the manufacturing company that is pumping it out. Well, that is obviously how it looks, you know, putting something through a trial is expensive and difficult and scientifically difficult so is manufacturing so it's not like it's not like making a widget but um it is interesting they they also were splitting the um splitting the revenue which some people say they they split um the profits 2020 um 50 50 which is some people say is unusual for um this kind of deal i think it's fair enough um given given the success of the vaccine and how important it was to the world um that they get half half the profits and obviously half the profits to a small company the size of biontech is a huge deal and you'll see that their share prices is massively up but in terms of yeah in terms of reputation and credit they have a lot of credit in germany and a little bit in the rest

of europe and basically none in the u.s yeah i mean pfizer was already a company that you know sponsors baseball games here you know like it's a it's a well-known company in the u.s and the fact that it is called the pfizer vaccine here is like i mean you had uh a it's a well-known company in the U.S. and the fact that it is called the Pfizer vaccine here is like I mean, you had, I think, a U.S. official quoted in your article saying this is the biggest marketing coup in the history of pharmaceuticals to the fact that we all call it the Pfizer vaccine when they did not, in fact, invent it. Yeah, yeah, it does. It does. I also tried to slip into the piece that some people in the beginning of the vaccine rollout were calling it the hot person vaccine. But that line got cut. when the vaccines were first rolling out about how,

well, they were not going to seek to make a big profit off of it. This is the World War II moment where the pharmaceutical industry realizes that they need to step up and save the world. And that would benefit their reputation, but they weren't going to try to make a whole bunch of money off of it and weren't going to price it rapaciously or anything like that. Is that actually the case? Well, I mean, one of the things that I did report on is that this price that they offer it to us now-ish, though it is creeping up, the original price in the U.S. contract was $19.50.

That is a lot lower than what you would think of as like a, you know, a brand new innovative vaccine, they often would come in about $200. And so, so Pfizer has said, you know, many times, look, you know, this is a pandemic price after the pandemic will go up. But for now, you know, what a great offer. Except, of course, what I reported in the piece is that that was not their first offer to the U.S. government. Their first offer was $100 a dose. Wow. $200 a course.

So much more in line. Ten times more. With those, you know, innovative vaccines. Yeah. So much more money. And so I spoke to Monsef Slaoui, who is the head of Operation Warp Speed. who is the head of Operation Warp Speed. And he said, basically, we said to them, you will look like you are trying to make money off a once in a century pandemic.

And then the fact that Moderna was coming in much more around that $20 mark meant that they really felt they had to pull back. Now, that's all my reporting. Pfizer will not talk to you openly about its pricing strategy and how it ended up at that price. Wow. So they're out there in the press saying, oh, we're not going to try to make that much money off of it. Meanwhile, their first offer was 10 times what it ended up being. And what Moderna, which is funded by largely taxpayer funded or to some large extent taxpayer funded a lot more than than they were offering. That's that's what at the very least that shows like a huge amount of like hubris to do that. Yeah, I'm not sure I entirely understand it. I know that, you know, Pfizer said we are not going to be the ones to take government money, partly because they wanted the freedom of pricing.

money partly because they wanted the freedom of pricing and um and so you know it makes sense actually if you think about it that moderna wasn't going to have that same freedom came in lower and and pfizer thought we don't take the government money then we can come in higher um they you know they have tiered pricing they're not charging that for the whole rest of the world but it is interesting there's a lot of little details about how they're pricing that I think are interesting. You know, they already raised prices for the more recent contracts. Some other things actually didn't make it in the piece because I think they're interesting, but there may be smaller details. Things like they charge more for delivery in 2020, right um in 20 yeah so you know you had that like last four weeks or something just before but after the vaccines are approved and in different

countries around the world they said oh if you want them straight away you can pay more um and little things like that that you just yeah you just think oh really yeah so they're so basically it's all these little ways in which you can see that Pfizer is still trying to sort of milk this situation a bit for all it's worth. Is that what it's feeling like? I know you're a reporter and that's a value judgment, but that's the way I put it. You put it however you want. I mean, I think we can see by the numbers they made an awful lot of money out of it. I think it's really interesting that they made a lot of money and have had a reputational win. Whereas

you have companies like AstraZeneca and J&J doing this on a nonprofit basis for the duration of the pandemic. And they seem to have also lost the reputational battle, which I don't think anyone could have predicted. Yeah. Yeah. Wait. So, so you said companies like AstraZeneca and J&J are doing it on a nonprofit basis. So explain to me what is different because those are still pro for-profit companies. So what is the sort of the structural difference in how they're doing it as opposed to how Pfizer is doing it? Well, so, um, AstraZeneca is the one I know best. So that's coming in about $4 a dose. So and, and that's, um, you know, that was partly because they did this deal with the university of Oxford and the scientists at the university of Oxford say, we're only going to sign up with a pharma company if they're not going to make money off it during the pandemic and if they're not going to make money off low-income

countries forever so that um so that that price means um about it's cost of goods plus about 20% overhead so that's obviously like people time um and things and J&J's was ten dollars but remember obviously it's a single shot so that's quite similar to astrazeneca and again cost of goods i don't know what margin they put for overheads in that um so so you know much cheaper we think fives this vaccine we don't know how much it costs we think that the cost that the price they're offering to low income countries is quite close to cost. And that's $6.75. Okay, so Pfizer is offering a lower rate to lower income countries, which is good. But is there another? Is there a flip side of that? Is there a way in which, you know, I mean, I'm certainly

seeing that, you know, the news with Omicron variant, you know, especially, you know, which originated in African countries and then all the countries are closing their borders and the leaders of those countries are saying, well, hold on a second. We didn't get the vaccines that we needed in order to prevent a new vaccine from rising. This is why. Sorry. In order to prevent a new variant from arising. This is why we need more vaccine equity around the world. This is why we need more vaccine equity around the world. So does Pfizer play a role at all in those countries not getting the vaccines that they need? Well, yeah, I mean, they have vaccines. I think that one of the big themes of my piece is basically that, yes, they have done things like make a lower prices, but they have not got the vaccines there. I mean, clearly, they're one of the biggest vaccine suppliers in the world.

And the low income countries are still only 6% fully vaccinated, right? Wow. Compared to like 66% in like OECD countries. Wow. So, yeah, it's incredibly stark. As we go around boosting and boosting and boosting, there is a huge section of the world that, you know, it's really hard even for their healthcare workers or their elderly to get vaccines. And of course, that could be laid at government store, and we could discuss that and maybe we will. But it's also, you know,

store and we could discuss that and maybe we will but it's also um you know very interesting to see how the order books developed and so i had a lot of people in my piece who said to me you the problem is is we just don't understand we put in these orders and yet we then see other countries getting them first and we think well if it was just like first come, first served, then wouldn't we be higher up the queue? And then there's some countries that even say we didn't get our calls answered by Pfizer, which is quite stark. I think there's a big stark contrast here because you saw Albert Bula, who's the Pfizer CEO over the summer, you know, really spending quite a lot of time with world leaders. He was at the G7. He was up on stage with Biden, who called him his good friend. He went to this Japanese palace that no corporate leader has ever been entertained in. And, you know, he was given, he went to the

Olympics. He was given sort of a big stage because, of course, a lot of countries and a lot of politicians are really grateful to him. But at the same time, you have these low income and sometimes even middle income countries that are really finding it hard to get attention and to get orders. And the story that I tell at the beginning of the piece is this guy who orders on behalf of the African Union, saying that in December 2020, he thought he had agreed and ordered just for two or three million doses, which would cover some healthcare workers across Africa, and that he just waited and waited and tried to get the contract to sign and that he couldn't get hold of it. And no one was responding. And in the end, he said he wrote to this Pfizer CEO and said,

and this was actually in, I think, May, because the EU had just signed a deal for 1.8 billion doses. Now that's over a couple of years into 2023. And he wrote to them and he was mad. He was saying, we're drowning here. Like you can't, you know, where are these doses? Pfizer will say, well, we contacted everyone. And if you know, when they get back to us, we give them orders. They didn't respond to that particular anecdote, but obviously I put it to them. Wow. This is so, okay. So the price is not the issue. They're,

they're offering a low price, but they're just simply not literally not returning the calls of people in Africa, people in other, you know, in low income countries that, that need the, the vaccine. That's like, it's, it's unconscionable, but also kind of not surprising in a way. Cause it's sort of like,'s how the entire world is set up, that the people with the most need get the shortest end of this. You know, it's like, hey, a bus ride is real cheap, only costs a dollar to ride the bus, but it only comes once every two hours. And if your bus doesn't show up, you can try to call, but no one's going to pick up the phone. It's like that kind of just neglect where like, all right, yeah, the price is cheap, but because the price is cheap, who gives a fuck about you? We've only got like one person in the call center with an old broken phone answering, you know, with, and you're on hold for, for a million

hours. Yeah. I think, I mean, if you've even, I think I love your examples, but if you even think about it in health terms, we don't spend that much time here thinking, oh, you know, the cancer drugs we take, they never get to huge parts of the world. But this has been like a really stark example. Everyone in the world needed something really fast. Only a couple of companies had control of it. Governments did not coordinate. There was no sense of international prioritization. They were not funding bodies like COVAX, which are meant to

procure for internationally early enough for them to make a real difference. And now what you have is this almost like this hand-me-down vaccine situation where you have, you know, countries giving away their spare doses, but they're often giving them away with really short shelf life left on them. So what you're doing is you're giving it to the countries that don't necessarily have fantastic infrastructure to deliver stuff really fast anyway. And yet they can't do it in the sort of easy ways

that we've organized them in the West, where we say, look, we've got all these vaccines and we just go down by age brackets five, you know, five years at a time or vulnerable people get first because what they're getting is, you know, dribs and drabs of vaccine, depending on which country is like, oh, God, these guys have only got a couple of weeks of expiry off of them and we're not going to use them. So let's send them abroad. Yeah, I mean, I just saw that like a million doses expired in Nigeria last month. There's a story from like yesterday. And part of that is, yeah, I think must've been what

you're saying is short shelf life, but also like the lack of infrastructure as well. Like, so there's a lot of, there's a lot of problems coalescing here all at once that are causing uh you know nations like this to not be able to vaccinate their people and you know a lot of it it looks like the extension of every other problem in the world like the same you know sort of the same reasons all those countries have their other problems both neglect from more powerful richer company countries uh you know a history history of colonization and like resources, blah, blah, blah, blah. The whole big mess, right,

is the rich get rich and the poor get poorer. That's a, you know, natural law of the world, except that Pfizer appears to be in a unique position to be able to turn that around, you know, to be able to say, no, we are going to prioritize. We are going to do our duty, as we've been saying we're going to do in the press. And yet they haven't been. And it makes me curious about this guy, Borla, is that is that his name?

Did I pronounce it correctly? The CEO. I mean, how much of this is because, you know, he can go to, he can go to Japan, he can go hug Joe Biden, and, you know, go to the fancy palaces. And there's less prestige for him personally in doing that if, you know, he helps out, you know, Nigeria or another country like that. I don't know. I mean, I don't know him. I don't um really actually you know because he was a sort of Pfizer lifer he wasn't one of these people that before the pandemic you had you know long profiles of or in-depth understanding of of his his psychology I mean he he's kind of in an

interesting position right there's we don't normally give this much power to CEOs. And the question is, you know, have we given it to him by sort of neglecting global governance where we could have governments step up and everyone sort of looking after their own in a way? And, of course, some things may also be somewhat by accident, that they happen to have one of the most effective vaccines, that they happen to be really good at expanding production. And, you know, he is a corporate leader. And what do we, you know, brings up those big questions

about, like, are companies only responsible to their shareholders? To what extent do we expect them to, you know, prioritize their home countries? That's been a big debate when we talk about domestic production and vaccine nationalism during the pandemic. But I certainly don't know whether it's because he likes going to passes. But I think you raise a really great point that, when we've built a health system that has, you know, outsourced the job of developing these, you know, really important medications to the private, you know, to the private sector, right? Here in the United States, we have a system where we have the National Institutes of Health. It's the largest funder of biomedical research in the world, but it specifically does it in partnership with private companies a lot of the time. And, you know, the NIH does the research and the companies, you know, produce the drugs. And depending on the drug, it'll work differently. But certainly, you know, we end up with, because we have a system like that, where a company like Pfizer has so much power when, I mean, ideally you'd be like, we want the UN to be doing this,

right? Like if somebody is, somebody has the job of divvying up, you know, this incredible life-saving vaccine between all the different countries of the world, it's starting to seem like it's a mistake to leave that to a private corporation that is going to be subject to the incentives and pressures of a private corporation, not those of geopolitical necessity. Yeah, I mean, I think it's really interesting. I think it's something we actually, you know, one of the reasons I want to write the piece is because it's something we need to think about now because, you know, okay, with Omicron coming, maybe we're suddenly not feeling like the pandemic is receding. But certainly, if we're even pandemic preparedness efforts around the

world, starting to get less attention sometimes, because people just want this behind them so badly. And actually, I think this is the moment where we ask those questions and we say, if we want to prepare for other health emergencies, whose responsibility is it? And, you know, you mentioned the UN as if it's kind of like this like fantasy idea. I mean, the World Health Organization is an agency of the UN, right? So like, it does exist. Now, it has been definitely underfunded, not really cooperated with. Partly that was because Trump actually tried to leave it during this whole process. So that was a particularly devastating move that was hard Trump actually tried to leave it during this whole process so that was a particularly devastating move that was hard to come back by but it also was clearly not in that

strong position because you have to be in a really strong position to say actually your voters they you know maybe the young healthy ones don't get get a shot or the kids don't get a shot yet or, you know, people don't get not as much of the population gets a booster because we need to distribute this to people who are most likely to benefit, who are the most likely to die in other countries. Yeah. But I mean, one of the things that really troubled me about your piece is that with issues of life and death like this, you know, ideally in the ideal of democracy, we want democratically elected leaders and the, you know, say international representatives at the UN who those leaders then appoint, you know, at the end of this democratic process to help us make these decisions. Right. But instead, you write it in your piece about how Pfizer actually pushed countries to change their laws in or, you know, before they brought vaccines in, which seems like the opposite that that is than a private company telling a country what.

Now, I don't know the details of what those laws were, but that seemed like a troubling precedent to set. Tell me more about that. Yeah, no, I think it is a symbol of how powerful they are that, of course, lots of countries did change their laws. Now, what they changed them for is liability. So, you know, the US and the UK and some other countries previously had these laws that said, we really want private companies to make these vaccines. But because the vaccine is a product where you put something into a healthy person, we want, you know, we might need to incentivize them by insuring them against healthy people suing, basically. And so these were laws that do exist in the US and the UK and things, but

they didn't exist in many, many countries around the world. And often partly because I guess the government maybe couldn't always afford to, you know, the power imbalance is different between a middle income country and a company versus like the US and a company. And so they said, put these liability things into your laws. Many of them had to sort of pass them through their parliaments. But the other part of it, which I think is quite, so obviously they couldn't necessarily feel like, well, this government is really solvent enough that they're going to be able to do this.

So they would get some governments to have specific collateral. And so say, well, and this, so they'd say like, oh, well, you know, we need things like sovereign assets. So we have the South African government complaining in there that they were things like sovereign assets. So we have the South African government complaining in there that they were asked for sovereign assets. We know from other people's reporting, the Bureau of Investor Journalism did a good piece on Latin America, that that included things like embassies and military bases, which seems because then, of course, you just jump to the idea that Pfizer is going to own these military bases, which I don't think is the idea. But it is

basically that they needed, they didn't, you know, they needed something, they wanted something in the law that said, if this vaccine project goes wrong, it's the government that has the enough assets to deal with the consequences. So there, so Pfizer said, you know, a country like South Africa, Latin American country goes to Pfizer and say and say hey we need vaccines to save our people from this deadly pandemic and pfizer says okay but we need you to like pawn a military base or two or just have it as collateral so if you don't pay up because we're a little bit worried about you oh i don't know what's your cash flow like uh they literally are you know sort of like putting their taking out as taking out a second mortgage on the on the old military base. That is that seems profoundly fucked up to me.

I mean, you know, what Pfizer will say is we have these laws elsewhere and, you know, we needed to cover and hey, we didn't need to use them. Right. Because the vaccine is and obviously I want to reiterate this for everyone. Very safe. And therefore you know, protect us on liability, that's taking more time. And okay, we don't know if that means that the country then gets further behind in the queue, because we don't know what the order book is, and there's no transparency. But there was a lot of suspicion and fear that basically, the longer you take negotiating, we know this is the case in any negotiation, right? That when it's drawn out, you can get behind, especially if there's this imbalance of power when all these countries in the world want this vaccine. Maybe it is, as I think someone from Transparency International said to me in the piece, it is a case of, you know, give up. The more you give up, the faster you get your vaccine.

Yeah. And Pfizer is negotiating with a gun held at these countries' heads because, you know, their people are going to get sick and die. You know, they need the vaccine as quickly as possible. So they're not able to, you know, I don't know if we should sign over our military base to you. Well, all right. You don't get any vaccine. You know, it's like it's really, as you say, it's a striking power imbalance between, you know, sovereign nations and a pharmaceutical company that that suddenly has all this power. I also just have to say that, again, yes, the vaccines are very safe, remarkably safe, given the number of people who've gotten these shots and the very low number of side effects. But like for folks who are skeptical, if we're trying to reduce skepticism about the vaccines,

I don't think requiring countries to pass a law that will protect you from being sued, but like if anything goes wrong, is going to increase, you know, is going to increase trust in those vaccines. Seems a little bit counterproductive if that's something you're really concerned about. Yeah, I mean, that's a very good point. I try my best not to read vaccine misinformation, but I wouldn't be surprised if that kind of thing comes up. You know, people pick on lots of things. I mean, I actually had a state agent recently, a real estate agent, sort of say to me that they weren't vaccinated because they'd heard that there'd been lots of lawsuits against Pfizer. And of course, as a pharma reporter, I had to be like, oh, every single drug maker in the world has lots of lawsuits.

I wouldn't worry about it. You know, that's not a reason. But, of course, any little thing like that can be picked up. And, yeah, trust has to be thought about. Well, I want to ask you about some new news that's come out about Pfizer and the Omicron variant. But we have to take a really quick break. We'll be right back with more Hannah Kuchler. All right, so we're back with Hannah Kuchler. So we've been talking about how powerful Pfizer has become as a result of the pandemic and all of the sort of perhaps

unwanted side effects of that power geopolitically that we might not be happy about. I mean, how should that, I guess my question is, how should that change how I feel about, you know, when I see, you know, Pfizer in the news regarding, I believe, that their COVID-19 booster shot, this is from the LA Times, Pfizer says its COVID-19 booster shot offers protection against the Omicron variant. And it says that I think more or less that even though the first two doses seem a little bit less effective than Omicron, on Omicron, the booster, it really increases people's resistance to it. booster, it really increases people's resistance to it. And so, you know, normally I'd say, well, hey, that's great. Everyone's worried about Omicron. I know the financial markets had a big uptick because of this news. Everyone's very excited, optimistic about it. Except that now that I'm talking to you, I'm thinking, well, hold on a second. That is what a company that would want to make a lot of money off of booster shots would say, right? You know? So, yeah, I mean, first of all, yeah, have you covered that new report at all?

And what's your feeling on it? Yeah, yeah. So the report is good news to that extent. actually, you could, if you were going to come with this very cynical mindset that I can see you sort of edging towards, you would, you could also argue that they could say, it didn't work, and then we're going to make a whole tweaked version. And then we're gonna have to sell even more tweaked version, because even the people that had the booster already. So I think, you know, there's always a way that people can make money in this business. And I wouldn't I wouldn't read it like that. I think that the science, the science is solid. And the great thing as well is that we have a fantastic scientific community who is reading all this stuff and they will be pointing out if they're not solid.

And we are obviously like our governments have scientific advisors who are independent of the companies. have scientific advisors who are independent of the companies and um i also don't think it is in visors interest to go that far and start selling something um of course that doesn't work because i think i think uh we would notice um but i think it is interesting because again of course this means that we end up having to do a whole new round of boosters, which really exacerbates that problem in terms of getting vaccine to the developing world. Right. There's way more boosters been given in the West than there has been given to low versus second doses given to low income countries. So as much as I do think they work and I will be getting my booster when it becomes my turn in the UK, they work and I will be getting my booster when it becomes my turn in the UK. I will, you know, if in an ideal world, there would be some system which meant that actually,

maybe someone that needed it a little bit more than me got it. Yeah. So yes. And so yeah, Omicron, I think, is just going to see what's happened before repeat again. Yeah. Yeah. And no, look, I don't have that cynical mindset. But once you start, you know, looking at, all right, here's the behavior of the company in terms of how it's distributing these things, in terms of what it's charging for them, it starts to complicate the picture a little bit, you know? And it starts to, you have to start to like really separate out, I think, as you did really wonderfully in that answer. Like, here's what we know scientifically, here's the scientific community is going to

evaluate, and here are the, you know, business practices of the company that, you know, we can say, all right, it's not the business practices of the company are not getting in the way of the science, but they are getting in the way of the equitable distribution of these vaccines. And yeah, the boosters only intensify that, right? but they are getting in the way of the equitable distribution of these of these vaccines. And, yeah, the boosters only intensify that. Right. If we need more shots, then it's going to be. I mean, the fact that, you know, it says here Pfizer is working on a new Omicron specific booster in case it's needed. Well, hell, like you say, and 94 percent of people in a lot of countries haven't even gotten their first shot yet.

And 94 percent of people in a lot of countries haven't even gotten their first shot yet. No, no. And there have been questions about I mean, not just for Pfizer, for other companies as well, to the extent to which we want these executives to be out on TV giving public health advice. of release that you're talking about which is you know scientific tests that they're in the best position to do because they obviously ran the trials they have all the blood from vaccinated participants that can be tested against these variants um is is very necessary but there have been questions about ceos going on tv and sort of making proclamations about when boosters are needed um when there wasn't data out there yet. In particular, for Pfizer's case, there have been some questions around Scott Gottlieb, who is the former FDA commissioner, who you probably know because he's on US cable TV almost every day. And they do usually mention that he is a board member of Pfizer,

but maybe not as prominently as people would like. Certainly, AstraZeneca sent a legal letter to Pfizer at one point to say that they didn't like him disparaging their vaccine on TV because, of course, he's not the former FDA commissioner. He is also someone who represents Pfizer's interests. Pfizer will say he speaks independently of them. Well, so I mean, how can we as, you know, people who are going to get these boosters, people who are concerned about this, how do we parse out the one from the other? Because certainly, you know, we should be also thankful that we have access here in the United States always in the public interest in exactly the way that we would want it to be, right?

And so as media consumers, right, when we're watching these folks speak on cable TV, how do we parse out the one from the other without falling into, say, an unproductive cynicism, right? Because that's a real danger here. Yeah, it is. And I think that, you know, it's partly the job of journalists to ask when people make proclamations where the data is behind them, right? And not every cable TV channel is doing that. So I guess as media consumers, it's about making sure you are consuming media where people

are asking those questions. And then also, you know, we've never had more accessible scientific experts who are completely independent people like Anthony Fauci in the US. And so, you know, prioritizing maybe what they're saying over what a corporate leader is saying and recognizing that a corporate leader never has the full picture and is always got some self-interest. Yeah. Well, returning to the question of, you know, power, how much power Pfizer has gained as

a result of this, again, power that we should be a little bit concerned about. How do you see the pandemic changing the pharmaceutical industry going forward? I mean, is this, you know, 50 years from now, are we going to look at this as a moment that, you know, gave Pfizer like a huge market advantage that it then, you know, continued to have for many years or or what? I mean, I'm speculating, but but how does it look? Oh, no, that's it's actually really interesting. So I can answer that on like four different fronts. So the first is, you know, reputationally, and despite some of the issues we've been discussing, the reputational surveys show Pfizer, you know, having a far better reputation than it ever did. did uh you you mentioned you know it had been a name that sponsored football matches or whatever but actually it is it was either not at all known or it was associated with you know its previously most famous product which is viagra um or um it was um disparaged because of the whole industry

being sort of tarred by concerns about drug pricing. And so, you know, it's really interesting with the drug pricing. Investors were quite excited through 2020 that they thought the minute that the general public and the politicians see how useful the pharmaceutical industry actually is, they would take the pressure off drug pricing. And so, like, stocks for the pharma industry have been lagging, you know, previously prior to the pandemic, ever since there was this sort of famous in this world tweet from Hillary Clinton in 2015, which just basically suggested she was going to come after them on drug pricing. So prices, you know, stocks dropped.

Everyone was really worried they're going to try and put in controls around pricing in the US, which is the world's largest pharmaceutical market. It's interesting. So Albert Boula Politico reported, sent this video to employees as drug pricing reform started to creep back on the agenda in Congress, saying, well, I need you to sort of pursue this with the same kind of vigor that you pursued the vaccine and educate yourselves about how damaging these reforms will be. Pharmaceutical companies will always say these are really damaging to innovation. But of course, they're also, you know, perhaps better enabling better access to drugs if they're cheaper. Yeah, of course. I mean, do you think that there might be more of an attempt to rein in these drugs? I mean, there's been something that politicians have been trying to do for decades now, but that, you know, given what we've seen from Pfizer and Moderna and these other companies? Do you think that there'll be more of an attempt to rein them in to regulate these prices,

or is this actually going to put wind in their sails? Well, it hasn't gone away in the way that investors hoped it was last year. There is still interest in drug pricing reform. It's just know it's it's an unusual thing that both sides of the aisle are united that there should be some drug pricing reform but how how you do it and how you get it to the most benefit from uh the consumer is um you know really tricky and we could probably spend three episodes trying to explore how drugs are actually priced in the US because it's insanely complicated. So that's one element, of course, of how it enables them to dominate. If they do have more political will, that they can curb some of what they think are the excesses,

the most dramatic reforms, which is things like negotiating prices on on medicare which some people would say isn't dramatic at all every other country in the world negotiates when they buy drugs um but then the other thing that's interesting in terms of pfizer specifically is that they've got obviously a huge amount of money from this, right? And this looks like continuing revenue next year. In October, they said next year they see at least 29 billion in revenue from this vaccine, which is based only on orders they've got up until October. And they've actually got loads more since then, actually, especially after Omicron.

So they're going to have a huge amount of money. They're going to have the best balance sheet in the business, which means they can go and spend on other things. They can buy other companies. They can out-compete their rivals. And then in mRNA, it's really interesting, right? We started by talking about how this wasn't their vaccine. But, of course, over the process of working with way on tech they have developed an

expertise in mrna they say that they have something now like 400 scientists working on mrna we know that this is a transformative amazing technology that could be deployed on other things other vaccines and also in drugs potentially um and so if they got an advantage from that relationship, and perhaps some intellectual property that other companies didn't get through, you know, learning how to produce these vaccines at scale, they could really be the ones that go on and dominate that whole new sector. Wow. So, I mean, it really is that kind of – it's almost the post-war economy for them where after they show their expertise and they save everybody, then they're able to sort of use that to slingshot themselves into a new world of possibility and profitability perhaps. Well, let me end with this question.

Well, let me end with this question. We've talked a lot about how the real injustice here is the difficulty that lower income countries have had getting the vaccine. what more could countries like the United States and, and, you know, the EU be doing like what, what role do they have in, you know, when, when Joe Biden is saying, you know, my good friend here, the CEO of Pfizer, you know, we've been, we've spent this entire podcast talking about Pfizer's culpability in that respect. But when we're talking about, Hey, what can our elected leaders be doing in order to solve this problem? What is what is that in your view? I think, you know, there are things that they could be doing now and there are things that they could be doing in the future so that we start from a better place in the next pandemic.

And there are things that maybe they should have done earlier. So the things they could be doing now. things that maybe they should have done earlier. So the things they could be doing now, now Biden is donating an awful lot of Pfizer vaccine now. It's not getting through the system very quickly. They, you know, there's a billion doses promised, but they're not getting there until mid-2022. And we have to remember that, you know, as we know that vaccines save lives, not getting vaccines quick enough means that lives are lost yeah um so i think that um trying to accelerate those and we don't know because there's no transparency whether whether that's because visor isn't given the administration those vaccines or because for some other reason um we also know that the as i said this kind of dribbles in and out of countries is not very helpful to

countries and the best thing that you could also invest in is improving the infrastructure on the ground of course it would have been better if we'd done that before but then there are still things you could do to ensure that you're you're getting stuff out quickly remember these are cold vaccines that are hard to transport and so yeah anything to help improve that process would would be would be good to do and then when we're looking forward to you know the things that unfortunately you know i called it at one point quoting someone a once in a century pandemic but unfortunately we have no way of knowing. There's no pattern to these things. We can't say that there isn't going to be a really bad pandemic

of some other sorts in five years' time, in 10 years' time. And we should be thinking about when we write contracts with companies, do we put clauses in that say, yeah, you deliver me 100 million and low-income countries 100 million at the same time. That was within countries' power and they didn't do that. We can be thinking about how we do better cooperation through organisations like The Who or alternatives to The Who if people are unhappy with them,

wherever you think about okay well could we at least get to a situation where every health care worker in the world was vaccinated because we know that we really desperately need them to look after other people um and then we need to think and unfortunately one of the big trends in pandemic preparedness at the moment is sort of everyone tussling for domestic production, which sounds great. But of course, you know, not every country in the world is going to get these big companies to build facilities in their country. So we have to actually be kind of wary of that kind of push and think, are there other ways that we can, you know, put bounds on export

controls and things to make sure that actually vaccines flow around the world rather than everyone has their own little factory. Yeah. I mean, at the very least, we need to make sure that, you know, we are having those conversations in a democratic way and not allowing, you know, a small group of people to call the shots on who is getting these vaccines that everybody needs. I think that in some ways, you know, what happens on a micro level in the pandemic where everyone kind of had their own bad experience. And so we didn't always look out for each other in the way that we would have sort of swooped and helped our friends previously is kind of almost like happened on a global level. So many people feel like, you know, how they suffered was because of, you know, either they couldn't see their family at the holidays or they had problems with their work

or, you know, really legitimate problems. But they kind of distract us from the fact that, you know, huge swathes of the world are still at risk of dying of something that's now preventable. Yeah. Well, Hannah, I can't thank you enough for coming on the show to talk to us about it. This has been a, it's been a pleasure. It's been a little bit depressing, but it's been important. It's been a pleasure for sure. Yeah, I can be a bit depressing. Sorry about that. Well, where can people follow your, I mean, your reporting is incredible. You're, you're uncovering details about these stories that no one else is. Where

can people find you and, and keep up with your reporting on this topic? Yeah. Yeah. So obviously I write for the Financial Times, so you can find me on ft.com. I tweet at Hannah Kuchler, which is spelled K-U-C-H-L-E-R. And I'm sure it might be in the show notes. Awesome. Thank you so much, Hannah, for coming on the show. Well, thank you once again to Hannah Kuchler for coming on the show. I hope you enjoyed that conversation as much as I did. Once again, I hope you have a happy

and healthy rest of your 2021. And I hope you roar into 2022 with some new energy and some new intention to keep learning and keep making the world a better place than it was the day before. I'm making some big plans over here in my world and I'm hopeful that when we come back, I'm gonna have some cool new shit to tell you about.

But until then, I wanna thank our producers, Sam Rodman and Chelsea Jacobson, our engineer, Ryan Connor, Andrew WK for our theme song. The fine folks at Falcon Northwest for building me the incredible custom gaming PC that I'm recording this very episode for you on. You can find me online at Adam Conover or Adam Conover dot net. And until next year. Thank you so much for listening. We'll see you next time on Factually.

next time on Factually.