Front Burner - The fight against Big Pharma's grip on vaccines

Episode Date: April 27, 2021

Led by South Africa and India, more than 100 mostly developing countries are calling on the World Trade Organization to temporarily waive vaccine makers’ intellectual property protections. Today, science writer Stephen Buranyi on why he believes this could boost global supply of COVID-19 vaccines, and save lives.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. The World Health Organization has called it a shocking imbalance. Oxfam has called it vaccine apartheid. Here in Canada, and on average in other wealthy countries like ours, nearly one in four people have received at least one dose of a COVID-19

vaccine. But in low-income countries, it's more like one in 500. The world urgently needs more vaccines, but only a handful of pharmaceutical companies like Pfizer, Moderna, Johnson & Johnson, AstraZeneca control their production. That's something a growing chorus of people are actually trying to change. To fight the pandemic, we need to pool all our resources. It is essential that the wealthy states stop blocking or putting in legal barriers and delaying this essential proposal. More than 100 mostly developing countries, led by India and South Africa, are calling on the World Trade Organization to temporarily waive vaccine makers' patents and intellectual property protections in order to boost global production of COVID-19 vaccines.

I'm Jamie Poisson, and today I'm joined by science writer Stephen Baranyi on the case for making pharmaceutical companies share their vaccine secrets. Hi, Stephen. Thanks for being with me. Thanks for having me. So I was hoping we could start with a small example that helps illustrate the issue we're going to be talking about today. And can you tell me about this Canadian company called BioLyse? Yeah, sure. So BioLyse is a small pharmaceutical producer. They mostly make chemotherapy drugs, and they are based in St. Catharines in Ontario near the border. And starting about a year ago, they started to make inquiries with pharmaceutical companies, basically asking if they could produce their vaccines. So for AstraZeneca and for Johnson & Johnson. And in both cases, they didn't hear back about it. And so they've essentially been trying to work through the Canadian government

to get an exception to the vaccine patents so that they can produce these vaccines themselves. And, you know, they're not a giant operation, but they think that they could produce up to 20 million doses a year. Hmm. Wow. And have they heard back from the Canadian government on this? So they've been in preliminary talks with various people at sort of low levels, but they don't seem, you know, super optimistic that it's moving forward. What they told me was basically that they feel quite passed over, that they brought this plan forward and that nobody's really taking them seriously on it. The vice president of this company, BioLyse, said to you that this is supposed to be like a wartime effort, everyone in it together, but that doesn't seem to be the case. And so before we get into what you and others believe

needs to change here, can you give me a sense of what is the case right now? Like, what does the landscape of coronavirus vaccine production and distribution look like right now? I mean, I like the way that he put it, like this is supposed to be wartime footing. Because if you really look at it, the way that the landscape is now is it looks like the sort of pharmaceutical industry's business as usual. I mean, they've scaled up production a huge amount individually. But they're all working totally separate from each other. So there's no sort of technology sharing, capacity sharing. There's been no international coordination. There's no sort of global effort, global joined

up effort to increase production. So, you know, if you want to ask, is this actually a crisis? You know, you would say, yes, I would say, I think everybody would say, you know, this is like an unprecedented crisis, but the way we're structuring production is just totally business as usual, which is just to say that the pharmaceutical companies take care of it themselves, and we just queue up to buy it. Are there exceptions here? Because Oxford, AstraZeneca, I thought they were sharing licenses so that their vaccine could be manufactured elsewhere, like in India, for example. So initially, Oxford University, who developed the vaccine, said that they were going to have

it basically open license, which meant that anybody could make it. That changed when they allowed AstraZeneca to have exclusive access to the license. And so that means that AstraZeneca essentially has control of the license, and they have licensed it out to the Serum Institute of India, which is a huge scale producer. And I believe they've also are working on some licensing in Brazil. But it's not like open source where anybody can just have it. So it's up to the discretion of the company. And I do think that in most cases, you know, with something like BioLyse for a smaller producer, they would just feel it's not worth the hassle to add 20 million doses. Were there ever any other attempts or ideas in addition to the Oxford one for any kind of information sharing system for any of these vaccines? or any kind of information sharing system for any of these vaccines?

Yeah, I mean, early in the crisis, there were a lot of pushes. I mean, the WHO, which was a much more prominent voice around this time last year, tried to open up like a patent access pool to share technologies. And the WHO has a really long history through polio and through smallpox of doing these sort of joined up technology sharing, where people give up information and know-how and they help distribute it to set up production around the world. In fact, after the spread of H5N1 influenza in the mid-2000s, WHO supported technology transfer

for the production of pandemic flu vaccines to 14 countries. But, you know, for the most part, almost no information has gone into these pools and they're basically just sitting defunct right now. Can you give me a little bit more information about how this has worked? In the past, you mentioned polio. Yeah, I mean, I think polio or smallpox are a really good example here. I mean, basically, in the case of both of those epidemics, there was, again, like a joined up worldwide effort to take them on. And so what happens in these cases is, you know, with polio, the scientists

who created the vaccines released them patent free. With smallpox, there wasn't a patentable vaccine. And so basically, like the World Health Organization, with the support of member states, would create these overarching committees who would create technology pools and sort of collate the best way to make these things and expand production around the world. I mean, for smallpox, when the effort to eradicate smallpox started, most vaccine production was in North America and Europe. And then within a couple of years of the program, 80% of the vaccine being produced was from countries where smallpox was actually endemic. So you saw this like mass

worldwide scale up. And you also see countries like empowered to take these diseases on themselves rather than just get in line and wait for production from the Western world. world. So this growing pressure to change this approach we've been taking this time around, I mentioned in the introduction that India and South Africa spearheaded this effort at the World Trade Organization to suspend intellectual property protections. To fight the pandemic, we need to pool all our resources, our capabilities, our knowledge and intellectual property. They have the support of more than 100 other countries. The WTO, hundreds of Nobel laureates and former heads of state have signed on endorsing this message. Nobel Prize winner and former head economist of the World Bank, Joseph Stiglitz, is one of those calling for what's become known as the people's vaccine.

This is an emergency. This is a no brainer. Make this available to everybody as soon as possible. What are they calling for here? Are they calling for the same thing that has happened in the past? Yeah, I mean, there's sort of two things going on. The top line thing that you hear is always this sort of suspension of intellectual property. And that's so that companies that are trying to make these vaccines can't be sued or can't face legal action for trying to make them.

And that's like the first step. But I think what everybody's really calling for is again, this like joined up effort to expand production across the world. Another important step is to enable the transfer of medical technology for the duration of the pandemic. So it starts with opening up patents, but it extends to sharing know-how and sharing technology

and perhaps providing funding to allow countries worldwide to sort of take this production on. I'm going to go ahead and guess that the pharmaceutical industry is against this proposal. And am I right there? Yeah, you'd be right there. Okay. And why? There's sort of two levels to it. I mean, on the one hand, they're going to make more money selling to the Western world now and the developing world later than they would if production expanded worldwide. Pfizer, Johnson & Johnson and AstraZeneca have paid out $26 billion in shareholders in the last 12 months. That's enough to vaccinate at least 1.3 billion people, which is the entire population of the continent of Africa. You know, it's just in terms of disrupting business as usual. It's a hassle

to do tech transfer. If they had to send out scientists to teach people how to make these, you know, that's not so easy for them. But I think there's a second level to it, too, which is that it really is sort of an existential concern for the pharmaceutical industry. I mean, ever since they've instituted these very strict intellectual property regimes, which basically allowed them to monopolize production of not just COVID drugs, but all of the drugs across the world, this has been sort of the main business model of the industry. And so when you see people opposing these requests at the WTO, it's not just pharmaceutical companies. You see the American Chamber of Commerce, requests at the WTO, it's not just pharmaceutical companies. You know, you see the American Chamber of Commerce, which is a massive business lobby, supporting briefs against this. So it goes beyond

just one drug or one industry and into the sort of entire worldwide intellectual property regime that underpins a lot of these companies. And so, you know, we think in terms of an exception, right? Like we think, well, it's a crisis. It's such a big deal, you know, why can't we just make this exception? But they think in very legalistic terms. And, you know, for them, an exception is a precedent. And then, you know, if not, if for COVID, you know, why not for HIV medication or malaria or what have you? So I think they do see it as a sort of slippery slope that presents sort of an existential concern for them. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem.

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together. To listen to this podcast, just search for Money for Couples. I wonder what you would say to those like the International Federation of Pharmaceutical Manufacturers and Associations, that was real mouthful, who say that cutting into companies' returns by forcing them to share their intellectual property in this way would actually be a disincentive to innovation, that these companies aren't going to invest hundreds of millions of dollars in R&D on important life-saving medicines if they're just going to have to turn around and share what they've learned. Yeah, I mean, I think there's two really easy things you could say back to that. I mean, first off, a huge amount of pharmaceutical research is underwritten by the public anyway, through academic research and funding and grants and what have you. So there's that approach to it.

But there's also the case that this very strict control of intellectual property that they're trying to protect is a very recent innovation, stretching back to the 1950s. I mean, during the Second World War, the US government forced Pfizer to share its recipe for penicillin with all of its competitors and the U.S. government. And that didn't stop them from making huge profits then or in antibiotics over the next half century. And so I just think, you know, historically, I don't think any of these arguments really hold up. That's really interesting to hear there's actually been a precedent with Pfizer. And I guess talking about the COVID-19 vaccine specifically, hasn't there been a lot of government money that has gone into the development of these vaccines too, right? Moderna itself received $5.45 billion in public subsidies from the U.S. Huge, mind-boggling amounts of public money.

mind-boggling amounts of public money. I mean, the gold standard here is Operation Warp Speed in the United States, which spent over $8 billion on research for coronavirus vaccines. And again, the incredible thing is they spend all that money and it worked. You know, they got these vaccines faster than anyone thought possible. But then there's no involvement for the state in actually producing it. They, again, just have to get in line. Considering that the United States, you know, specifically has spent this kind of money, I know that Joe Biden was asked about this on the campaign trail last summer by Adi Barkan. And for those who don't know,

he's this quite famous universal healthcare advocate and he actually has ALS. So he's speaking here through a computer. If the U.S. discovers a vaccine first, will you commit to sharing that technology with other countries? And will you ensure there are no patents to stand in the way of other countries and companies mass producing those life-saving vaccines? And Biden answered. Yes, yes, yes. And it's not only a good thing to do, it's overwhelmingly in our interest to do it as well.

But now the U.S. and Canada, I should add, have not supported South Africa and India's proposal to waive vaccine makers' intellectual property protections at the WTO. And I wonder if you have any hopes that the Biden administration will change that position, a move that I would imagine would carry a ton of weight at the WTO. Yeah, it certainly would carry a lot of weight. I mean, I'm hopeful. There's a lot of momentum on this.

I mean, even in the past month or so, the number of people sort of jumping on board, showing support, especially former world leaders, and people that I wouldn't really expect, you know, coming from a more activist space, I wouldn't really expect to back this sort of thing, I mean, have jumped on. And so, you know, I remain optimistic. I mean, I think trying to predict Joe Biden's fortunes or what he will decide from either the right or the left over the past year would be kind of wild. He's surprised us before, and I really do hope he'll surprise us again. I wonder if it's worth mentioning here, I know The Intercept has reported on lobbying disclosures that show more than 100 lobbyists have been mobilized to urge the Biden administration and U.S. lawmakers to oppose this plan at the WTO. Yeah, I mean, that's to be expected. The pharmaceutical lobby, I think, is still the biggest lobby,

the biggest single lobby in the United States. It's huge. It's extremely powerful. I mean, I think the great hope is that, you know, unprecedented times and unprecedented pressure can overcome that incredibly powerful force. I want to ask you about one more sort of argument against this proposal. wouldn't actually fix the scarcity problem and that only a handful of manufacturers in the world actually have the necessary capacity to make these vaccines to standard and safely and that they're already doing so.

This is a view that's even espoused by Bill Gates, who of course is an enormous player in global public health due to the Bill and Melinda Gates Foundation. There's been some speculation that the changing intellectual property rules and allowing the recipe for these vaccines to be shared would be helpful. And do you think that would be helpful? No. Why not? Well, there's only so many vaccine factories in the world. And people are very serious about the safety of vaccines. Moving a vaccine from, say, a J&J factory into a factory in India, it's novel. It's only because of our grants and our expertise that can happen at all.

The thing that's holding things back in this case is not intellectual property. There's not like some idle vaccine factory with regulatory approval that makes magically safe vaccines. Yeah, I mean, I think that if the argument is being made in good faith, which I think it's often not, I think often, you know, you just say, look, there's not very much capacity, and you totally allied the fact that what people are asking for is, you know, a joined-up world effort to create more capacity. But again, you know, even if it is being made in good faith,

I would return to this argument from history, which is simply that this gets said over and over. You know, it was said that, you know, countries in Africa couldn't make the smallpox vaccine. And then, you know, after a few years of WHO support, they did. And I just think it's an incredibly pessimistic way, you know, to look at the world. So this idea that, you know, we couldn't expand production, countries can't make these things, it's too advanced, it's too hard. I mean, I think the history gives lie to that. And then I guess in response to the Bill Gates comment, I can't help but think of that Canadian company BioLice, you told us about off the top, that's been saying, hey, we really think we can make coronavirus vaccines here. Yeah, that's right. And I mean,

they were hoping to put together sort of a coalition, which would look a lot like things did in the past, which is like, you know, many small actors coming together to face this thing. What happens if we don't change course here? You know, listening to you speak today, I cannot help but think of the episode that we just did yesterday on India, a humanitarian catastrophe is essentially unfolding there. And what happens if we don't heed the call of the more than 100 low and middle income countries asking for this? I mean, it's just going to stretch on as long as some of the worst, you know, projections say it will. I mean, the Economist Intelligence Unit has this analysis quite

recently that suggests that for most low-income countries, they won't reach widespread vaccination. I mean, widespread just means 60% vaccinated until 2023. And it's just a world where they get doses when we're done. And I think also it doesn't just extend to this crisis because we've been warned that this could happen again in this super industrialized, super interconnected world. Pandemics may become an unfortunate and regular part of life. And so if we don't come up with a precedent for a worldwide response,

we're just gonna not only stretch out, you know, this crisis, but also we'll have the same response next time as well. Stephen, thank you. Thank you so much for this. This is really fascinating. Thank you. Thanks so much for having me. Okay, so before we go today, some good news on the vaccine supply front. On Monday, the U.S. has announced they will share its entire stock of the AstraZeneca-Oxford COVID-19 vaccines once it's cleared federal safety reviews. That means as many as 60 million doses of the vaccine will be available for export in coming months. The U.S. has yet to finalize

where exactly those doses will go. And Ontario has made a formal request to the Canadian Armed Forces to help deal with the surge in critical COVID-19 cases. Both to supplement what's going on as we're creating more intensive care beds, but also to provide some respite for some of our frontline professionals who have been doing an amazing job over the last year. This just days after declining an offer from the federal government to send extra personnel.

The military will be deploying three medical assistance teams to the province. According to the Ministry of Health, a record 877 people with coronavirus are being treated in intensive care units across the province. That's twice as many as there were at the beginning of the month. That's all for today. Thanks so much for listening to FrontBurner. We'll talk to you tomorrow.