The Munk Debates Podcast - Be it resolved: To fight this pandemic and the next, vaccines should be free to everyone the world over

Episode Date: March 17, 2021

We are into the fourth month of the largest global vaccination programme in history with over 335 million COVID-19 jabs administered in 108 countries. Critics of the vaccine rollout are deeply concerned about the inequitable distribution of the life saving inoculations. They say the vast majority of vaccinations have taken place in wealthy countries with inoculation rates dramatically lower in Asia and almost non-existent in Africa. They argue that we are experiencing an artificially created shortage and the culprit is intellectual property protection rights that give a small number of pharmaceuticals control over the global manufacturing and supply. The solution is a simple one: remove World Trade Organization intellectual property rights for the duration of the COVID crisis so that countries can manufacture their own vaccine supplies and save possibly hundreds of thousands of lives. Proponents of intellectual property protections argue that this would be disruptive and undermine future investment in innovation, and the hard work that go into producing effective treatments for deadly diseases. Removing these protections will undermine future drug development needed to prepare for future pandemics while doing nothing to contribute to the unprecedented challenge of how to safely manufacture billions of doses in a short period of time. Vaccine production requires knowhow and trained employees to run hugely complex and highly regulated manufacturing processes. Rather than suspend COVID-19 vaccine patents, the answer to an equitable vaccine roll out lies in international collaboration to scale up manufacturing and in the COVAX public private sector partnership that works to ensure that everyone, regardless of wealth, has access to safe and effective vaccines. Arguing for the motion is Dean Baker, Senior Economist & Co-Founder of the Center for Economic and Policy Research. He is the author of the blog ‘Beat The Press' and How Globalization and the Rules of the Modern Economy Were Structured to Make the Rich Richer. Arguing against the motion is Thomas B. Cueni, Director General at the International Federation of Pharmaceutical Manufacturers and Associations. He's also the biopharmaceutical industry representative to the Access to COVID-19 Tools Accelerator, the global partnership that aims to accelerate equitable access to COVID-19 treatments. Sources: Blooomberg Quick Take, The Telegraph, France 24, Democracy Now, SABC News, Atlantic Council, KTN News, News4Jax, Al Jazeera English, BBC News The host of the Munk Debates is Rudyard Griffiths - @rudyardg.   Tweet your comments about this episode to @munkdebate or comment on our Facebook page https://www.facebook.com/munkdebates/ To sign up for a weekly email reminder for this podcast, send an email to [e-mail].   To support civil and substantive debate on the big questions of the day, consider becoming a Munk Member at https://munkdebates.com/membership Members receive access to our 10+ year library of great debates in HD video, a free Munk Debates book, newsletter and ticketing privileges at our live events. This podcast is a project of the Munk Debates, a Canadian charitable organization dedicated to fostering civil and substantive public dialogue - https://munkdebates.com/ The Munk Debates podcast is produced by Antica, Canada's largest private audio production company - https://www.anticaproductions.com/   Executive Producer: Stuart Coxe, CEO Antica Productions Senior Producer: Christina Campbell Editor: Kieran Lynch Producer: Marilyn Mazurek Associate Producer: Abhi RahejaBecome a Munk Donor ($50 annually) to get 72-hour advanced access to the full length editions of Friday Focus and Munk Dialogues. Go to www.munkdebates.com to sign up. Hosted on Acast. See acast.com/privacy for more information.

There are options, and that's why we need to take this opportunity seriously. There's no way you can prevent global warming unless China is part of the solution. This is not normal male behavior. This is predatory behavior. We don't know how bad this bug is. We don't know what this bug does. All of that was thrown away in those eight minutes and 46 seconds, and that's the moment that I became an abolitionist. Extraordinary claims require extraordinary evidence. Welcome to the month debates. Every episode, we provide you with a civil and substantive debate on the big issue of the day

to arm you, the listener, with enough information to make up your own mind. Today's debate, be it resolved. To fight this pandemic and the next, vaccines should be free to everyone the world over. Everyone loves round numbers, and the U.S. hit a big one, administering more than 100 million COVID vaccine shots. I'm absolutely delighted that over 20 million people have now. been vaccinated across the UK. It's absolutely fantastic. In Israel, it's now the turn of the teenagers. Anyone over 16 can now get a coronavirus jab, cementing the country's status as the world's

fastest inoculator against COVID-19. Hello, I'm your moderator, Rudyard Griffith. We are now into the fourth month of the largest global vaccination program in human history, with over 355 million COVID jabs administered in 129 countries. But critics of the vaccine rollout are increasingly concerned about what they say is a deeply inequitable distribution of the life-saving inoculations. The vast majority of vaccinations are taking place in wealthy countries where inoculation rates are dramatically lower in Asia and almost non-existent in Africa. The culprit is supposedly the intellectual property rights that give a small number of pharmaceutical companies control over the global manufacturing and supply. The solution, remove these protections for the duration of the COVID-19 crisis so that countries can manufacture their own vaccine supplies and possibly save hundreds of thousands of lives. In order to be able to gear up, we need a broad waiver that covers that whole way.

of intellectual property rights that Big Farmer right now has that's constricting the ability of countries around the world to make these meds. Drug manufacturers argue that striking down patent protections would be hugely disruptive to the vaccine rollout and undermine future investment in the innovation and manufacturing that leads to new treatments and cures. Vaccine production is based on more than just good science. It requires decades of know-how and highly trained

employees to run large, complex, and state-regulated manufacturing processes. The key to achieving an equitable global vaccine rollout lies in COVAX, an international initiative to ensure collaboration and the scale-up of vaccine manufacturing globally. Here's the newly appointed head of the World Trade Organization. There is a way which is a compromise in the middle, which private sector companies already doing. They are licensing companies in developing countries to produce

and manufacture these vaccines and these drugs. And one of the biggest problems we have is just a sheer manufacturing constraint in the world. On this installment of the monk debates, we challenge the essence of these arguments by debating the motion, be

resolved to fight this pandemic and the next, vaccines should be free to everyone the world over. Arguing for the motion is Dean Baker, Senior Economist and co-founder of the Center for Economic and Policy Research. He's the author of The Blog Beat the Press and several books, including how globalization and the rules of the modern economy were restructured to make the rich richer. Arguing against the motion is Thomas B. CUNY, the Director General at the International

Federation of Pharmaceutical Manufacturers and Associations. He's also the industry representative at the access to COVID-19 Tools Accelerator, the global partnership that aims to increase equitable access to COVID-19 treatments. Dean Thomas, welcome to the Monk Debates. Thanks for having me on. Hello, very pleased to be here. Well, we're really pleased to have both of you on the Monk debates today. This is a fascinating and critical issue, I think, for all of us to consider the future of vaccines globally.

How are we going to address what is a worldwide pandemic using these incredible breakthroughs in science and vaccines that really have the potential to, if not defeat COVID-19, certainly lessen radically the impacts of this disease, this virus on our collective way of life? So the opportunity for our audience to hear your considered opinions on how the world should be approaching the global world. rollout of vaccines is really a privilege indeed for the monk debates community. Our motion today is succinct and to the point, it's be it resolved to fight this pandemic and the next vaccines should be free to everyone the world over. Dean, you're arguing in favor of the motion. Let me put two minutes on the clock and pass the program over to you. Well, thanks for giving me a chance to make my case here.

I'm going to make three main points as to why vaccine. should be free the world over. The first one is simple humanitarianism. Second one is a clear self-interest for people in the United States and other wealthy countries. And the third is the fact that the government actually paid for most of the development of these vaccines. As far as the first one, we're looking at a situation where much of the world still has no access to vaccines, and we can well be in a situation where it'll be 223 or 224 until the world's fully vaccinated. I shall point out that China and Russia are filling much of the gap with their vaccines, which is great. But we should be doing our part trying to get the world vaccinated as quickly as

possible, preventing potentially hundreds of millions of people from getting the disease and perhaps tens of millions from dying. That's a very big deal. Second point is we have a very direct self-interest. We know this virus mutates, all viruses mutate. We could well end up with the situation where we get a vaccine resistance strain, perhaps one that's more deadly than the ones that are already circulating, and then we're back to the drawing board. Maybe we could develop a new vaccine, but do we really want to go back and shut down and have everyone vaccinated again? That's a very, very big problem.

The third one is that unlike the typical story where the pharmaceutical industry will tell you they spent eight to ten years in pre-clinical research, could take years and years of clinical testing, and then going through the food and drug administration or other registry process. In this case, it was a very short process. And much of the tab was picked up by governments. In the case of Pfizer, the first vaccine, the U.S. government had a $2 billion advance purchase agreement. So there was relatively little risk here. They started in March. They ended up in November with approved vaccine, and they got

$2 billion. Now, they had comparable agreements with other countries. So they didn't have a lot at risk. In the case of Moderna, the other big one in the United States, also Europe, we basically picked up the tab completely. We paid about $450 million for the basic research in early clinical testing and another $450 million for the phase three trials. So in these cases, there was very little risk for the pharmaceutical industry, and they've already been paid. So there's not really much of a case as to why we shouldn't try to make these vaccines as widely available as possible, as quickly as possible, so that we could go all out in stopping the spread of the pandemic. Dean Baker, thank you for that opening statement. Thomas now, your opportunity to come in here, arguing against the motion, be a resolve to fight this pandemic and the next vaccine should be free to everyone the world over. Let's have your opening statement. Thank you. Now we have come a long way since WHO declared this pandemic on March 11 a year ago. Few at that time would have believed it possible to have not one but several safe and highly effective vaccines in less than.

one year. If you would have believed it possible to have a realistic chance of making more vaccine doses than the world has ever produced for a single virus and believed to have the first deliveries of doses, two capitals such as Kigali, Akra, Abidjo and Nairobi at the same time as Tokyo. The facts are we have vaccines that are more effective than even the world's leading experts could have hoped for. The fastest vaccine ever developed in the past was four years for Ebola. Now it was 326 days for COVID-19. Pre-COVID 19, the total capacity for producing vaccine was around 5 billion doses for all vaccines, shingles, measles, flu, polio, hepatitis, and more. Now we're on the road to getting more than 10 billion doses manufactured this year for

COVID-19 vaccines alone. This has only been possible due to unprecedented collaboration. Nobody told us to, but what has been achieved so far is because academics, biotex, big farmer, developing world vaccine manufacturers, and suppliers of all come together to make this happen. We are in a war against the virus. We are fighting a war against time. We have seen far too many lives lost and livelihoods destroyed by this pandemic. and we know that no one is safe until all is safe.

To fight this pandemic and the next, I agree, vaccine should be free to everyone the world over. And we agree that's why from the outset we committed to fair and equitable access. But the only way to do this is that we teamed up with WHO and the Global Vaccins Alliance and others to ensure that we are doing Mission Impossible. We cannot afford this fraction by discussions, waiving patents because time is not on our side. We need to keep going on. Thank you, Thomas. Great opening statements from you both. A real sense of the tensions in this

debate. So coming back to you, Dean, your opportunity now, another two minutes on the clock to rebut what you've heard from Thomas. Well, a couple of points. First off, I don't want to denigrate at all the great scientific accomplishment by the pharmaceutical industry. I will just point out that Russia and China also developed vaccines in roughly the same time frame that are comparably effective. So again, not to denigrate the great work. It's great work. We should all be thankful for it, but I just want to point out it wasn't uniquely our pharmaceutical industry that was capable of doing it. But again, the point here is to get the vaccines out as quickly as possible. We still have almost no coverage throughout sub-Saharan Africa, the area with population

of well over a billion people. The current statute of where we are today as a continent it's really regrettable. Let's not fool ourselves with pockets of vaccines that have been distributed here and there, 50,000 doses here, 200,000 over there, and for a continent of 1.2 billion people. You do not fight such a pandemic, the size of the COVID-19 with such a distribution of vaccines. And if we just say, okay, let's get vaccines as quickly as possible, one, let's get rid of patent rights, so that that's not an obstacle. Anyone who could produce it should be able to produce it.

I realize that there's also a lot of technical skills associated with the production of the sophisticated vaccines. We want them to share that technology as well. And what we should do is pay Pfizer, pay Moderna, the other companies for that technology. And if they're not willing to do it, then just pay their engineers. Give them $2 million a month, $3 million a month,

have them do webinars, have them write up in detail what their processes are so that information could be shared with producers all over the world. Let's do it as quickly as possible. And let me just point out, suppose we had done this from the beginning. We had open-source knowledge, open-source research. It turns out that the Pfizer vaccine, originally they thought it had to be cold stored at a temperature of below 90 degrees Fahrenheit.

It turns out that it could be kept in a normal freezer. Well, they didn't know that from this onset. But if they had open-sourced all their technology, perhaps they would have. The last point, Pfizer announced last month that they found a way to double their production capacity. That's fantastic news. But suppose this knowledge about their production capacity had been widely available throughout the world. We almost certainly could have had many, many more vaccines available today, which has to be the goal. So, again, what we want is to not have patent monopolies interfering with the ability of the whole world to produce and distribute as many vaccines as quickly as possible.

Thank you, Dean. Now your opportunity, Thomas, for a rebuttal of Dean's opening statement or what you've just heard now. We agree with the goal, just not the solution, because we don't only agree with the goal of vaccinating the world. It is actually happening. As we speak, almost 30 million doses have been handed out and used in more than 35 developing countries. We are fighting the pandemic with new vaccines, but we also fight the pandemic. by making it possible for governments in poorer countries to give the vaccines for free, in 92 countries in the world.

But we are fighting the pandemic by producing the new vaccines in colossal quantities. Dean has mentioned the scale up and of manufacturing, but the scale up and the daunting scale of traveling global vaccine capacity wouldn't be possible

without the huge collaboration with developing country vaccine manufacturers. But this tech transfer, and that's where we differ. It is not about the patent. The patent is just the tip of the iceberg. It is not like you get a recipe and then you know how to make a cake.

It is the know-how behind it. It is the training of skilled workers. It is trade secrets, sharing, getting the equipment in shape, and really working together. And developing country vaccine manufacturers have been very public about this. Vaving patents would not.

solve the problems you need to address when you have this massive tech transfer with companies such as Serum Institute of India, Barat from India, and many others, who are all teaming up with companies such as Asfra-Seneca, Oxford, such as Johnson and Johnson and Dothers. It is happening. Therefore, it's not just the view of Western manufacturers, that waving patterns would more be a disruption than a solution. It's also the view of the leading vaccine manufacturers of developing countries. The system my opponent is questioning is actually working. We wouldn't have been able to come up with a response to COVID-19 to develop these vaccines

at such a record speed if we wouldn't have started from a strong innovation ecosystem based on competitive research protected by intellectual property. Thank you, Thomas. Now an opportunity for me to try to think of some questions that are top of mind for our audience and put them to both of you in terms of this debate. And, Dean, let me start with you. there's an old saying that we receive the world the way it is and then there's the world the way we want it to be. When it comes to vaccines and vaccine production, you know, Thomas seems to

paint a pretty compelling case here that we've arrived at a place, an amazing place, thanks to patent right protection that has allowed these companies to develop not only deep knowledge and expertise that created these life-saving vaccines, but the manufacturing processes and scale that will eventually allow for a global rollout. So why isn't Thomas right that if you start pulling that system, that those series of protections, those manufacturing processes, that human capital apart to try to solve for some world that we would like, which is a world of vaccines for everyone, you could end up doing more damage than good to the ultimate cause, the ultimate effort of bringing COVID-19 to heal? Well, I think we have to look at the world as it is and not as some

would have us imagine. Moderna did their research almost entirely on the government's dime. So the idea that they did it for patent protection, now we gave them a patent monopoly as well. So we paid them twice. I don't quite understand the logic of that. But it's just fanciful to say, oh, this was just a patent monopoly. No, we paid them. We paid them up front. And frankly, I think that's a great way to go because if you pay for research up front, then you eliminate the perverse incentives that you give with patent monopoly. So we have a huge opioid crisis in the United States, which was driven in part, at least by the perverse incentives created by patent monopoly. The leading opioid producers have paid billions of dollars in settlements based on the accusation that they deliberately

misled doctors about the addictiveness of their drugs in order to mass market them. So this is not a wonderful system. This is a bit of a hallucination. Now, in terms of vaccinating the world, Thomas made a point, we got 30 million doses to the developing world. That's a population of 4, 5 billion people, depending how we're counting this. The U.S. alone has over 200 million doses. So great that we got 30 million, but that's really just the beginning of the story. So I'm very much looking at the world that it is and saying how, given where we are today, we can get people vaccinated and developing world as quickly as possible. And intellectual property and industrial secrets, I'll throw that in.

Those are obstacles that we should look to overcome. Hi there, Rudyard Griffiths, the moderator of the monk debates. Look, this we know. Our society is becoming dangerously polarized. We don't listen to each other. We don't search out opposing views. Instead, too many of us live in tribes, convinced that we are right and they are wrong. It's time to put a stop to polarization before it wrecks our democracy.

This is what the monk debates charity is all about, ending polarization, searching for common ground. We do this by producing the world's only weekly debate radio program through our monk dialogue series and through mainstage debates on the big topics of the day. Support civil and substantive public debate by becoming a monk member. As a member, you get access to our 10 plus year online library of great debates in streaming high-definition video, a free monk debate book of your choice, ticketing privileges, and so much more. 30% off when you use the promotional code, Monk, 2021, at our website, monkdebates.com. Again, that promotional code, Monk, Munk, Munk, 2021 at MoncDbates.com. Join now and help fight the polarization of our democracy.

Now back to our program. You know, another listener issue that's top of mind for me, Thomas, I want to put to you, was Dean's original point just about the risk of these variants. Isn't there just an emergency situation here whereby we know this virus will mutate? We know that if there are billions of people who remain uninoculated for potentially years to come, that we will inevitably face a variant that will have a significant impact on the efficacy of existing vaccines. So simply given that risk, in this one instance, in this one situation, why isn't it the time to say, okay, let's loosen up the patents, let's transfer technical expertise,

let's help stand up manufacturing capacity in these developing nations. If there was ever a moment, why isn't that moment now? I can understand that kind of feeling. And I, I shared the impatience and, you know, the eagerness to really do whatever is needed to further scale up. Actually, we just co-convened a workshop with Jatham House in London where we brought together more than 100 suppliers, vaccine manufacturers from developing and developed countries exactly looking at where are the bottlenecks. What are the issues? Amazingly, for many people who are not familiar to the complexity of vaccine manufacture, which is a, a very complex biological process. Everybody there agreed. The issues are scarcity of, for example,

glass vials, scarcity of syringes, scarcity of raw materials, bottlenecks in single-use bioreactors, giant plastic bags. Serum Institute of India has warned that vaccine makers are falling short of raw materials to manufacture COVID-19 vaccines, which may affect the supply chain of vaccines two countries like Kenya. And people are concerned about how can we make sure that we make the impossible happen? We have just over the last few weeks we have seen that vaccine manufacturers whose projects unfortunately failed, Merkenko for example, Sanofi, who is delayed and others, they team up with others.

They offer spare capacity. They offer partnerships. and they have made it possible together with vaccine manufacturers from India, but also we have seen scaling up in China because everybody really wants to make the impossible happen. We are concerned about the variance, but taking away the patent, as I said, would lead rather to disruption. You wouldn't get a single dose more. Patents was not once debated among these experts because they know where the bottlenecks are.

The Indian manufacturers said what we need is know-how sharing. What we need is agreement also to train the skilled workers. 70% of vaccine manufacturing is quality control and quality assurance. That's something which you can't just take away. Taking away would lead to disruption and it would be a huge disincentives to companies who have really now been all out 24-7 to make it happen because it would indicate to them if there's a pandemic, forget about your IP.

We will take it away. And therefore, where's the incentive to do what is done now? Okay, so Dean, let's have you come back on both those points because they're really interesting ones. You know, Thomas is saying here, it's not about the patents. That's not what's stopping a rollout in the developing world of vaccine doses. It's supply constraints within existing supply chains and its technical know-how, which is simply is not there. And then let's go to Thomas's second point, which is a fascinating one, which is, you know, what about the next pandemic?

I mean, if you're going to obliterate patent and intellectual property rights, what's the motivation for these companies to maintain their investments to remain at the cutting edge of vaccinology? Let's hear you on both those points, Dean. I'm just fascinated here, Thomas talk about that at a meeting in March to discuss, you know, what are the shortfalls and vials and syringes? March, March, March of 21, not March of 220. What were these people doing over the last year? It is a little mind-boggling. I'd be reluctant to accuse them with that level of incompetence, but he seems to think that's the case.

I mean, I don't doubt those are the shortfalls, but why was this not planned a year ago? Again, this speaks to the important of open-sourcing technology, open-sourcing, these developments so that hopefully you'd be sitting down and people could be figuring out where are the shortfalls. But when you have everyone trying to secret away what they're doing, well, then you wait a year later and you suddenly realize, oh, we don't have enough syringes. Kind of mind-boggling. But, yeah, technical expertise. Now, a lot of this is caused and effect.

You have very little incentive to develop the technical expertise to produce the Pfizer vaccine if you're going to get arrested for doing so. We want them to share that knowledge. Why don't they write up blueprints of how you do this, have webinars, have consultations, have this widely available all over. over the world. So again, I recognize that there's technical expertise that many of these countries, many of vaccine manufacturers they don't have. They're not producing the MRNA vaccines or the other vaccines that are effective. We need to get that as widely available as possible. The last point incentives, yes. What was Moderna's incentive? We paid them. They didn't need a patent monopoly. Of course, they were delighted to have the patent monopoly because they, in fact,

get paid twice. But, you know, I've had people argue with me on this, why would drug companies do this if they didn't get Pat Monopoly, and I go, we pay them. Maybe I'm old-fashioned, but as an economist, I think people have incentives to work for money. So we will pay them. So I'm not worried. The next time we have a pandemic, we could sit down and do exactly what we did with this and say, okay, who's got useful technology? We will pay you.

And it's all open source, all available for everyone all over the world. So, Thomas, come back on that point. I mean, why couldn't we move to a different type of model, a model where, instead, of patents being the way that companies claim their investments back over time, we move to a scenario where, as Dean said, governments up front pay companies a reasonable fee for the development of both the technology and the actual vaccines themselves. And why can we expand this, not just from COVID, but to all kinds of other diseases and just leave this whole patent model behind This is something from the past and it doesn't need to be part of our future in terms of how we deal with public health crises and everyday epidemiological challenges.

Now, you know, I really need to say that I was a little bit baffled listening to Dean because, of course, it's not that we waited for a year to make the impossible happen. Actually, we met because we are on the road to treble global vaccine manufacturing within 12 months, something which all the experts considered almost impossible. A year ago, and it was possible because all these experts have been working 24-7. And then, of course, as a result of that, if you have this troubling of manufacturing capacity, it's normal that it's also a challenge to scale up the raw materials, the ingredients. A single vaccine has up more to 200 ingredients and global supply chains, which can easily be disrupted. The second element where I was baffled with Dean is it's not that Modernos research was all paid for by the government.

Actually, when you look at one of the reasons why I've had this fantastic result with highly effective vaccines, Bioentech, Pfizer, as well as Moderna, was that the MRNA, the MRA, the messenger RNA, which really has been a game change now, goes back to the early 1990s. The history behind RNA technology starts in 1990. First, researchers from the University of Wisconsin published a study testing RNA in mice. And over the last 16 years, that technology has proved effective against many other viruses. And for more than 15 years, most of the academics, the labs, small startup who believed in that technology.

They struggled even to get grants for tiny government-supported research. It took off around 15 years ago when actually big pharma thought that it could have a future in cancer research, in using to treat cancer. But until 2020, not a single message RNA medicine, let alone vaccine, has come to the market. It wouldn't have been possible to be where we are now without this 30 years research, which has been funded by venture capitalists, by big pharma and others. Therefore, in terms of where the system is, we do acknowledge that the public-private partnership. For example, Bada and the US has certainly been the bank for the rest of the world.

We wouldn't have had these fast vaccine developments without that. But the enabler at the origin is really the rich competitive. with research you have in academia as well as in pharma. Thank you, Thomas. So, Dean, I want to come back to you because, I mean, Thomas, to me, is painting here a kind of a compelling story that you simply have innovation occurring as a result of these companies reacting on, you know, within a capitalist system being queued by consumer demand, by competitiveness amongst each other.

Why isn't it just essential that we maintain that? because that is the heart of innovation. And why, Dean, your scenario, your vision of the future of a kind of government-subsidized pharmacological industry, why doesn't that lead to a retarding of invention and our ability to rise to the challenge of the next pandemic? Well, a few points. First off, we already have a very heavily government-subsidized industry. And, you know, a part of it was mentioning how much we paid Moderna up front.

But, you know, going back over the history, the NIH fund. a lot of the research on MRNA technology. NIH is, of course, a National Institutes of Health that gets over $40 billion a year in government funding. So the idea that we don't have a government subsidized industry, no, let's talk about the world as it is. We have a very heavily subsidized industry. In this particular case, the spike protein, which is the point of attack of the coronavirus,

that was discovered on government grants. Now, I'm not talking to gain rid of capitalism. I would expect companies make profits. and a model here defense contractors in the United States. Lockheed, Boeing, you find many other very profitable companies that make money on defense contracts. They're very capitalist, but they get paid for developing weapons systems. Now, they might get patents as well,

but they're getting money on their contracts. So the idea that you would have companies making profit on contracts that shouldn't sound alien to anyone. And the huge advantage of the round I'm talking about, well, two huge advantages. One is that everything could be open. source. So you wouldn't have Moderna trying to hide away what it might have developed or Pfizer or or whoever else. All that would be shared. That's a condition of getting the money. The other point is,

again, the point I made in reference to the opioid crisis, you take away the perverse incentives that you create with patent monopolies. So when you could sell a drug for 10, even 100, sometimes even a thousand times its cost of production, you have an enormous incentive to push it as widely as possible. And that means misleading clinicians about the effectiveness and safety of your drug. And that happens all the time because that's a predictable result of giving those sorts of incentives. So I'm not talking about a whole new system. I'm talking about looking at our system as it is and doing some tweaks on it to make it more efficient, both for this pandemic and more generally.

Thomas, do you want to come back on those points? Yes, indeed, because I fully respect to public-private partnerships. I do respect the role of NIH or Barta. But when you actually look how the world was prepared for this pandemic, by and large, wed in Europe and the US, not that well. By and large, we saw inefficiencies in terms of lack of masks, lack of PPEs, lack of beds in intensive care units. When you compare that with the speed with which the private sector has come up and ramped up PCR testing,

rapid antigen tests, companies such as Abbott or Roche, for example, when you look at how companies were really willing to invest it risks in repurposing for Putex, whether it's Gilead, Eli, Lili, Roche, Regeneron or Ardus. Unfortunately, we don't have the magic bullet in the medicines yet, and our companies were willing to take risks. Faisal, for example, they invested more than $2 billion at risk. Of course, there was an advance purchase agreement And apart from that, but when I look at how companies really stepped up to it, but also

companies realized early on that you did need tech transfer. You did need a collaboration. But as I said, this is not a blueprint. This is not adding water to the soup. It is a very sophisticated biological process. And we have seen companies whom we had fought would most likely succeed, like Sanofi, like Merck and Co, like CSL. Well, Sequeiros from Australia, their projects failed.

Others, on the other hand, succeeded and actually they deserve to be rewarded, and I think we are lucky, that they succeeded. I think that's the way the system works, and the system has been extremely effective in this pandemic, but of course we want to do more, and we want to do it more rapidly. So, Dean, let's just hear your view on that, that the system has been effective. Why aren't these real successes that suggests that the current model is working? Well, look, we all should be very happy with vaccines. And again, I just made the point. It's not uniquely the U.S. and Europe.

Russia and China also have vaccines. And that's a great thing. I'm not, you know, so I'm just pointing out it wasn't uniquely our system. Those are different systems. The issues about text transfer, again, it's great to hear, you know, Thomas was talking about the seminar earlier this month, about how they could facilitate tax transfer, why didn't that happen long ago? And one of the things that's probably worth mentioning in this context, of course, there's a resolution before the World Trade Organization put up by

South Africa and India that called for, in effect, suspending patent rights on vaccines, treatments, tests for the duration of the pandemic. South African India are leading a movement to suspend the World Trade Organization's agreement on intellectual property rights for COVID-19 vaccines. But many high-ins, countries, including the United States and those in the European Union, have rejected the idea. I suspect that the concern now with tech transfer, which again, fantastic, it's happening, that that's at least in part related to the fact that we had the threat of having their patent rights to spend it altogether for the period of the pandemic. So again, we should be very happy

for what's been done, but just refer to what Thomas pointed to earlier. 30 million doses in developing countries is not something to bring. hang about it's much better than zero but it's a population of several billion people so yes we're doing much better than we could but we want to solve this problem as quickly as possible and the failure to have more tech transfer the insistence i maintaining pat monopolies those are obstacles just in our final moments before we go to closing statements i i just want to touch on the the second part of our resolution which is vaccines should be free to everyone the world over so thomas i think listeners would like to hear, you know, what are you saying right now to a person in, say, Senegal,

who is potentially looking at not months, but possibly years to wait for a vaccine that would provide them with the basic protection that many people in the United States, Canada, the UK, Europe will receive in the coming months? I can understand and, you know, share the. eagerness to move fast and equitable so that no one is left behind. But also what we need to bear in mind and put in perspective, it is not true that young and healthy people in which countries are vaccinated in masses. I'm living in Switzerland. I'm older than 65. We don't know yet when I will be vaccinated. When you look at whom did COVID-19 hit most in terms of health impact,

lives lost. It was in Europe, UK, the United States and Latin America. Africa, fortunately, was less impacted. One of the reason probably is much younger population. But nonetheless, I'm so pleased we have had already more than 30 countries, many of them in Africa, getting significant numbers of doses. And we have a realistic chance of getting more than 2 billion doses to these people. And we have this partnership with COVAX, with W.E. But today there's been a victory of sorts. Ghana has become the first country to receive vaccines through the Kovacs vaccine sharing initiative. They're produced by the Serum Institute of India.

The total of 600,000 doses of the vaccine developed by AstraZeneca in Oxford University, has arrived in the Ghana capital Accra. And that, Dean, before we go to closing statements, would be my final question for you. COVAX. This is the global alliance amongst advanced economies and nations to invest and provide vaccines to the developing world. So why isn't COVAX the right answer to the challenges we face at this moment? Well, COVAX is helpful, but we're talking about commitments for developing world population that's much, much larger than the population of the wealthy countries. You know, certainly we should be glad we have it as opposed to not having it. But we could have many, many more vaccines in the developing world if we got rid of the obstacles in the form of

tech transfers and patent monopolies. I should also add the numbers that we have on how badly it hits the developing world are badly skewed by the lack of testing. So I know there was a study done in Zambia last fall that looked at deaths and it found that they had death rate from COVID, the percentage of the people who died from COVID, was comparable to the U.S., even though they were reporting less than one-tenth as many infections as the United States. So the point is just that our numbers on infections and deaths in much of the developing world almost certainly grossly understate the true impact of the pandemic. Thanks, Dean. Let's move to closing statements.

This has been just a terrific debate. I've learned so much. And I can just sense in both of your arguments your commitment to facts and explaining those in ways that certainly have been accessible for me in terms of educating and understanding these complex issues and ideas. So, Thomas, we're going to put final two minutes on the clock for you to allow you your closing remarks. What do you want to sum up for us in this debate? I've also very much enjoyed the debate, and I believe we all agree the system is not perfect, but most of the time we get it right.

and in this case, we are getting it right. The industry is delivering, science is winning, and the stakes are high. Our task is to develop vaccines that are both safe and work. In the most complex organism, we know human beings, namely us. Our goals are absolutely the same. The world is not safe until everyone is vaccinated. But the way to get there, I will believe how to get there is very different. Vaving IP, and that's what Dean basically asked for, on COVID-19 products would be a disincentive to any third innovation for future pandemics. Thinking that waving patterns will get more COVID-19 vaccines to more people now is really strong in belief, but weak on facts. Vaving IP wouldn't deliver a single extra dose of vaccine to tackle this pandemic, but it would send a

disaster signal for future pandemic preparedness. And we do know there will be future pandemics. Thank you, Thomas. Dean, we're going to give you the last word on this debate. Two minutes on the clock to bring us to a conclusion. Well, thanks a lot for staying us up, and I really appreciate Thomas taking the time for exchanging his views with me. Let me just say, you know, look, we should be very happy of the vaccines, and I'm very happy that the pharmaceutical industry is now more seriously concerned about trying to get vaccines to developing world. But again, we should be thinking very clearly, one month delay. If we're just delaying one month, the amount of vaccines that we're getting out, we're probably talking about millions of infections. We're probably talking

about tens of thousands of deaths. And of course, massive economic losses. So saying that we're doing good, no, that's not good enough. The question is, are we doing everything we can to get vaccines out as quickly as possible. We're still looking at a situation, even with the steps that Thomas is talking about where we clearly not going to get most of the developing world vaccinated anytime this year, we'll be very lucky if they're vaccinated by the end of 222. And again, in terms of our structure of intellectual property, it's not new that we have problems with it. We have lots of problems with it. I keep a point to the opioid epidemic. That was a huge deal. That costs the United States thousands of lives, tens of thousands of lives, and billions of dollars

in lost economics. I'll put if you want, put dollars and cents on it. So the idea that somehow we have a perfect system that I'm proposing to tamper with, no, we have to look at the world as it is. It's very far from perfect, and there's lots of evidence

that publicly refunded research, particularly open source research, could be very effective and likely to leave us much better prepared for the next pandemic. Thank you. Thank you so much both for this debate. Again, just great to have this engagement of ideas

and intellect on behalf of the Monk Debates community, Dean Thomas, thank you for coming on the program. Thanks for a minute. Thank you very much. Well, that wraps up today's debate. I want to thank our participants, Dean and Thomas. They certainly gave me a lot to think about it. I hope they did the same for you.

If you have any feedback or reflections on today's debate, please send us an email to podcast at monkdebates.com. Again, that's podcast at Monk-M-U-N-K. Debateswithan s.com. Here's some recent feedback on our cancel culture debate courtesy of Tamara. She writes, I was very disappointed with the debate on cancel culture. Usually the monk debates has excellent debaters.

Taking the time to find strong debaters with strong, clear ideas is worth the effort, even worth postponing the topic to get them. Hey, thanks, Tamara, for the critique. We appreciate all your feedback, the good, the bad, and the downright ugly. Keep it coming, Monk debaters. And finally, here's some email feedback about our new weekly members-only podcast. Irina writes, thank you for the useful and entertaining Friday programs. The voice of reason prevails in these discussions, and that is very much appreciated.

While our members-only podcast is yours to listen to any time as a perk of our free basic membership, available at www.munkdebates.com. The Monk Debates podcast is that special place for civil and substantive debate on the big issues of the day. To listen to more debates on everything from climate change to religion to geopolitics to the future of human progress, again, visit our website, monkdebates.com. Thank you for lending your time to our efforts to bring back the art of public debate, one conversation at a time. I'm your host and moderator, Rudyard Griffiths. The Monk Debates are produced by...

Antica Productions and supported by the Monk Foundation. Rudyard Griffiths, Christina Campbell, and Marilyn Missouri are the producers. Upi Rahaja is the associate producer. The Monk Debate podcast is mixed by Kieran Lynch. The president of Antica Productions is Stuart Cox. Be sure to download and subscribe wherever you get your podcasts. And if you like us, feel free to give us a five-star rating. Thank you again for listening.