Pandemics don’t destroy societies, but they do expose their weaknesses. As the historian of medicine Frank Snowden recently told the New Yorker: “Epidemic diseases are not random events that afflict societies capriciously and without warning … on the contrary, every society produces its own specific vulnerabilities.”
Coronavirus has exposed the effects of successive budgetary cuts on the NHS, leaving the health service under-resourced and ill-equipped to cope with a pandemic. And like other pandemics before it, coronavirus will disproportionately take the lives of those who are most vulnerable: the elderly, the homeless, prisoners, migrants denied access to healthcare, and those with existing health conditions such as cancer and HIV.
The virus has also shone a light on another fatal weakness in our health system: the profit-driven pharmaceutical innovation model that we rely upon to develop life-saving vaccines and medicines.
The news that Donald Trump has sought to buy up the exclusive rights to a promising Covid-19 vaccine from a German biotech firm has been greeted with anger. During a global crisis, when all of humanity is at risk, our sense of fairness – and our own self-interest – makes this shameless attempt to buy the right to life (with little regard for those it excludes) seem immoral.
But this is about more than just Trump. Coronavirus should give us pause to reflect upon whether the pharmaceutical industry, and the monopolies that drive its profits, should continue to control which medicines will be developed, and who will get to access them.
Profit is what drives decision-making in the pharmaceuticals industry. It’s why we don’t have drugs to treat diseases such as tuberculosis, which kill millions of the world’s poor every year – and it’s also why we aren’t closer to finding a vaccine for Covid-19. This isn’t the first coronavirus to threaten the world, after all. Researchers had a promising candidate to treat viruses like Sars and coronavirus in 2016, but with little money to be made, they instead focused their efforts on more lucrative lines of business.
After the Ebola crisis in 2014, which briefly threatened the rich world, western countries decided to research treatments for the disease that had been killing people in Africa for years. The Coalition of Epidemic Preparedness Innovations (CEPI), a foundation based in Washington DC, was established in 2017 to drive public investment in R&D for pandemic treatments, but even today it complains that it has struggled to interest pharmaceutical companies in research that could save countless lives.
As companies are starting to see the potential for profit in Covid-19, investment has grown; like almost every drug brought to market, the public sector will play a critical role in funding almost every candidate vaccine and treatment. But there is a huge risk that without government intervention, any vaccine for coronavirus will be priced so steeply that only rich countries will be able to afford it.
In the US, Bernie Sanders has called for any coronavirus vaccine to be made available for free. Trump’s move to buy up exclusive use of a candidate vaccine for Americans does not bode well. The UK must act differently. In the same way that we have seen the moral imperative of an NHS that guarantees equitable healthcare to all, we need to apply conditions on research funding that prohibit profiteering from Covid-19, so everyone across the globe who needs treatment can get it. This should be the first step towards a reordering of the pharmaceutical innovation model, away from profit and towards public health.
In the same way that pandemics show the worst in us, they can also teach us how to make ourselves safer. This should begin with proper care for the vulnerable, committing to health as a human right, and investing sufficient money in a publicly owned and operated NHS to ensure we can all realise that right.
If coronavirus teaches us anything, it should be to reject the selfish Trumpian response to this crisis, and embrace a pharmaceutical model that is driven by public interest, and which rewards the creation of universally accessible treatments. In the face of a pandemic, rampant profiteering and national exceptionalism are transparently unacceptable.
• Diarmaid McDonald is lead organiser of Just Treatment, a UK-based patient activist group