Podcast: Share the Vaccine ‘Recipe’

What difference could it make worldwide if the U.S. waived patents for vaccines?

When the Biden administration announced support for waiving COVID-19 vaccine patents last week, it was met with praise, relief, skepticism, and alarm by different groups—but surprise all around. Pharmaceutical giants have long fought efforts to have their intellectual property released to meet international needs. And they’ve backed it up with immense political muscle. Could this time be different? Would it discourage future research, as critics such as Bill Gates claim? And how much (and how quickly) could it help?

To understand the issue, James Hamblin and Maeve Higgins are joined on the podcast Social Distance by Julie Rovner, the chief Washington correspondent for Kaiser Health News. Listen to their conversation here:

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What follows is a transcript of their conversation, edited and condensed for clarity:

James Hamblin: What was your reaction to that news last week when the Biden administration indicated that they would be backing patent waivers?

Julie Rovner: Well, of course, because I cover politics, my first inclination was political. It was like, Wow, the Biden administration is doing something that the drug industry really doesn’t want them to do. And, of course, the drug industry is flying high right now. Everybody loves them because they brought us these miraculous vaccines. But someone reminded me that [President Joe] Biden did, in fact, promise to do this patent waiver back last summer. So it was a campaign promise.

Maeve Higgins: I’m over in Ireland and some of the E.U. leaders have said this isn’t going to make the biggest difference. Do you think they have a point?

Rovner: I think it’s not going to make a difference right away. And, in fact, the CEOs of the companies making the vaccines are worried about competition for the raw ingredients that they need to continue to make the vaccines. I was at a meeting with the ambassador of one of the E.U. countries ... [and] he did say that it was really important that less-developed countries not just get vaccines from more-developed countries but that they actually manufacture their own vaccines. I had not heard that before. This was a month ago [and] this was a country that makes its own vaccines.

He thought this waiver was really important. He really wanted to get the rest of the world up and running. Obviously, it will take a very long time. It’s not going to help India with its current crisis. India needs vaccines. India has lots of vaccine manufacturing. So I think it may be a long-run thing. The other question is: Is this the first nose under the camel’s tent about intellectual property and waiving patents? Particularly for the very powerful drug industry, which I know is powerful, not just in the U.S. but also in other parts of the world, including the E.U.

Hamblin: So, just to clarify the terms, these patent waivers would mean Pfizer would kind of upload its plans ...

Higgins: It would put them on TikTok and anybody could screenshot them ...

Rovner: It would be a recipe. It would be like Tasty for vaccines.

Hamblin: Yeah, but not everyone can just go make a vaccine in their kitchen. It still requires a lot of overhead, and time to ramp up, and technology. And so the question is: Are there actually companies out there that would make that investment if they could get the IP? And hasn’t Moderna already shared theirs, and not a lot of people took them up on it?

Rovner: I would think the companies would want to, but these are not easy vaccines to make, particularly the mRNA ones. I don’t think it would be that simple for even some of the countries that have vaccine-manufacturing capabilities to necessarily do these quickly.

But it’s definitely an interesting prospect, assuming the World Trade Organization goes ahead and does this. Remember: This is just us supporting it. The W.T.O. actually has to do it. Assuming that they do, it’ll be interesting to see what happens with it.

Higgins: Is Biden just potentially really upsetting the pharmaceutical industry, while not necessarily taking a meaningful step to actually help the countries that desperately need vaccines?

Rovner: The U.S. is also doing other things to help countries that desperately need vaccines. There’s been a lot of concern about the U.S. [being] slow to help India. And there is this lingering irritation of “Why are we vaccinating 12-to-15-year-olds when there are so many countries in the world that can’t vaccinate anybody yet?”

What obligation does the U.S. and all the developed countries that now have these vaccines have to less-developed countries? And [there’s a] continual reminder that people don’t appreciate that: Nobody is safe until everybody is safe. There are countries that are basically on fire and creating new variants that could undermine all of the vaccinating that we’re doing now.

Hamblin: Do you have concerns about the argument people like Bill Gates have made, that if we set a precedent now that vaccine patents can just be made public, that there will be even less investment from the industry in vaccines we might need for future pandemics?

Rovner: Well, my impression is that most of the investment was made by the government. (Laughs.)

Higgins: (Laughs.) Yes!

Hamblin: In point of fact, yeah.

Rovner: Drug companies are still not investing that much. And drug companies not investing in vaccines is not a new thing. I’ve been writing about it for 20 years. And there is this whole argument—and I’ve been covering drug prices since the 1980s when we first started complaining about them, maybe before that, but that was when I started—and drug companies have always said, “If you don’t let us make big profits, we won’t have money to invest into the next lifesaving medicines.” Drug companies have been investing in things that are not vaccines for a really long time, so I’m not sure how much of a precedent this sets for intellectual property on other drugs, but certainly it’s something that the drug industry is not thrilled about. I was amazed at how quickly the reaction started flooding into my inbox when this was announced last week. I mean, within seconds.

Hamblin: And the argument is like, “This is going to destroy access to so many medications.” Or, “We won’t be able to do our jobs if we don’t have a billion dollars in profit.”

Rovner: Basically, yes. “You take away the incentive for us to sink money into it if you’re just going to give away what we discover.” And this is not a new argument. This has been the argument about drug prices too. “If we can’t earn unlimited profits, then we won’t have money to put into R&D.” That’s effectively what they’ve been saying since the 1980s.

Hamblin: Yeah. But it’s an effective argument.

Rovner: It’s an extremely effective argument. I always say: The two industries we’re forever haranguing are the drug industry and the tobacco industry. And, unlike the tobacco industry, the drug industry makes things we want and need.

Hamblin: Is it a bundling issue? Could we just have companies that just make vaccines? That way they wouldn’t be able to say, “We’re not going to make vaccines because we need the money to invest in cancer research.” It becomes very muddled and complicated.

Rovner: It does. I mean, there were not enough companies making childhood vaccines for a while. This is not a new thing. They don’t make as much money off of vaccines, which you give once ... Well, the flu vaccine you give every year, but generally, childhood vaccines you give once, maybe twice, rather than a statin drug that a lot of adults will take every day for 20 or 30 years. Vaccines are sort of the least-profitable piece of the drug industry.

Hamblin: Because they work so well.

Rovner: That’s right, yeah. We have problems with antibiotics for the same reason. Which is to say: You don’t take them constantly. You just take them when you’re sick.

Hamblin: Does the kind of pandemic matter here? This is a global emergency for everyone in the world. Do you think the kind of emergency we’re seeing now incentivizes research for another disease that could pop up?

Rovner: We’ve obviously never had this kind of a global pandemic before. And that’s part of the problem. Even when we had Ebola, we could send everything to the one place where it was. This is a true pandemic. And I do think that things are different. Although a lot of scientists are expecting that this will not be the last pandemic, [and] that as we have these diseases that jump from animals to people that people have no resistance to, it could happen again. And it could conceivably happen again with something that’s even more deadly than this one. I mean, it’s definitely uncharted territory, but I think people are kind of looking at it to see [whether] we’re going to have a different feeling for how public health and the medical system work.

I was interested at the beginning to see how the nation’s various health systems were able to deal with this. And I realized very quickly that it wasn’t so much a test of health systems as it was a test of public-health systems, and that places that had good, very robust public-health systems were better able to deal with it than places that necessarily had universal health care.

Hamblin: If you could take politics out of it, how should we get the global vaccine supply into a more sustainable place where we’re not having to rely on hoping that companies come through for us next time? If companies won’t do so unless they can be guaranteed a large profit, how do we get around that to have a sustainable plan for the future?

Rovner: Well, you know, if we had a functioning U.N. and a functioning World Health Organization ... and that’s what COVAX [COVID-19 Vaccines Global Access] is. I mean, that’s the idea that the wealthier countries are going to come together and help fund vaccines for the poorer countries who can’t do it themselves. Because, as I said, no one is safe until everyone is safe. So, there is self-interest in this too. One would hope that self-interest would help this along.

Hamblin: We have that in abundance.

Rovner: Yes, we definitely have that in abundance. But I think people don’t see it. This is the constant: “Why do we give money to other countries? Our foreign-aid budget must be huge. Why should we give money? Why do we care if the rest of the world is at war?”

Well, we get a lot of our stuff from the rest of the world, which I think we’re discovering now. The disrupted supply chains are an eye-opener to a lot of people.

Hamblin: How much can you see the influence playing out of the money that Big Pharma donates to politicians? Do you kind of see that happening like clockwork in your work, or is it more subtle?

Rovner: With the drug companies, it’s not that subtle. They do give a lot of money to lawmakers, and lawmakers tend to do their bidding. And it’s not just Republicans. They give money to Democrats, and there are Democrats who are kind of loath to cross the drug industry. This is why Congress has been fighting about drug prices for 40 years and still hasn’t really done anything about it.

They haven’t even done some of the very low-hanging fruit, like letting drug companies buy off their generic competition temporarily, which helps the generic company because they’re getting paid, and it helps the brand-name company because they don’t have competition. And the only people who aren’t helped are the people actually trying to buy the drugs. That’s been one of these things that just about everybody agrees on. And yet Congress has had great difficulty doing even the easy stuff, much less the hard stuff that might actually do something about the price of prescription drugs.

Higgins: I just keep thinking about insulin. I have friends who, immediately, when Biden made his announcement, they were just like, How about insulin?

Rovner: Insulin is such a good example because the original patent for insulin was sold for $1. The whole idea was that insulin wasn’t supposed to make money. And yet all of these little variations on insulin now cost hundreds and thousands of dollars. And we’re seeing people in the United States literally dying because they’re diabetics and can’t afford their insulin.

Hamblin: And this is coming off of a presidency where Donald Trump said many times that we need to do something about drug prices. He would get cheers at his rallies for it, and Biden has said the same thing. It would seem like there’s bipartisan support for this to happen. And Americans certainly want lower drug prices. And yet here we are.

Well, what I would love to hear you say that this is a big, significant move and it’s one you think is really going to change things, waiving these patents. But unfortunately ...

Rovner: I will believe it when I see it. Waiving the patents for vaccines is an important step, but I don’t know that it gets followed by anything else. I’d love to be proven wrong, but I have grown cynical about drug prices over almost 40 years of covering them.