Opinion: Pharma profiteering isn’t going away, and so we can’t either

At the height of the COVID-19 pandemic, while people in high-income countries were receiving booster shots, nurses in Africa were still waiting for their first. Moderna, Pfizer, and BioNTech were calling the shots — making $1,000 a second from vaccines that were developed with public money, building on years of work from scientists at public institutions. This vast power imbalance created nine new pharmaceutical billionaires in a matter of months, while many of the world’s poorest died without vaccines. To the millions of people in the global south, the message was clear: When the chips are down, your lives are not as valued as those in high-income countries. We saw this coming. We had both lived through the darkest days of the AIDS pandemic. We had seen the lives of relatives, friends, and colleagues taken because pharmaceutical monopolies meant lifesaving HIV/AIDS medicines cost thousands of dollars a month. We fought then, and we won; generic, HIV/AIDS drugs are now available to millions of the poorest people on earth. But we could see that the same scourge of greed, nationalism, and profiteering would hold back the global response to COVID-19. From the People’s Vaccine Alliance to the People’s Medicines Alliance The People’s Vaccine Alliance emerged from a simple idea — that a handful of pharmaceutical companies should not dictate who had access to lifesaving COVID vaccines, which were backed by billions in public funding. A coalition of health workers, world leaders, civil society, academics, experts, and activists built a global movement around that principle; calling for COVID-19 vaccines to be freely available to all, regardless of where they may live. Since then, activists around the world have fought doggedly for equitable access to COVID-19 medicines, and for a fairer response to COVID-19 and future pandemics. “Because life is sacred and every person has the right to access the medicines they need when they need them, we believe that medicines are a public good.” --— But this was never just about vaccines. It is about all medicines including vaccines, tests, and treatments. A new analysis has found that the removal of patents led to a two-thirds reduction in the cost of certain medicines. This means that they become accessible to millions more people; affordable for many more governments; and that they save more lives. Yet patents and other intellectual property rights on other drugs continue to enforce monopolies that systematically prioritize profit over people’s health. This is not just a problem for the global south; it is an issue all over the world, from the United States to South Africa — from insulin to cancer treatments and HIV prevention — prices for lifesaving medicines are kept far too high. High prices are draining government budgets and bankrupting individuals in the global north and south. Meanwhile, there is a dearth of research and development for diseases that mainly affect lower-income countries. So the medicines are either not there, or available only at an unaffordable price. Because life is sacred and every person has the right to access the medicines they need when they need them, we believe that medicines are a public good. Many medicines, just like vaccines, are developed with public funding and public research. They are the people’s medicines. That is why we are changing the name of our coalition to the People’s Medicines Alliance, to reflect the breadth of our fight better. And it is a fight that can be won if a broad collective of those committed to health equity stands strong. The harm of pharmaceutical monopolies Our coalition has repeatedly warned that, regardless of the pledges made by pharmaceutical companies, relying on their goodwill does not work. When under extreme pressure over the grotesque inequality in access to their COVID-19 vaccines, Moderna and BioNTech pledged to open African manufacturing sites. But now they have shelved or scaled back their plans. Around the world, patients and activists are speaking out against the devastating impact pharmaceutical monopolies are having on people’s lives and demanding that their governments take action. In Colombia, the government has stood up to pharmaceutical companies to issue a compulsory license for dolutegravir, a move that will make that essential HIV medicine more affordable and widely available. In the United States, pressure from legislators and activists has forced manufacturers to slash the price of insulin by up to 70%. And, in the global campaign for access to tuberculosis medicines, a coalition of TB activists along with American author John Green pushed back against Johnson & Johnson’s attempts to “evergreen” its patents on a lifesaving treatment. “Continuing with the status quo in which where one lives decides whether one should live or die cannot be seen as an option.” --— Without a strong, diverse, and dynamic civil society coalition campaigning for equitable access, lifesaving medicines will remain the preserve of the rich. That’s why our alliance has mobilized more than 300 community leaders, public figures, scientists, health activists, and medical professionals to call on Gilead to ensure its new long-acting HIV medicine is available and affordable where it is most needed: in stigmatized communities in low- and middle-income countries. That is also why we continue to push for a pandemic accord that embeds equity and human rights in the prevention, preparation, and response to future health crises. All governments including those that host pharmaceutical companies must recognize that they must take concrete actions to ensure equitable access to pandemic-related products to protect everyone everywhere. Continuing with the status quo in which where one lives decides whether one should live or die cannot be seen as an option. It is profoundly immoral, irrational, and economically suicidal. While a few pharmaceutical companies raked in immense profits during the COVID-19 pandemic, the global economy as a whole lost at least $2.3 trillion. It doesn’t have to be this way. As the People’s Medicines Alliance, we choose to work for a better system; one where medicines are developed to tackle health problems such as malaria, dementia, and diabetes instead of concocting new ways to extend patents. Where private sector players who develop and produce medicines are rewarded fairly but are not handed absolute monopolies and the power to profiteer at all costs. The People’s Medicine Alliance is committed to that fight. We will push governments to take bolder action. We will fight for a pandemic accord that values the lives of everyone, everywhere over the profits of a wealthy few. And we will keep fighting for people’s medicines until we have a new way of developing medicines for humanity based on human need, not Big Pharma greed.