The US has ordered 250 million doses of swine flu vaccine, mainly from foreign manufacturers. That’s a large proportion of the world’s productive capacity. A couple of the biggest vaccine makers, Glaxo-SmithKline (GSK) and Sanofi Pasteur, have promised to make donations to WHO for use in the poorer countries and with some smaller donations that’s maybe 160 million doses. Countries like the US that earlier had pledged 10% of their supply have yet to do so, and given the political problems of sending overseas vaccine when there’s not enough for US citizens, well, good luck with that. So at best we’re talking maybe 200 million doses for the poorer parts of the world (about a third of the globe). WHO estimates this might cover 2% of their population. Might. (For a good summary, see Martin Ensirenk’s story in Science, 6 November 2009: Vol. 326. no. 5954, p. 782 DOI: 10.1126/science.326_782 [sub required], h/t Don S.).
WHO Director General Margaret Chan has talked bravely about “global solidarity” on this matter but it’s hollow talk:
“It’s probably going to be too little, too late,” says David Fidler, an international law professor at Indiana University, Bloomington, and an expert on global health security. Tido von Schoen-Angerer, who directs the Campaign for Access to Essential Medicines for Doctors Without Borders (MSF) in Geneva, calls WHO’s operation “largely symbolic.” Years of debate and negotiations have failed to produce a system to ensure equal access to the lifesaving vaccines, he says, leaving WHO to distribute mere table crumbs. The only good news, he adds, is that the pandemic is relatively mild. (Martin Enserink, Science)
Everyone has seen this coming. But everyone also decided that we would have to rely on the “market” and the private sector to solve it. Well, not everyone. We have been calling for years for ten or a dozen international regional vaccine institutes to manufacture flu vaccine for their regions, using open licensing and the best technologies. This should be extended to antiretroviral HIV drugs and malaria drugs. We can get the world’s best scientists to work on this as a public good, put public licenses on the products and start making and providing them at cost. For years the drug companies shunned vaccines because it wasn’t as obscenely profitable as impotence drugs or cholesterol lowering drugs or antidepressants. Now that governments have guaranteed them a market they have rushed in to scarf up the profits.
And now rich nations like the US and the Europeans will leave the rest of the world in the lurch. That’s not a surprise. That’s what everyone expected. Let’s stop depending on the people who run those countries (the drug and insurance companies) to take responsibility they will never take. The world doesn’t need them. International financing of research, development and scalable manufacturing, regionally distributed, all under a public license could be undertaken at a fraction of the cost and more efficiency than having a half dozen profit making companies make their own products, differing little but each requiring their own trials and subject to licensing fees and inflated costs. The market doesn’t work for public goods like these. If it did we wouldn’t be facing a shortage that was foreseeable years ahead of time.
We’ve been saying this for years, here. We don’t expect anyone to listen, even now. We’re realists. Unhappy and disgusted realists.