This is why the private sector should support equitable vaccine R&D and manufacturing

As we approach the second anniversary of the initial COVID-19 outbreak, there is plenty of talk about how the global response, or lack of it, has exposed deep inequities in our world – above all, in access to healthcare.

Yes, we have a range of effective vaccines developed and distributed at stunning speed by private companies, building often on government-supported research. But at the same time, we have failed dismally to ensure adequate provision of these vaccines to the Global South.

Stepping up the supply of vaccines to countries whose vaccination rates remain terribly low is clearly an urgent task. But at the same time, there are pressing questions about where we go next, and – for corporate members of the World Economic Forum – about the role of private companies in addressing the underlying inequities we are struggling with.

There is here, I believe, also a historic opportunity for action, but one that will require some visionary thinking from all of us.

How to prepare for next pandemic

To restate the numbers: by December 2021, some 66% of the population of G7 countries had received two jabs; in Africa the figure was only 8%.

The primary responsibility for this dire situation undoubtedly lies with the governments of the wealthiest countries and a scramble for vaccine supplies driven by national self-interest. But the private sector is also taking some of the blame – reporting by the Financial Times in December highlighted criticism of Pfizer in particular, with complaints that the world’s dominant producer of COVID-19 vaccines had used its “influence and control over access to its vaccine to prioritize short-term profits over global access to essential vaccines and treatments”.

Pfizer would undoubtedly disagree. But the fact of one company emerging with so much market power out of the competition to meet the urgent demands for vaccine should cause all of us concern.

Overall, the industry is in something of a defensive crouch, notably in its unsurprising opposition to the demands from South Africa and India for the World Trade Organization to push through a patent waiver on COVID-related technologies.

But perhaps the biggest question for the private sector is about how we prepare ourselves for the next pandemic – and how we ensure that we take the opportunity of genuinely addressing global inequities in access to health, an issue of concern for many private philanthropic funders including the Open Society Foundations.

That includes how the sector should respond to the call from the African Union and others for the creation of research, development and manufacturing capacity in the Global South for a full range of healthcare goods, as the only way supplies and affordable access for the Global South can be assured in the future.

Supporting a private sector committed to more distributed vaccine production

Making this happen clearly requires more than the public policy rhetoric that the only way we can be safe from the threat of a global pandemic is that if we are all kept safe.

But so far, this is not a challenge for which the private sector and market forces yet have sufficient answer. Aside from the need to develop local capacity and expertise, the demands of shareholders in New York or London mean that pharma companies are incentivized to focus on the highest value markets; why invest in developing new, likely low-profit-margin markets?

That’s one of the reasons that Open Society, together with other philanthropic and impact investors, have joined forces in supporting private sector companies that are committed to taking the risks involved in creating more distributed production. Most notably, perhaps, working with the Bill & Melinda Gates Foundation, this year we led a remarkable non-profit buyout of Mologic, a leading UK-developer of innovative low-cost lateral flow diagnostic tests. The aim, through our new non-profit enterprise Global Health Access, is to expand an existing production partnership with Senegal’s Institute Pasteur Dakar to other geographies, including southeast Asia and Latin America.

Low-cost tests are being developed not just for COVID-19, but for a range of devastating tropical diseases that commercial diagnostics companies ignore. The distributed local manufacturing network can rapidly respond to neglected epidemics, as well as scale up in the event of a future pandemic to ensure local markets have access to the best tests.

But the broader aim of this investment is much more ambitious: to demonstrate that this kind of approach, with affordability and access built into the business model, can be profitable, although in our case, any profits will be reinvested in the business. We believe philanthropic and impact investors, as well as other providers of concessional financing, must be taking a lead here.

And for private companies or investors that follow, it might be worth considering the bigger picture. Africa is continuing to expand economically at a dramatic rate – it has a vast underserved healthcare market, and one where global companies will want to have an active presence. Establishing production capacity in those countries would be a vital part of efforts to build back trust and reputation.

The African Union is spearheading efforts to capitalize on the interest of African political leadership in medicines manufacturing on the continent. Ideally, established manufacturers should be working in partnership with new players who are locally or at least regionally based – bringing rewards both for local stakeholders and for internationally-based shareholders.

Global pharmaceutical executives must demonstrate in 2022 their commitment to rapidly unlock COVID-19 vaccine supplies and offer a different business model for the long term. Just as the management of fossil fuel companies and oil companies are now belatedly beginning to face the real impact of climate change, under pressure from their shareholders, so their pharmaceutical counterparts will one day have to explain why they didn’t take the steps needed to promote the long-term resilience and health equity necessary for supporting global economic stability – if not for the sake of the world, then at least for the sake of their bottom lines.