Viruses never stand still! Like all living things they continually change in unpredictable ways – and change is sometimes very rapid. Nobody could have foreseen Covid-19 – the new corona virus causing worldwide repercussions within weeks of identification of the first patient.
What was entirely predictable, however, was the threat of infectious diseases to people across the world – and the inability of profit-driven capitalism to protect us.
Viruses have crossed from animals to humans since farming began thousands of years ago. In 1918-20 so-called ‘Spanish flu’ infected around a quarter of the world’s population, killing 30-100 million people. (The two world wars killed about 77 million.) The virus spread widely after years of war left millions uprooted and poorly nourished, without modern health services.
In the following century new strains of flu killed between one and two million in 1957-58, 500,000 to two million in 1968-69, and 284,000 in 2009. Other new viral infections such as HIV/AIDS have caused 35 million deaths, mostly in Africa. Ebola’s rapid and high death rate restricted its spread, with over 11,000 deaths in 2014-16. Since 2015 Zika has caused few deaths but many birth defects in Brazil.
‘Old’ infections, such as TB, malaria, dengue and cholera, continue to kill millions each year. Antibiotic resistance is an increasing problem, making illnesses untreatable. At least 700,000 deaths a year are thought to be due to antibiotic-resistant infections.
Tropical rain forest clearance for mining, farming and roads bring many more people closer to previously remote animals and their diseases. Industrialised intensive animal farming also increases the likelihood of animal diseases, which can then infect people. Bringing wild animals into crowded cities, cramped housing, poor sanitation and unequal access to health care all help new diseases spread quickly. Climate change’s ever-increasing impact spreads some disease-carrying insects to new areas. Twelve million people a day take commercial flights, soon spreading disease around the world.
All these well-known factors should have made research into prevention, identification and treatment of infectious diseases a global priority. Laboratories and scientists should have been working in a co-ordinated way researching vaccines and treatments. Factories should have been built, ready to start production whenever needed. Expert reports repeatedly advised this. Governments can’t claim they weren’t aware of the dangers.
The World Health Organisation (WHO) reported in 2012 that “current incentive systems fail to generate enough research and development (R&D), in either the private or public sectors, to address the health-care needs of developing countries”. For “incentive systems” read profit!
The report continued, “the market failure which intellectual property rights try to correct is compounded by a lack of reliable demand for the products generated by research and development… There is therefore an economic case, based on market failure, for public action. There is also a moral case. We have the technical means to provide access to life-saving medicines, and to develop new products needed in developing countries, but yet millions of people suffer and die for lack of access to existing products and to those that do not yet exist”.
Giant and hugely profitable pharmaceutical corporations won’t spend money on research and development if those who would benefit can’t afford to buy it. In 2016 two thirds of spending on development of vaccines and treatment for ‘neglected diseases’ (ie those particularly affecting poor people in poorer countries) was from public funds. A fifth was from charities (including the likes of the Bill and Melinda Gates Foundation). Private industry contributed under a sixth.
Financing ‘neglected disease’ product development actually fell between 2009-15 apart from a one-off boost due to Ebola. Since the 2014 Ebola outbreak the US government’s infectious diseases’ R&D has been cut 50 per cent.
WHO experts found global health R&D was highly fragmented and lacked co-ordination. Together with the World Bank, WHO set up the Global Preparedness Monitoring Board (GPMB) in 2018 to take on a co-ordinating role. But it meets just twice a year and has only been funded for five years – clearly inadequate to head off a global emergency.
Another attempt to kick-start this failing system was the establishment in 2000 of the Global Alliance for Vaccines and Immunizations (GAVI). Bill and Melinda Gates set up this public-private partnership, which gets donations from governments, ‘philanthropists’ like the Gates, and private companies.
GAVI’s International Finance Facility for Immunisation was Gordon Brown’s brainchild in 2006 when he was Tony Blair’s Chancellor of the Exchequer. This was an attempt to raise money for vaccine programmes in poor countries through international financial markets. Government and ‘philanthropic’ donations were used to issue ‘vaccine bonds’ for sale, paying back bondholders with interest. Following the 2008 banking crisis it became harder to raise finance this way.
After GAVI came CEPI – the Coalition for Epidemic Preparedness Innovations founded in 2016 – “a new alliance between governments, industry, academia, philanthropy, intergovernmental institutions, such as the World Health Organisation, and civil society”. Despite warnings from new diseases like SARS (2002-03), bird flu (2006), swine flu (2009) and Ebola, “some diseases offer little economic incentives for pharmaceutical companies to take on the high development costs for vaccines, [so] public funding by the international community is needed”.
CEPI aimed to raise up to US$1 billion in five years for vaccine R&D. However, its own figures showed that early development of potential vaccines against eleven of the most serious known diseases would cost between $2.8 billion and $3.7 billion (2018 prices). This did not include the cost of scaling up vaccine production and delivery in the event of an outbreak, nor did it cover all potential epidemic threats.
Universities, other public institutions, and small biotech companies conduct most of the research. But only Big Pharma has the capacity for large-scale vaccine production. Companies like Sanofi, Johnson and Johnson, GSK and Merck can manufacture vaccines but it costs them money to keep factories on stand-by, ready for a future emergency.
CEPI’s chief executive, Richard Hatchett, was asked in early February whether these corporations would launch mass production if a vaccine was developed. “I’ve been talking to a number of the global multinational partners, all of whom are extremely concerned and interested in understanding how they can help”, he said. “Nobody has said, ‘Sorry, we’re sitting this one out’. It’s a question of what they can do, how they can help, what capabilities they have internally”.
As things stand, mass production of a new Covid-19 vaccine would halt an existing vaccine due to lack of spare capacity. All big pharmaceutical corporations need to be publicly owned and run for need, not profit. Democratic planning on an international scale is needed to meet this and future emergencies. Medical experts, scientists, engineers, community representatives from around the world (especially the most vulnerable areas) and trade unionists should decide priorities for vaccine and treatment research and production – not profit-seeking directors and shareholders.
Huge sums are spent on arms and military spending each year – approximately US$220 for every human on the planet. CEPI’s figures for eleven serious infectious diseases show that spending barely 50 cents for every human could produce vaccines for these. Perhaps a similar amount would provide the spare capacity necessary to research and manufacture when new diseases arise.
Resources and skills now wasted in defence of the ruling classes’ wealth and power need redirecting to real defence – of the health and security of the world’s population. New viral threats will always arise but international socialism would reduce their risk by investing in decent living and working conditions, medical research and manufacturing capacity.