Expanding Vaccine Manufacturing Capacity Solely Within the Pharma Cartel is a Recipe for Perpetual Vaccine Apartheid and Artificial Scarcity

Big Pharma scored another big PR victory this week, announcing an “unusual pact between fierce rivals” Merck and J&J. The agreement, which will give Merck $268.8 million in U.S. taxpayer funding to use its capacity to manufacture J&J’s vaccine, was heralded as “the type of collaboration between companies we saw in World War II.” But Pharma companies must not be viewed as liberators while they continue to block efforts to solve global vaccine scarcity in an effort to guard their intellectual property rights and exorbitant profits.  

Every country in the world is up in arms about inadequate supplies of COVID-19 vaccines. Rich countries had tried to ensure against delayed vaccinations by advance purchases of more than 60% of vaccine doses that can be manufactured this year. 

For the rest of the world, including 130 countries that as of last week had received no vaccines, artificially limited supplies means waiting in line for years, more deaths, more social and economic disruption, and development of more  contagious and vaccine-resistant variants. It’s a recipe for a never-ending pandemic.

The solution to the false supply scarcity should have been advance planning and early agreement to override patent protections, to share secret know-how, recipes, and biologic resources, and to mobilize all needed capacity, existing and new, to manufacture 12 billion doses of COVID-19 vaccines as quickly as possible–the number of doses needed to extend vaccination equitably–to the world. Instead vaccine monopolists schemed to maintain rigid control over supply, price, and distribution, both to increase profits and prioritize their monopolies at the risk of public health. Under extreme pressure to share know-how and remove intellectual property  barriers to save lives, they have now agreed to co-manufacture exclusively within their cartel — the appearance of a solution that in reality continues to restrict supply and keeps the industry in full control of life-saving medicines that should be global public goods.

Instead of sharing the fruits of scientific progress with everyone – progress that came via collaborations with publicly funded research centers and catalyzed with billions in public funding – companies are expanding their own internal supply capacity and entering into contract manufacturing agreements with a restricted subset of global producers. Despite tired arguments that technology transfer is difficult and time consuming, vaccine manufacturers have entered into dozens of agreements with “trusted” and “controllable” partners to manufacture components, to formulate the vaccine, and to fill, finish, and package for sale. 

Several major vaccine producers have recently agreed to allow production of other companies’ vaccines in order to accelerate supply of COVID-19 vaccines. On March 2, Merck made an agreement with Johnson & Johnson to manufacture its newly approved adenovirus vaccine, devoting production lines both to production of the key vaccine ingredient and fill-and-finish. Sanofi had previously promised to help Johnson & Johnson with final production steps and bottling vials in Europe. Sanofi and Novartis each announced deals in January to supply fill and finish capacity for the  Pfizer/BioNTech vaccine.   

No doubt there is some value in repurposing existing manufacturing capacity in Big Pharma companies just as there is value in entering into contract manufacturing agreements with major contract manufacturing companies like Serum Institute of India, the largest vaccine producer in the world. But the inside-the-cartel approach is leaving other capacity unutilized. And it is forestalling investments to permanently expand vaccine capacity globally. Above all else, it is protecting Big Pharma’s entitlement to profiteer throughout a pandemic that will drag on even longer if this so-called third way is implemented instead of real solutions. 

The shortage of vaccines and the refusal of vaccine manufacturers to share their technologies voluntarily led South Africa, India, and now over 100 countries to demand at the WTO that intellectual property protections on COVID-19 health technologies be suspended. In response to the mounting pressure to put people’s lives ahead of profits, Big Pharma companies have tried to convince the world that supply problems are under control.  

“Under control” is paradoxically the right term. Because that’s exactly what vaccine innovators are trying to guarantee – that all supply, price, and distribution decisions remain under their control. Despite the fact that developing countries and COVAX have been consistently outbid by rich countries and Big Pharma vaccine manufacturers don’t have the capacity to make enough doses to meet existing global demand, they do not want to allow construction of vaccine capacity in developing countries that would make those countries more self-reliant and potentially more competitive in the future. Big Pharma companies are betting that by working together and making it seem like that is good enough they can preserve their IP empires.  

To truly break the pandemic and end vaccine apartheid, we must break the cartel. We must break a cartel that prioritizes the rich and punishes the poor – a cartel that paradoxically puts us all at greater risk of a longer pandemic with cyclical variants and incalculable human costs. The Biden Administration and other G7 country governments should not be satisfied with these insufficient half-measures. Sufficient supply expansion will only be achieved through pharma relinquishing intellectual property rights, sharing know-how, with governments taking all steps within their power to expand production capacity.