The deadly public policy of letting Big Pharma companies like Gilead control access to COVID-19 therapies is clearer now than ever before. While promising “global access” out of one side of its mouth, Gilead has shown its true intentions with new, confidential bilateral licenses negotiated with five generic companies in India and Pakistan. These licenses only cover approximately 52% of the global population leaving the other 48% to the whim of Gilead’s monopoly-based predations.
These licenses exclude people living in at least 73 countries and territories, including, outrageously, 30 low- and middle-income countries. Gilead wants to exercise total monopoly control over manufacture and sale in those 73 countries, giving it unfettered freedom to charge prices far in excess of the estimated $5-$10 per treatment that it costs to manufacture remdesivir.
The U.S. government has invested massively in coronavirus research over the past two decades, including over $70 million directly on remdesivir. It sponsored the clinical trial that proved remdesivir’s effectiveness in shortening hospitalization and speedily granted it emergency use authorization, opening up the right of Gilead to market the antiviral in the U.S. Despite these investments, Gilead cynically insists on maintaining iron-fist control over prices and sources of supply in the U.S., Europe, Latin America, the Middle East, and Eastern Europe and Central Asia.
Gilead has claimed that it is expanding its own manufacturing by contracting with undisclosed manufacturers to make its branded medicine to be in non-licensed countries, but there is no assurance that Gilead will be able to quickly supply the quantities needed to treat the massive number of COVID-19 patients in the rich and middle-income countries excluded from its licenses.
Equally problematic, it is unlikely that the five companies granted voluntary licenses (Cipla Ltd., Ferozsons Laboratories, Hetero Labs Ltd., Jubilant Lifesciences and Mylan) will be able to supply the millions of doses needed as the pandemic intensifies in the Global South. Although Gilead has failed to publicly disclose its new licenses, it appears that it has imposed a straitjacket on its licensees preventing them from supplying generic remdesivir to excluded countries even if they issue fully lawful compulsory licenses.
Even so, countries excluded from the licenses should immediately mobilize to issue compulsory licenses on remdesivir both to expand manufacturing capacity and to ensure competitive generic pricing through local and regional sources of supply. They will have multiple grounds to issue such licenses: high prices, inadequate supplies, and competition violations relating to Gilead’s licensing policies.
The proposed Costa Rica/WHO COVID-19 Technology Pool will offer a vastly superior option to the half-baked licenses offered by Gilead. The soon-to-be launched WHO Call for Action proposes truly global licenses that will address all intellectual property, trade secret, data exclusivities, and other barriers to existing and newly discovered COVID-19 medical products – from vaccines and therapeutics, to diagnostics, medical devices, and personal protective equipment.
Gilead’s licenses offer the sound of one hand clapping. A cold-blooded, half-hearted measure designed to earn a modicum of praise while preserving its monopoly control over half the world’s population. Double its shame and shame on global leaders if they don’t condemn this undercutting of a unified global response to COVID-19.