Covid Vaccine Production: If you build it, they might not come
May 2, 2021 5:40 PM   Subscribe

Gates suggested that it could be unsafe to share the critical information that allows vaccines to be more widely produced “Typically in global health, it takes a decade between when a vaccine comes into the rich world and when it gets to the poor countries.” Yet, in the past few months, the danger of not transferring the knowledge more quickly has become painfully clear, with deaths climbing in India, Brazil, and other parts of the world that have been unable to procure adequate supplies of vaccines while richer countries stockpile them.

The inequality is only increasing. The state of Florida, which has a population of 21.5 million, has now received some 20 million vaccine doses — more than Covax has delivered to all of Africa, which is home to 1.2 billion people. Worldwide, Covax, which is now supplying vaccines to over 100 economies, has only delivered 49 million doses so far, less than have been distributed in California and Illinois.
posted by mecran01 (161 comments total) 28 users marked this as a favorite
 
>100 economies
((twitch))
posted by Heywood Mogroot III at 5:48 PM on May 2 [30 favorites]




There’s only so many vaccine factories in the world, and people are very serious about the safety of vaccines. And so moving something that had never been done — moving a vaccine, say, from a [Johnson & Johnson] factory into a factory in India ....

OK — well, now that demand in the US is declining, how about sending teams to other countries to train local teams in safe virus production protocol? We are not done with this pandemic, and from what I’ve read, the climate emergency may well seed others.

...it’s only because of our grants and expertise that that can happen at all.”

This is just chilling.
posted by Silvery Fish at 6:07 PM on May 2 [30 favorites]


Tangent: in non-covid vaccine news, there's a new malaria vaccine with promising preliminary results (nature news 2021/04/26). WHO estimates 229 million malaria cases and 0.41 million deaths (67% in children aged 5 years and under) in 2019.

From preliminary results, the new vaccine is estimated to be up to 77% effective, versus ~50% effectiveness of the best existing malaria vaccine.

> The team has also been working with the Serum Institute of India, a vaccine-manufacturing powerhouse in Pune that has pledged to produce at least 200 million doses of the vaccine each year if it is eventually authorized for use

The malaria vaccine is discussed in recent nature & economist podcast episodes. One of the discussions (I forget which) made the suggestion that manufacturing malaria vaccine could be a good niche with regular demand to support a domestic African vaccine production industry. It is handy to have domestic vaccine production capability, but expensive to sit around maintaining idle capacity & know-how waiting for a pandemic.
posted by are-coral-made at 6:17 PM on May 2 [18 favorites]


India is where many medications and vaccines sold around the world are based. Half the medications I got in NZ had an Indian factory's logo on it, and I'm pretty sure it's been the same for Aus. This is bullshit.
posted by rednikki at 6:19 PM on May 2 [54 favorites]


((twitch))
I understand that reaction, but if you're a company that sells things, that's how you see the world. It sounds cynical, but if it's your job to count this stuff, you likely end up needing to use some fairly tortured language to accommodate things like Taiwan and Northern Ireland.

Even if we were all living under fully-automated space communism, the question of how to manage the supply and distribution chain for a once-in-a-lifetime vaccine distribution effort still would boil down to economics, and we'd be seeing the same sort of language being used by the people organizing the effort.
posted by schmod at 6:25 PM on May 2 [22 favorites]


India has a ton of expertise and know how in vaccine manufacture. The new mRNA tech is different, and it might indeed take years to get it going. It's not like anyone is going to learn it if they don't start, though. The other options should be going as quickly as possible. Are they not? I have the impression J&J was scandalously underprepared to scale up but AstraZeneca can't be that bad.

I suspect there's enough novel tech on the mRNA vaccines--especially Moderna--that it really would impact future competitiveness if they gave it up. It's not just the sequence and mRNA (the patented parts), it's trade secrets around manufacture. If they don't want to part with it come up with some eminent-domain like rule to make it happen; Moderna's market cap is 71B, at a 40% premium compensating the shareholders is $110B. This is a rounding error on the various bills Biden is passing.
posted by mark k at 6:25 PM on May 2 [17 favorites]


I'd love to see more light shed on Gates and just how much he's done to impede the spread of the vaccine. Clearly, he's got great publicists, and he's treated as some sort of saint by any journalist who he deigns to speak to, but damn, he seems perfectly okay with letting corona spread unchecked throughout poorer nations in the name of intellectual property. You can't take it with you, asshole.
posted by Ghidorah at 6:27 PM on May 2 [48 favorites]


This is Why the World is Facing a Covid Apocalypse
Covid Capitalism is a Catastrophic Failure For Most of Humanity — But the West Won’t Admit It.
posted by adamvasco at 6:40 PM on May 2 [31 favorites]


Here is my shocked face that a man whose ill gotten fortune was stolen via abusing a monopoly would want to generate more monopolies.
posted by Mitheral at 6:53 PM on May 2 [34 favorites]


It's not just the sequence and mRNA (the patented parts)

The patented parts are the easy part, actually (*). Patents are only national in scope. You can't enforce a U.S. patent against an Indian manufacturer selling in India.

(*) Note that you cannot patent a gene in the U.S.
posted by praemunire at 6:55 PM on May 2 [8 favorites]


This Gates bashing is nuts. He has devoted a huge amount of his time, his energy, and his fortune to global public health. Yes, he doesn't have the temperament or worldview to undermine global capitalism, but accusing him of actively trying to limit the pace of global vaccination is about as rational as believing he put little tracking devices in the vaccines.
posted by PhineasGage at 6:59 PM on May 2 [112 favorites]


All of the steps in the manufacturing process have to be done in such a way that the GMP staff can run it, record it on the batch record, and have it pass review (paper review, to say nothing of product characterization and lot release and...)

And you don't make those documents super difficult and hard to transfer or teach because then you have Deviations. And Deviations eat a lot of time for investigations and CAPAs and and and.

So you design everything (or should be designing everything) to be basically foolproof and as straight forward and as instructional as much as anything can be.

We can do this, we can run the tech transfer process and have the many and varied medicines agencies be there, as they are there now, to catch people trying to sneak by with an adulterated batch (adulterated being "not the characterized process" here as opposed to purposefully spiked with something nasty).

There are CMOs with GMP suites all over the US that probably aren't running vaccine production right now. As seen with emergent, sometimes the contractors get it wrong. But that's what lot release and quality control are for.

We could be doing this and doing it just in the US at full throttle. There are critical drugs that CMOs are making, there are drugs for studies ongoing, and presumably there's capacity being used for not-really-necessary-but-nice-to-haves. The CMOs aren't even big names! They can be tiny (there's one with their own fill/finish line in one of the four wings of the building I work in now).

Why aren't they being mobilized?
posted by Slackermagee at 7:15 PM on May 2 [11 favorites]


Easing intellectual property restrictions in the middle of a once a century (we hope) public health emergency is equivalent to undermining global capitalism? I don't think you need to be Karl Marx reincarnated to see why getting as much vaccine in as many people as possible is both humane and rationally self-interested, especially if you take seriously the idea of the virus evolving to elude current vaccine and infection induced immunity.
posted by eagles123 at 7:17 PM on May 2 [40 favorites]


He has devoted a huge amount of his time, his energy, and his fortune to global public health.

No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy
posted by Cezar Golescu at 7:19 PM on May 2 [67 favorites]


My understanding is that Indian factories capable of making the vaccines are already working at full capacity under contract and that the biggest issue in that country has been that the government decided covid was mostly under control in India and let a lot of the production be exported. This decision has been reversed. The Pfizer and Moderna vaccines require new equipment and because of their ultra-cold storage requirements are struggling to scale up production and distribution.

I think placing the blame on patents, Bill Gates or others is mostly just scapegoating for what is an unsolvable problem — building manufacturing and distribution capacity takes far longer than anyone wants it to when faced with this kind of emergency.
posted by interogative mood at 7:59 PM on May 2 [43 favorites]


He has devoted a huge amount of his time, his energy, and his fortune to global public health.

Oxford Pledged to Donate Covid Vaccine Rights, Then Sold Them, Thanks to Bill Gates
posted by dopeypanda at 8:02 PM on May 2 [58 favorites]


The other issue is that not only are the vaccines ensnared by patents, but many of the technologies used to make the inputs and QC assays are themselves quite expensive and patented. You can share a GMP protocol with a less-rich country, but it may take a year to replace the expensive assays with bridgeable cheap assays that don't compromise safety. And in the race to make these vaccines, money was no object and the vaccine manufacturers spent like drunken sailors on equipment to manufacture and scaleup. I don't know what the real cost of goods is for Moderna and Pfizer; the adenoviruses are probably quite a bit cheaper to make (excepting GMP grade plasmids) but still have QC steps that need to be followed, or you end up with replicating virus contaminating your lots a la Sputnik V.
posted by benzenedream at 8:24 PM on May 2 [13 favorites]


I don't know enough to judge whether freeing the vaccine tech might in actual practice massively backfire, or actually help things. But Bill Gates' argument is disingenuous because patents are not safety tools.
posted by polymodus at 8:29 PM on May 2 [31 favorites]


IIRC, for mRNA vaccines the bottleneck is the lipid nanoparticles, which is largely controlled by technologies from companies like Knauer, Precision Nanosystems, and the like. Fill-and-finish isn't really the problem, so mobilizing random CMOs who lack the assembly gear (and specialized staff; lipid nano assembly expertise at this scale can probably be found in less than a thousand people worldwide) isn't going to help anything -- you can't make an F1 racer go faster by just adding more wheels.

Even if you removed all IP protections from the BioNTech/Moderna side of things, you wouldn't fix the problem, because you'd still be stuck with Knauer and their competitors. So, remove protections from the equipment suppliers! Well, then you still have the problem of a lack of expertise. OK, so forcibly "recruit" techs and require they learn lipid nanoassembly? Alright, but people don't learn overnight, and you're gonna need to train up your QA/QC people as well. And so on, and so on, and so on.

It's a genuinely hard problem with exceedingly complex solutions.

There are something in excess of sixty vaccines known to be in development; production is the problem, not IP, and you can't simply scale up production by wrangling every CMO you can find. For one thing, basically everyone capable of doing the work is already doing it; capable CMOs aren't just sitting by the phone looking all forlorn because nobody is calling them.
posted by aramaic at 8:30 PM on May 2 [48 favorites]


He has devoted a huge amount of his time, his energy, and his fortune to global public health.

And now he is using his tremendous power and influence to prevent COVID vaccines being distributed for free or at low cost. Both of these things can be true.
posted by His thoughts were red thoughts at 8:53 PM on May 2 [36 favorites]


I kind of understand all the condescension I see for the "free the patents" advocates on Twitter, most of whom know very little about vaccine manufacturing or epidemiology. But at this point, the advocates for that position go well beyond know-nothings on social media, and I don't understand how the "Global North" maintains such a fierce level not just of disagreement, but of condescending dismissal -- well-exemplified when Gates says, “It’s not like there’s some idle vaccine factory, with regulatory approval, that makes magically safe vaccines". Even apart from that being factually wrong, it works really hard to erase just who is advocating for the other side.

In addition to almost every major international health NGO, Fauci supports it in some fashion, as does Trade Secretary Tai:
Fauci briefed Tai on the benefits of sharing technologies from companies that hold vaccine patents — a position that he supports, arguing that it would allow developing countries to rapidly produce their own vaccines, said people with knowledge of White House deliberations who spoke on the condition of anonymity because of the conversations’ sensitivity. Tai separately told colleagues that she’s considered advocating to lift some patent protections but is still gathering information, said two of those people.
Warren supports some version, and it's not like she's some sort of naif when when comes to policy implementation challenges in the real world:
“In light of this growing humanitarian crisis, I urge you to leverage all tools and resources available to the United States to provide relief to India,” Sen. Elizabeth Warren (D-Mass.) wrote Biden on Wednesday, laying out possible steps such as using the waiver to compel companies to share their “know-how” with the World Health Organization.
The Biden administration is split, and it's not like there's a major faction of naive idealists in there:
Within the Biden administration, the patent-protection debate has split the White House along multiple political and policy factions, said three officials with knowledge of the discussions... “The people whose job it is to protect the property of U.S. businesses are up in arms that it’s a bad idea,” said one official involved in the patent discussions who spoke on the condition of anonymity. “The people whose job is to defeat the pandemic are much more receptive to it.”
The WTO IP panel itself is divided over it, and it's not like there's a major faction within that group of patent-hating leftists:
A proposal to waive intellectual property rights for COVID-19 vaccines and treatments left a World Trade Organization IP panel deadlocked again Friday ... just as they were at their previous meeting in March, according to a Geneva trade official.
Heck, just look at the map of countries who support it. It takes pretty epic levels of Northern condescension to think that all of those countries are run by naive or pandering politicians whereas all of "us" are opposed thanks to our proper understanding of medical logistics.
posted by chortly at 8:56 PM on May 2 [57 favorites]


I mean, I just look at what armaic wrote and think, yes, do that! I'm sure there could have been lab techs from other industries re-trained for purposes such as QA. Now it might be too late, it probably is, but that doesn't mean we shouldn't question a system that let people needless die just because they didn't live in the right country. And there are plenty of experts who do know a thing or two about vaccine production who seem to think releasing the patents is worthwhile, so I'm not exactly impressed by someone listing the steps of the vaccine manufacturing process to make it seem like some arcane art.

And I'm not sure why I should expect everyone on Twitter to prove their credentials in 212 characters or whatever. It's a deadly disease; people are scared; they see loved ones dying; they see people suffering; they want to help. The horror.

As for Bill Gates, I'm sure in his own way he wants to help too, but if his efforts in this instance are anything like his "education reform" philanthropy, I'm gonna give the critics the benefit of the doubt.
posted by eagles123 at 9:24 PM on May 2 [9 favorites]


I am not a fan of Bill Gates but bashing him on vaccines is just insane. That malaria vaccine that’s mentioned upthread, guess who paid for a good chunk of the research. As for throwing open the patents on the mRNA vaccines all you have to do is look at the disaster when Emergent was manufacturing the far more conventional J&J vaccine. If you want to get more vaccines out to the global community throw money at the Serum Institute and try to figure out how to get Modi out of power. The Serum Institute got trapped into diverting a good chunk of the vaccine they planned to distribute globally due to Modi’s fuckups.
posted by rdr at 9:43 PM on May 2 [15 favorites]


Billionaires do not engage in philanthropy. They appropriate money from the public purse and from the labor of their employees and then spend a portion of it on getting to make choices about how money that should have been controlled democratically as a matter of public policy is spent; they replace democracy with themselves. They are all dangerous monsters, and Gates is a thief who spends part of the proceeds of his plunder on replacing democratically-controlled education and healthcare policy with his own judgment and agendas.
posted by Pope Guilty at 9:43 PM on May 2 [175 favorites]


I'd love to see more light shed on Gates and just how much he's done to impede the spread of the vaccine. Clearly, he's got great publicists, and he's treated as some sort of saint by any journalist who he deigns to speak to

Tim Schwab in CJR on how the Gates Foundation influences media reporting on itself.
posted by riddley at 9:54 PM on May 2 [14 favorites]


How Bill Gates Impeded Global Access to Covid Vaccines
Through his hallowed foundation, the world’s de facto public health czar has been a stalwart defender of monopoly medicine.
The Access to Covid-19 Tools Accelerator, or ACT-Accelerator, was Gates’s bid to organize the development and distribution of everything from therapeutics to testing. The biggest and most consequential arm, COVAX, proposed to subsidize vaccine deals with poor countries through donations by, and sales to, richer ones. The goal was always limited: It aimed to provide vaccines for up to 20 percent of the population in low-to-middle-income countries. After that, governments would largely have to compete on the global market like everyone else. It was a partial demand-side solution to what the movement coalescing around a call for a “people’s vaccine” warned would be a dual crisis of supply and access, with intellectual property at the center of both.

Gates not only dismissed these warnings but actively sought to undermine all challenges to his authority and the Accelerator’s intellectual property–based charity agenda.

“Early on, there was space for Gates to have a major impact in favor of open models,” says Manuel Martin, a policy adviser to the Médecins Sans Frontières Access Campaign. “But senior people in the Gates organization very clearly sent out the message: Pooling was unnecessary and counterproductive. They dampened early enthusiasm by saying that I.P. is not an access barrier in vaccines. That’s just demonstratively false.”
Ignore the hagiography.
posted by They sucked his brains out! at 10:03 PM on May 2 [24 favorites]


There was a good CitationsNeeded episode on this the other week.
posted by progosk at 10:38 PM on May 2 [3 favorites]


Bill Gates is a monster, like all other people hoarding vast amounts of money.

That said, I do understand his position, only in the sense that he is a human being, like all of us, and he has both a worldview, a reputation, and a purpose. And yet he wields monstrously god-like power, and in that sense he does not think like a human being at all.

He sees one of his god-like contributions to humanity to be the distribution of vaccines, literally saving millions of lives-- not just now, but in the past and future. He's concerned that if something goes wrong with COVID vaccines, it will impede progress with future vaccines, erode his legacy, tarnish his reputation, and diminish his purpose.

His perspective is not that of desperate doctor, patient, or relative of the dying on the ground, it's that of god-like Billionaire, taking the long view. Possibly producing sub-par vaccines, which is easily within the realm of possibility, would be very damaging to the world, but also to him.
posted by chaz at 12:14 AM on May 3 [10 favorites]


This is yet another riff on his infamous Open Letter to Hobbyists. Dude has been running the same shitty playbook for 45+ years.
posted by Ten Cold Hot Dogs at 12:53 AM on May 3 [12 favorites]


All the problems that exist with vaccine production can be solved by additional funding and under existing US law. We don't even have the break the patents to do so.

28 USC § 1498 (government patent use, which includes third-party contractors), the Defense Production Act, and other means can be used to set up factories in other countries. Doing so would help reduce the creation of covid-19 variants that remain a huge risk to the nation, and this is arguably necessary for national defense. At the same time, the government has broad powers it can level against companies that refuse to go along with it. Build a training center for learning lipid nano assembly.

The fact that Bill Gates has any say in this shit is BS, but the constructive thing to do here is not to be mad at Gates on the internet. He doesn't give two shits about what you write here. but if you instead write to your representatives, sign petitions, and otherwise put pressure on the government to do what is necessary to protect the world, well there isn't really much he can do.

Investing in other countries and their ability to create vaccines will create immeasurable benefits in the future, and we should be doing so. The thing about scientific knowledge is that it isn't lessened by being shared, it can only be increased.
posted by Chrysopoeia at 1:07 AM on May 3 [19 favorites]


He sees one of his god-like contributions to humanity to be the distribution of vaccines, literally saving millions of lives-- not just now, but in the past and future. He's concerned that if something goes wrong with COVID vaccines, it will impede progress with future vaccines, erode his legacy, tarnish his reputation, and diminish his purpose.

His perspective is not that of desperate doctor, patient, or relative of the dying on the ground, it's that of god-like Billionaire, taking the long view. Possibly producing sub-par vaccines, which is easily within the realm of possibility, would be very damaging to the world, but also to him.


As far as Gods and demigods go, this selfish, somewhat benevolent, results-oriented minor deity enclosed in a mere man seems to be doing a lot more worth givings thanks for than any these absent sky ghosts. I wish Gods did stuff like that.
posted by floam at 1:19 AM on May 3 [6 favorites]


He has devoted a huge amount of his time, his energy, and his fortune to global public health.

His left hand has always known exactly what his right hand is doing.
posted by Cardinal Fang at 1:27 AM on May 3 [12 favorites]


Agreed that patents are the least of the problems holding India back. In 1970, Indira Gandhi enacted legislation which barred medical products from being patented in the country. My pharmacist friend was in India and was aghast at how powerful antibiotics were combined and sold in convenience stores without any prescription required - antibiotics that are tightly controlled in the West and only meant to be used as a last line of defence to prevent antibiotic resistance from forming. Basically, once a drug is patented in the West, the formula and manufacturing process is publicly available, and manufacturers in India can just make copies of it. My friend says that many antibiotic resistant infections she's seen have been from recent immigrants from India... and they have to use exotic cocktails of drugs costing thousands of dollars per dose on them, with pretty significant side effects.

The AZ vaccine is currently the cheapest available (around $3 per dose) and AZ has committed to providing licensing and production of this vaccine at zero profit, effectively forgoing around $20 billion of revenue. This is what India is producing right now in Pune, under the Covishield name, and what Australia is also producing at our Broadmeadow's site.
posted by xdvesper at 2:24 AM on May 3 [22 favorites]


And now the MPA (formerly the MPAA, of DRM battles) has come out swinging against any easing of patents, because property rights slippery slope godless communism or something.
posted by acb at 3:27 AM on May 3 [4 favorites]


As far as I understand from what I've read in interviews with Gates on the subject, he justifies it in part by pointing out that if vaccines are poorly manufactured and end up causing dangerous side-effects or aren't as effective, it does more overall harm in reducing public uptake of well manufactured vaccines in the future. In other words, when choosing two from fast/reliable/cheap, it's better to always keep the middle option in there.

At the beginning of the vaccine rollout I might have agreed with him, but after the setbacks with AstraZeneca proving that "reliable" isn't necessarily something even the big manufacturers can guarantee, and facing untold suffering in India and other poorer parts of the world, all I can see is a overabundance of caution that's hiding a very well considered bottom line.
posted by fight or flight at 3:30 AM on May 3 [10 favorites]


I don't think Bill Gates considers himself to be bad. He thinks he's doing the right thing, and that necessarily includes the continued propagation of folks like Bill Gates to be unbelievably wealthy. If I were in that position, I would do terrible things, too. Having more money than you can actually spend affects your worldview, your judgement. Bill Gates thought he was doing education a favor but ended up royally screwing things up. And why did people in charge listen to a computer guy's opinion on pedagogy? Because he's rich, full stop.

The solution, then, is not to shit on Bill Gates, not really. Again, he's just a guy, not an evil mastermind. A symptom of a problem, but he's not the problem. The solution is to ensure that no one becomes that wealthy. It's bad for the individual and it's really, really bad for society. Tax billionaires out of existence. Past a billion dollars, your income is taxed at 99%. And we could go in on the hundred millionaires, too, but we can start with the billionaires, because that's a ludicrous amount of money for one person to have.
posted by zardoz at 5:25 AM on May 3 [38 favorites]


The solution is to ensure that no one becomes that wealthy.

I think there's a divestiture stage somewhere, or we've just enshrined a bunch of new monarchs.
posted by pompomtom at 6:16 AM on May 3 [5 favorites]


Pfizer in talks with India over expedited approval for COVID-19 vaccine:
Pfizer is in discussions with the Indian government seeking an "expedited approval pathway" for its COVID-19 vaccine, its CEO Albert Bourla said on LinkedIn on Monday, announcing a donation of medicines worth more than $70 million.

"Unfortunately, our vaccine is not registered in India although our application was submitted months ago," he said.

"We are currently discussing with the Indian government an expedited approval pathway to make our Pfizer-BioNTech vaccine available for use in the country."
posted by gwint at 6:19 AM on May 3 [7 favorites]


>his infamous Open Letter to Hobbyists.

yeah the thought occurred to me that the cooperative model of Linux is going to beat out Windows eventually. MS-DOS of course was a horrid basis to start the 2nd-gen PC revolution off of and boy did it hobble most everyone for the 1980s and much of the 90s -- critical innovation (desktop publishing, the WWW, OpenGL) happened outside MS-DOS, not from it.

I've done very little reading along the Marx-Engels axis but my understanding of left socialism as it pertains to the 21st century is that industry cooperation would be more productive than our current model of everybody throwing roadblocks at each other.
posted by Heywood Mogroot III at 6:35 AM on May 3 [4 favorites]


I don't think Bill Gates considers himself to be bad.

I agree. I don't think bad people consider themselves to be bad. Stephen Tobolowsky on playing Clayton Townley, the leader of the KKK in Mississippi Burning:

"This is true with a lot of things in acting. You need to ask questions, and you need to ask the right questions. Alan [Parker] asked me how I saw the man, and I said, 'I saw him as Abraham Lincoln — I don't see him as a villain. This man is a hero with his agenda, with his point of view.' I did not intend to play Clayton Townley as one chromosome short of a human being, like a lot of people will play various villains in movies ... In real life, everyone kind of sees themselves as the good guy, doing what they're doing. They see themselves as a kind of hero, and I wanted to make sure Clayton Townley ... wasn't played as some kind of genetic miscreant."
posted by ensign_ricky at 6:50 AM on May 3 [13 favorites]


Gates made billions by being an extremely aggressive capitalist, and playing fair wasn't necessarily part of his plan. But I have grudging respect for his commitment to using lots of his vast wealth to do some good things. And by doing it so publicly, he's a target for hate and weird conspiracy theories. I despise him less than many, and the foundation does good work.

Brief searching doesn't turn up articles agreeing with his stance on suspending patents on Covid vaccines, his comments are slammed widely.
posted by theora55 at 6:51 AM on May 3 [3 favorites]


I feel like the elephant in the room is that the United States has access to most vaccines but the among the least will to actually be vaccinated up to levels needed for even mere safety never mind herd-immunity or eradication.

I feel like there are going to be huge geo-political issues between countries that pursue covid-zero eradication strategies and the abject surrender countries like the U.S. that just won't. Will the U.S. try and force countries to open up to the virus against their will using their economic clout? I think we are going to find out.
posted by srboisvert at 7:21 AM on May 3 [13 favorites]


The guy that challenged the very concept of code-sharing (because he was born rich and was confused by others not seeing everything as sale-able IP) is now arguing against signing papers for techniques (which could legally be compulsorily-licenced by 2022) to save thousands or millions of lives (of poor people who were not going to buy his products). It's not quite Al Gore killing Africans, but it's not so far.

Won't someone think of the billionaires?
posted by pompomtom at 7:26 AM on May 3 [5 favorites]


Will the U.S. try and force countries to open up to the virus against their will using their economic clout?

Some client states will accept whatever the US offers - whether that is to the benefit of the local populace or not.

Ask me how I know.
posted by pompomtom at 7:36 AM on May 3 [9 favorites]


At the peak of the dotcom bubble in 2000, Bill Gates' net worth was $100 billion, adjusted for inflation that's $175 Billion in todays money.
Today Bill Gates' actual net worth is $146 billion, so in 20 years he has given away around 17% of his wealth.
posted by Lanark at 8:01 AM on May 3 [6 favorites]


And isn't it a bit of a misnomer to say he's "giving" his money away because it's all being funneled through organizations that Bill Gates still retains control over? It's all billionaire soft power, and it's just another way for him to influence public policy and project his own ambitions.

In contrast, MacKenzie Scott is actually giving money away. She's writing checks to existing organizations based on the work they're already doing and not taking any active role in their governance or policymaking whatsoever.
posted by RonButNotStupid at 8:13 AM on May 3 [48 favorites]


I think the true test of a millionaire/billionaire's largess should be whether they're able to recognize the profound good that simply cutting a check to the local food bank can do or if they instead create the "Joe Billionaire Center For Solving Food Insecurity In Our Lifetimes (Maybe)".

MacKenzie Scott is just writing checks to organizations she supports and that she thinks could use the help. Dolly Parton gave money to the Vanderbilt University Medical Center to support vaccine development.

If there's a cause you're passionate about, chances are someone's already doing the work and they could really use the money.
posted by RonButNotStupid at 8:31 AM on May 3 [27 favorites]


But Bill Gates didn't sell his Microsoft stock and put it all into inflation-protected treasury securities in 2000. $100 billion of Microsoft stock in 2000 would be worth about $450 today. If he's down to $146 billion, that means he's given away about 2/3 of his wealth.
posted by Hatashran at 8:31 AM on May 3 [8 favorites]


This is why I’m a democratic socialist. I believe that if it is the will of the people to nationalize the intellectual property so as to save millions of lives that this is what should be done. I believe that no one should have hundreds of billions of dollars in the first place: the resources of time and energy and materials that those hundreds of billions of dollars should have, instead, been allocated to the people of the country or to the instrument of their collective will: the government’s administrations. Bill Gates should have no more say about how we respond to the threat of global pandemic than I do and the resources that we as a country spend to mitigate the pandemic here and across the globe should be *our* resources. This whole scenario represents failure upon failure of our nation to work in a way that is representative of the people in my mind. The true failure is systemic and is primarily caused by the government representing the interests of capital over the interests of the people. It’s fine to analyze what is happening here, but I find myself filled with regret when the analysis always stops short of an assertion that the solution to these issues is for the people to take power back from capital.
posted by n9 at 8:45 AM on May 3 [16 favorites]


Anytime I see it phrased as a "once in a generation" pandemic, I start to wonder if this is a Hold My Beer moment for the world. Are we sure this is not going down as a "first among several in a generation" pandemics? I can't seem to shift my brain out of apocalypse gear at the moment.
posted by elkevelvet at 9:21 AM on May 3 [6 favorites]


Basically, once a drug is patented in the West, the formula and manufacturing process is publicly available, and manufacturers in India can just make copies of it.

That used to be true but is no longer true due to pharmaceutical lobbying.

As originally written, patent law was a social contract. The government would give a company a limited term monopoly in exchange for disclosing trade secrets to the public for public benefit. As part of the patent process the patent holder was required to disclose the best method for producing the product.

But that's not the way it works anymore. The laws were changed so that companies can have it both ways. They get their patent monopoly for the product and also get to keep their trade secrets for manufacturing the product.

So, no, it is not true that once a drug is patented in the West, the formula and manufacturing process is publicly available. The formula, yes, the process to produce it, no.

It was a cruel joke that Wall Street made such a big deal about the benevolence of Moderna in announcing that they would not enforce their vaccine patent in other countries. But Moderna was giving up nothing of value. The formula could be reverse engineered by RNA sequencing in a day. The real information, the manufacturing process remained secret.

The absurd notion that you hear about it being impossible for another country like India to replicate the Moderna or Pfizer manufacturing processes is just nationalistic if not down right racist bullshit. India is already one of the world's largest producers of pharmaceuticals. But Moderna and Pfizer are deliberately keeping information from them to protect their multi-billion dollar businesses. They want you to believe that their processes are so arcane that only they can do it. And that's a lie that some here are happy to repeat in service of the pharmaceutical companies.

It's kind of a distraction to lay all of this on Bill Gates. The pharmaceutical industry is happy for Gates to take the flak for them. But it isn't Bill Gates writing the patent laws. It's the pharmaceutical companies and their hundreds of millions of dollars of lobbying that pervert the system.
posted by JackFlash at 9:22 AM on May 3 [31 favorites]


I don't want to be the unpopular opinion here, but Gates' comment sounds like a technical problem. Making some kinds of medicine is _extremely hard_ at a technical level. Getting it wrong is very dangerous and could injure or kill a _lot_ of people - esp. in something like a mass vaccination program. Getting it right can take a lot of time and money - enough time and money that it would be potentially faster to just wait and buy the product from existing sources.
posted by goddess_eris at 9:58 AM on May 3 [12 favorites]


India, China and other countries that have vaccine manufacturers are already making vaccine and increasing production as quickly as possible. No one is saying they lack the ability to make it; in fact they are making it. We already have a problem fraudsters selling saline solution as vaccine. My understanding is that pro-patent people are arguing that the licensing process puts in place a mechanism to certify that what is coming out of the factories is the vaccine and to manage the handoff of key technical information and assistance to the manufacturers.
posted by interogative mood at 10:17 AM on May 3 [3 favorites]


I'm going to write a longer comment eventually, but the safety argument doesn't seem directly related to patents and IP. There are other government regulations that cover that, and relaxing patents doesn't automatically mean relaxing those. (The flip side is this is one more reason relaxing patents is much less impactful in the short term than I think many imagine.)
posted by mark k at 10:38 AM on May 3 [9 favorites]


Safety is just another canard thrown up by the pharmaceutical industry to create fear, uncertainty and doubt to protect their billion dollar profits. They have lobbied hard on this issue and have made it a crime to import drugs from that third world hellhole Canada in the name of safety.
posted by JackFlash at 10:52 AM on May 3 [17 favorites]


They want you to believe that their processes are so arcane that only they can do it. And that's a lie that some here are happy to repeat in service of the pharmaceutical companies.

Oh please. I seriously doubt anyone here is a pharma lobbyist. Pharma adjacent, maybe?

Given $50 billion dollars, and robust legislation forcing all involved companies to share manufacturing trade secrets with foreign sites (patents are off the table), it would still take about a year and a half IMHO to train and get all the technology set up in other countries.

I am for decentralizing manufacturing as a CYA measure; countries that are paralyzed by a pandemic are in no condition to ramp up manufacturing and should be able to rely on an international network of qualified vaccine providers, under the auspices of the WHO or some other international body. Part of getting the vaccine approved should be sharing of all manufacturing trade secrets in a deployable form. In an ideal world we would not need to deal with private industry at all for public health matters like vaccine manufacturing. Unfortunately we have so many erratic leaders that are willing to set fire to their own populace I have no idea how you could enforce robust multiyear funding, and this soon becomes a "world police" problem.
posted by benzenedream at 10:59 AM on May 3 [9 favorites]


But Bill Gates didn't sell his Microsoft stock...

He seems to have sold more than half and diversified into other funds:
Bill Gates is believed to still own 330 million shares of Microsoft, accounting for roughly $55B
posted by Lanark at 11:11 AM on May 3 [2 favorites]


Polio vaccines did not cause widespread death and destruction, despite a lack of patent protection or IP monetization. So I honestly cannot understand why we need to defend Bill Gates, nor his ill-conceived and self-serving notions that are doing actual, real-world harm, notwithstanding the chilling effect that his foundation's money has had and is continuing to have on speech within and by actual public health and other NGOs like WHO and UNICEF.
posted by They sucked his brains out! at 11:13 AM on May 3 [20 favorites]


Given $50 billion dollars, and robust legislation forcing all involved companies to share manufacturing trade secrets with foreign sites (patents are off the table), it would still take about a year and a half IMHO to train and get all the technology set up in other countries.

Silly nonsense. No company in the world had ever produced an mRNA vaccine in volume. The government gave Moderna $2.5 billion in advance to do it and they accomplished it in months. There's absolutely no reason the same couldn't be done in India or Brazil, especially if given all the hard earned knowledge paid for by the government. It shouldn't be Moderna to control that knowledge. We paid for it.
posted by JackFlash at 11:36 AM on May 3 [9 favorites]


Moderna agrees to supply U.N.'s Covax with 500 million coronavirus vaccine doses:
Moderna will provide as many as 500 million doses of its coronavirus vaccine to a United Nations-backed initiative to inoculate populations in lower-income countries, the biotechnology firm said Monday.

The company announced the agreement with Gavi, the Vaccine Alliance just days after its two-dose messenger RNA vaccine was approved by the World Health Organization for emergency use.

Gavi supports the U.N. program, known as Covax. The deal would bolster a global vaccine rollout that has so far been dogged by unequal access, with most immunizations happening in wealthier countries.

The WHO has warned that such lopsided distribution would be a “catastrophic moral failure.”

Under the agreement, Moderna will supply Covax with 34 million vaccine doses in the fourth quarter of 2021. Next year, Gavi retains the option to procure another 466 million doses, Moderna said in a statement. It said that the shots were being offered at its “lowest tiered price.”
posted by gwint at 11:55 AM on May 3 [3 favorites]


This Gates bashing is nuts. He has devoted a huge amount of his time, his energy, and his fortune to global public health. Yes, he doesn't have the temperament or worldview to undermine global capitalism, but accusing him of actively trying to limit the pace of global vaccination is about as rational as believing he put little tracking devices in the vaccines.

I agree: judging the man via the lens of a sensationalist headline would be shoddy analysis. So let's read the article. Wherein we learn that Gates has openly advocated for limiting the pace of global vaccination, because of some sort of hand-wave-y bullshit about poorer countries not being able to run complex manufacturing processes, even if we spot them the tools and technology. The money line here is Gates commenting "Typically in global health, it takes a decade between when a vaccine comes into the rich world and when it gets to the poor countries."

There's probably a more nuanced defense of his position out there. Based on this article, he sounds like a borderline-genocidal monster whose view of the developing world is so dim that he should recuse himself from all of his philanthropic ventures.
posted by Mayor West at 11:58 AM on May 3 [35 favorites]


The government gave Moderna $2.5 billion in advance to do it and they accomplished it in months.

Yes, because Moderna were already the world experts in mRNA vaccines, working in the same language in the same regulatory environment. They also tapped the expertise of the world's best oligonucleotide chemists and scaleup people at a bunch of subcontractors, all of whom dropped what they were doing to help.

I am not arguing tech transfer is impossible or not desirable, just that it will probably take longer than "months". But it's worth starting as soon as possible! Properly diversifying the supply chains so that e.g. everyone in the world is not using the same factory to produce acetonitrile will take years.
posted by benzenedream at 12:55 PM on May 3 [14 favorites]


Given $50 billion dollars, and robust legislation forcing all involved companies to share manufacturing trade secrets with foreign sites (patents are off the table), it would still take about a year and a half IMHO to train and get all the technology set up in other countries.

So you're saying we'd be just about up to speed right now given the serious development of the mRNA vaccines began in January of last year?
posted by Cezar Golescu at 12:59 PM on May 3 [2 favorites]


See previous comment, but thanks for the snark.
posted by benzenedream at 1:04 PM on May 3 [1 favorite]


Has Bill Gates done a lot of good with his money? Sure.
Could far more good be done if we took every cent away from Bill Gates and gave it all to organizations that desperately need funding? Absolutely.

Maybe, in honor of his philanthropy, we'll let him keep .00075% of his wealth. He's 65, and a million dollars is plenty for anyone his age to live out a comfortable retirement.
posted by Mr.Encyclopedia at 1:08 PM on May 3 [11 favorites]


Sorry Mayor West, if you look at the full quote Gates is saying things ARE moving quickly. So that no one here has to make the effort to re-read the original article:
The delay in getting vaccines to low- and middle-income countries, he added, was shorter than expected. “Typically in global health, it takes a decade between when a vaccine comes into the rich world and when it gets to the poor countries.”
"Ban Billionaires" is fine as a goal. Advocating for changes in the global IP system is great. (I agree!) But calling Gates a "borderline-genocidal monster" is just silly.
posted by PhineasGage at 1:57 PM on May 3 [6 favorites]


He's 65, and a million dollars is plenty for anyone his age to live out a comfortable retirement.

Not the way he currently lives, no it's not. And he lives decently modestly but still has a huge house, impending divorce etc.
posted by jessamyn at 2:07 PM on May 3 [1 favorite]


He has devoted a huge amount of his time, his energy, and his fortune to global public health.

And now he is using his tremendous power and influence to prevent COVID vaccines being distributed for free or at low cost. Both of these things can be true.


he dumped everything to focus on Covid vaccines. this is M$ v.2 for him.
posted by infini at 2:07 PM on May 3 [2 favorites]


He's 65, and a million dollars is plenty for anyone his age to live out a comfortable retirement.

He's also about to get divorced. That could be expensive.
posted by Melismata at 2:08 PM on May 3


I'd love to see more light shed on Gates and just how much he's done to impede the spread of the vaccine. Clearly, he's got great publicists, and he's treated as some sort of saint by any journalist who he deigns to speak to

Tim Schwab in CJR on how the Gates Foundation influences media reporting on itself.


In African twitter he sends paid shills out to try and argue their way into conversation threads about his greatness.

oh and btw, today's news Bill and Melinda Gates divorce after 27 years of marriage
posted by infini at 2:10 PM on May 3 [3 favorites]


Polio vaccines did not cause widespread death and destruction, despite a lack of patent protection or IP monetization.

The Salk Vaccine which you are referring to isn't used anymore and hasn't in decades. As far as I can tell the current polio vaccines have some level of patent protection. There were serious incidents related to polio vaccines during the initial rollout of vaccinations in the 1950s resulting in death and long term illnesses (including ironically polio). These problems were mostly traced to manufacturing issues such as the "Cutter incident"
posted by interogative mood at 2:27 PM on May 3 [5 favorites]


Not the way he currently lives, no it's not.

Welp, maybe he shouldn't have become accustomed to a lifestyle beyond the wildest dreams of most of humanity.
posted by Pope Guilty at 2:38 PM on May 3 [12 favorites]


He's 65, and a million dollars is plenty for anyone his age to live out a comfortable retirement.

This is wildly wrong. A million bucks would be just over $33,000/year if he made it to 95. Living wage proponents frequently point out that isn't enough to live on.

You might want to start thinking harder about your own retirement planning if you think a million is enough.
posted by srboisvert at 3:25 PM on May 3 [13 favorites]


billg's SSA checks probably look pretty nice to us 99%ers tho.
posted by Heywood Mogroot III at 3:28 PM on May 3 [1 favorite]


Anytime I see it phrased as a "once in a generation" pandemic, I start to wonder if this is a Hold My Beer moment for the world. Are we sure this is not going down as a "first among several in a generation" pandemics?

I wonder about the next pandemic in relation to this thread's main topic, actually.

This year, the rich countries who can afford an expensive privately patented vaccine will get their Covid jabs. Meanwhile the poorer countries will have to wait few more years for vaccines to trickle down to them (via Covax, or probably some other PPP with Gates in a prominent role).

In the meantime, won't this virus keep having a chance to mutate like crazy in the unvaccinated parts of the world? And mightn't some of those mutations evade the current vaccines on offer?

So then, if we're lucky, Pfizer et al. will develop booster shots... which will of course be bought up by the rich countries first. Meanwhile, people in poorer countries keep dying, and the mutations keep mutating.

Rinse, repeat?
posted by Beardman at 4:15 PM on May 3 [2 favorites]


Why a guy who just happened to luck into the early days of computers and had access to them is now an authority on healthcare who is seen as some kind of expert is beyond me. As has been said elsewhere, Bill Gates could vaccinate everybody in the world and still be a billionaire. It's a crime.
posted by bluesky43 at 4:20 PM on May 3 [7 favorites]


You will never win trying to argue a moral point with people who see it as an economic one. And even if Bill Gates could raise people from the dead like Christ, he shouldn't have a personal voice in what should be a global decision, not one of a few people born in the right place.
posted by lesbiassparrow at 4:34 PM on May 3 [3 favorites]


When the EU was sparring with AstraZeneca, the EU immediately threatened to adjust IP protections as necessary to meet the EU's goals.

https://www.smh.com.au/world/europe/we-are-in-the-crisis-of-the-century-europe-threatens-to-seize-astrazeneca-factories-20210318-p57bq7.html

No one needs to wait for permission to save lives. Who exactly is saying that they are currently blocked by IP issues from producing vaccine or taking steps to produce vaccine?
posted by Wood at 4:41 PM on May 3 [1 favorite]


I _do_ have a bunch of relatives in the pharma company. There is a ridiculous amount of capital and time invested in R&D&Manufacturing (which BTW, does not always pan out - at least one project which took 10+ years and literally hundreds of millions of dollars which was pulled from market due to 1-in-a-million side effects, millions invested in R&D which goes nowhere, 10's of millions invested in manufacturing because FDA inspectors wanted things cleaner or more precise).
These aren't (all) greedy bastards out just to make a buck - it's _really_ expensive to develop, and (can be) _really_ dangerous to get wrong.
It's one thing to produce a medicine which will be taken a little bit at a time by people who are sick and under doctor's care and you can see problems as they develop. It's quite another to have a medicine which will be taken by 10s of millions of people a week and you hope that 1. manufacturing QA was good and you didn't mess it up in a way that might hurt people and 2. manufacturing QA was good and you didn't mess it up in a way that will make it ineffective (and people won't know until they get sick later).
If you want to setup a new manufacturing plant that meets spec, you have several people on hand with a lot of experience in how to do it and unlimited capital - it'll probably be 5 years.
posted by goddess_eris at 5:51 PM on May 3 [15 favorites]


Look back at the last 20 years. We had 2 previous coronavirus outbreaks that we contained (SARS and MERS), and we had Ebola, Swine Flu and Bird Flu. We were really just incredibly lucky that those this didn’t blow up like Covid. I don’t think this is the last time we’re going to face a pandemic.
posted by interogative mood at 6:00 PM on May 3 [4 favorites]


It's not like this problem is anywhere near as simple as just building a new manufacturing plant somewhere. As we've all learned, the supply chain for mRNA vaccines is effectively the entire globe. But many of the things we need to do to expand the capacity of Pfizer and Moderna to make these vaccines are the same things we need to do to allow other companies to start producing mRNA vaccines -- we just need to do it openly and in public. While it takes a civilization to make this stuff, there are only a finite number of bottlenecks or genuinely difficult steps -- lipid ingredients, microfluidic mixers, recipes to replicate and purify the mRNA, guidelines for verifying accuracy and safety, etc. What we really need is the folks running the show from Moderna and Pfizer to sit down with the hundreds of pharmaceutical executives and PhDs from the hundred countries asking for help and basically do in a public what they've done internally (and possibly in private with government officials in the US and EU): walk through every complicated step in the toolchain, lay out everything they've learned technically, legally, logistically, etc, and identify the key bottlenecks in the process. And then we all spend tens of billions of dollars encouraging relevant companies around the world to build out lipid manufacturing, microfluidic chips, bioreactors for creating DNA and RNA, QC toolchains, etc, until there are a dozen suppliers at each bottleneck instead of 2 or 4. This process of diffusion and expansion is exactly what happens anyway with any complicated new technology, but we can speed it up significantly by providing funding, workshops and training materials, insurance, profit guarantees, etc, instead of just letting the byzantine pathways of capitalism run their slow course. Even if it takes years, as others have said, this problem is not going away any time soon.
posted by chortly at 6:46 PM on May 3 [6 favorites]


I want to make a really clever joke about how people defending Gates is somehow tied to the influence of his nanobot RFID 5G microchip in the vaccine.

But I just got my second dose and I'm really tired, so can you all please imagine i wrote something witty along those lines?

Thank you in advance.
posted by ananci at 6:47 PM on May 3 [2 favorites]


Business as usual and fuck everyone else.
Brazilian pharmaceutical associations on Friday called for lawmakers to reject a bill that seeks to suspend COVID-19 vaccine patents,
The executive, who asked to speak anonymously due to ongoing relationships with the government, said the legislation could especially hurt U.S. firms, which hampering Brasilia's efforts to improve relations with Washington.
posted by adamvasco at 7:29 PM on May 3 [3 favorites]


There's absolutely no reason the same couldn't be done in India or Brazil,
Bolsonaro and Modi are two very big reasons that immediately come to mind.
posted by schmod at 7:53 PM on May 3 [6 favorites]


>I _do_ have a bunch of relatives in the pharma company. There is a ridiculous amount of capital and time invested in R&D&Manufacturing

Glaxo-Smith-Kline

Topline revenue: $32B
COGS: $11B
SG&A: $11B
R&D: $5B
Tax Expense: $0.7B
Net Income to Shareholders: $5B

So exactly half of what people pay for GSK's products goes to overheads and the shareholders.

wow so capitalism much efficiency
posted by Heywood Mogroot III at 10:08 PM on May 3 [11 favorites]


Just as a comment, SG&A can include depreciation of non-specific capital investment - and not just physical capital (factories / production facilities) but also depreciation of any R&D spending that isn't expensed. Edit: I have a bit of doubt now, but say a general facility could be indirect, while the specific machines tied to a product could be in COGS.

Eg if GSK invested $30 billion upfront into a new production facility that was expected to last 30 years, they would reflect that as $1 bil per year in the SG&A line.
posted by xdvesper at 11:06 PM on May 3 [1 favorite]


Has Bill Gates done a lot of good with his money? Sure.

So did Pablo Escobar.
posted by Cardinal Fang at 11:18 PM on May 3 [6 favorites]


Look back at the last 20 years. We had 2 previous coronavirus outbreaks that we contained (SARS and MERS), and we had Ebola, Swine Flu and Bird Flu. We were really just incredibly lucky that those this didn’t blow up like Covid.

It wasn't luck for those previous outbreaks. It was rapid responding and international cooperation that minimized them. The U.S. had people onsite for those diseases before they even began and added more as soon as they were detected and mobilized so aggressively for containment and treatments that they were considered over-reactions by the politicos and the commentariat. The U.S. used to understand it was the world's pandemic cop and would lead the way.

The Trump admin and it's Republican driven ignorant isolationism/hostile international politics is massively responsible for letting covid-19 become a world wide pandemic that crashed through the US borders due to its rollback of disease surveillance and its unwillingness to help anyone including its own population by acting pro-actively.

There is luck in the randomness of the particulars of the evolution of diseases but it was not 'bad luck' that covid-19 became a viral evolutionary success story because that stage was set for it before it evolved.

An important part of being prepared for the future is seeing the past clearly and learning from mistakes.

TLDR: We need to recreate the conditions that produced the earlier "good luck" with previous pandemics.
posted by srboisvert at 3:08 AM on May 4 [8 favorites]


One thing which I don't think anybody has addressed is the possible problem of bad faith on the part of the other companies and states.

On the one hand, take Moderna; we can all see that they might well have been acting in bad faith when they announced the waiving of patent protection on their vaccine, because they were happy to take the good publicity without actually doing enough to let other manufacturers make their vaccine.

But on the other hand, we should also be doubting the good faith of the other manufacturers, and their host countries who are pressing their case. I wouldn't be at all surprised if, for example:
  1. some of them just don't have the very-high-level competence to safely manufacture these vaccines at this scale
  2. some of them are more interested in free technical training, with a view to future business, than they are in actually helping with the current covid crisis
If the firms and research institutes – the ones which have done the expensive and time-consuming R&D – do share everything they know with anybody who asks, there are many bad outcomes possible:
  • What if a less-than-competent manufacturer, in a country with few QA regulations, makes an enormous batch of ineffective or contaminated vaccines and makes the covid problem worse?
  • What if a bad-faith manufacturer takes all the expertise they're given for free, and cynically sets up in direct competition with the original manufacturers by under-cutting their prices, not just for covid vaccines but for everything else they now know how to make? So the Modernas and J&Js and Pfizers end up having put all the time and money into doing the research, but without being able to then recoup that investment? That's the kind of situation where companies give up doing that kind of research, leading to a worse vaccine crisis in the next pandemic because the next generation of vaccine research never gets done.
These conflict of interest situations are real, and are difficult to deal with; I'm all in favour of getting more vaccines into more arms all across the world, but there are co-operative ways to do it (e.g. the Covax scheme) which don't involve exposing the researchers to being ripped off along the way and maybe making the whole situation worse.
posted by vincebowdren at 3:24 AM on May 4 [3 favorites]


It's a non issue because patents can be voided by government for the purposes of national emergency. Second, biotech companies are out to make profit, so they weren't trying to invent a pandemic vaccine in the first place. Third, the cachet and social capital that a company earns for doing altruistic acts is advertising that money cannot buy.

As a Marxist my analysis/framing here nevertheless kind of terrifies me
posted by polymodus at 3:46 AM on May 4 [1 favorite]


So the Modernas and J&Js and Pfizers end up having put all the time and money into doing the research, but without being able to then recoup that investment?

To me this is isn't a huge issue - their work on mRNA was judged to be a sound business case to invest in given its other applications. At the time they were developing these therapies no one had even heard of Covid, it was used in cancer treatments.

Say it's $10 bil investment that would yield an expected $20 bil in revenues, a 100% profit margin based on revenues from cancer therapies and other medicines.

Suddenly Covid happens, and they could potentially earn an extra $100 bil unexpectedly from this windfall, this profiting from the misfortune of the world and suffering of the people. I have no problem with governments appropriating this "value" and using it for the good of mankind. Just buy the IP for $20 bil and make them whole.

To re-iterate, no one engaged in mRNA research in the 1990s knowing there would be a Covid outbreak in 2020, and that somehow if they knew that in 2020 governments would appropriate their IP, that they would have somehow decided NOT to engage in mRNA research at all.
posted by xdvesper at 4:08 AM on May 4 [3 favorites]


So the Modernas and J&Js and Pfizers end up having put all the time and money into doing the research, but without being able to then recoup that investment?

Might someone disabuse me of the notion that these large Western pharmaceutical companies don't really pay for their research, as much as milk national governments for funding? I am very much not an expert, but it seems like the basic research is generally done in tax-funded universiities, and then the IP is handed out to listed corporations for, umm, 'reasons',
posted by pompomtom at 6:51 AM on May 4


What if a bad-faith manufacturer takes all the expertise they're given for free, and cynically sets up in direct competition with the original manufacturers by under-cutting their prices, not just for covid vaccines but for everything else they now know how to make?

This wouldn't really be "bad-faith." This is what businesses do and would be a side effect--an effect, really--of this IP act. I would just amend this to say that in pharma not so much "undercutting prices" as undercutting/anticipating research. It'd certainly hurt the individual companies who invented the tech (especially Moderna; Pfizer has lots of other things), and help other companies.

The concerns around incentives could be significantly reduced by a hefty payout to the companies that developed these vaccines though.

To re-iterate, no one engaged in mRNA research in the 1990s knowing there would be a Covid outbreak in 2020, and that somehow if they knew that in 2020 governments would appropriate their IP, that they would have somehow decided NOT to engage in mRNA research at all.

Pharma research is weird by many standards in how long term and capital intensive it is. You generally understand that you don't know what the market or indication will be when you start, let alone the competition. While you always have some prayers and hopes you can put in a plan, the idea that there are multiple applications makes up for a lot of the uncertainty.

So yeah, if you knew the government would appropriate your IP if you were unexpectedly successful in one area and train up competitors, you might indeed invest in other things.
posted by mark k at 7:04 AM on May 4 [3 favorites]


Might someone disabuse me of the notion that these large Western pharmaceutical companies don't really pay for their research

Sure, so basically the public funding for pharmacological research is usually going to be through the NIH. Numbers for 2015 were a number I could quickly pull up and they were $30 billion NIH while private real R&D investment was $150 billion, which is five times as much.
posted by floam at 7:16 AM on May 4 [5 favorites]


Maybe Windows 10 wasn't enough to win her back after 8.
posted by floam at 7:47 AM on May 4 [3 favorites]


Pharma research is weird by many standards in how long term and capital intensive it is. You generally understand that you don't know what the market or indication will be when you start, let alone the competition.
There's also a ticking clock. Drug patents last 20 years from the date of filing, which can often be several years before trials begin, let alone actual sales.

I'd be strongly in favor of having governments "buy out" patents when there's obvious social good to be had for doing so. But the price needs to be fair.

There's a lot more to be said about how pharma R&D has changed over the past 20 years, but it's a fairly complicated subject. We definitely need to find a way to ease some of the tension that comes from the fact that public funding plays an extremely increasingly important role – but I'm not convinced that tearing up the patents is going to be a magic bullet.
posted by schmod at 8:03 AM on May 4 [3 favorites]


TLDR: We need to recreate the conditions that produced the earlier "good luck" with previous pandemics.

I used to think this too but on closer inspection much of it is outside of the control of any single country or leader. When you look at the relatively successful containment efforts like with 2005 Bird Flu there are lots of moments where essentially random events kept it from escaping. Just 4 years later in 2009 Swine Flu did escape and made 60.8 million American sick.

This isn't to excuse Trump and his awful job. A better US leader could have reduced the number of dead and sick significantly; but that's still 100,000 dead instead of half a million.
posted by interogative mood at 8:29 AM on May 4 [1 favorite]


I see the system is working.
‘Obscene’ bonus hike for AstraZeneca boss prompts investor anger.
Advisory groups ask shareholders to oppose bid to raise Pascal Soriot’s maximum share bonus to 650% of £1.3m basic pay.
posted by adamvasco at 8:39 AM on May 4 [1 favorite]


Drug patents last 20 years from the date of filing, which can often be several years before trials begin, let alone actual sales.

Doesn't matter quite so much when you can bribe the lead generic manufacturer not to manufacture, and release "new" versions of the drugs with minute changes to effectively extend the patent life.
posted by praemunire at 10:16 AM on May 4 [1 favorite]


if we're going to discuss AstraZeneca, let's remember that they've agreed to manufacture the Oxford vaccine and sell it at cost i.e. they're not making any profit on it at all.
posted by vincebowdren at 10:17 AM on May 4


Pharma isn’t gouging us with Covid vaccines; they leave that to other drugs and things like EpiPens where mostly the patents have long since expired; yet the prices keep going up.
posted by interogative mood at 10:49 AM on May 4 [2 favorites]


Pfizer coronavirus vaccine revenue is projected to hit $26 billion in 2021 with production surge:
Pfizer said Tuesday that it expects global sales of its coronavirus vaccine to reach $26 billion in 2021, a milestone that would make it the biggest-selling pharmaceutical product in the world and helps illustrate why Pfizer is planning to expand use of mRNA technology for other vaccines and therapies.

Sales of its mRNA vaccine are likely to eclipse those of Humira, the rheumatoid arthritis drug manufactured by AbbVie, with annual revenue around $20 billion, currently the world’s top seller. Pfizer had $3.5 billion in coronavirus vaccine sales in the first quarter.

Pfizer, which is in partnership with Germany’s BioNTech for vaccine development and sales, has said it expects to manufacture 2.5 billion doses of the two-shot vaccine in 2021. It has agreements to sell 300 million to the United States by late summer.
posted by gwint at 10:50 AM on May 4 [2 favorites]


Pharma isn’t gouging us with Covid vaccines

The problem isn't gouging. The problem is using patent law to withhold vaccine technology, while millions of people literally die of asphyxiation.
posted by They sucked his brains out! at 11:46 AM on May 4 [3 favorites]


So, folks who are concerned that making the pharma corporations share their proprietary knowledge would unfairly impact them, what is the actual negative outcome you are concerned about? Is the worst case scenario for the corporations really a counterbalance to the lives of millions of people?

We humans tend to discount the moral weight of inaction versus action. So what if the choice was already made to relax the intellectual property restrictions and compel the corporations to share their vaccine tech — if you had the power to veto the choice, would you?
posted by thedward at 11:58 AM on May 4 [6 favorites]


Great question, thedward. Overall I loathe the pharma companies for many of the reasons cited upthread. But in this specific situation, other comments upthread and elsewhere on the reputable press - from folks with specific knowledge - seem to make clear that simply busting the patents wouldn't make more vaccines available worldwide more quickly. Supplies, ingredients, expertise, safety certifications, etc. all would take longer to have ready than the big drug companies will need to continue to increase their own production and make the 10+ billion doses needed to vaccinate every willing person on Earth.

So yes, I would 'veto' a rushed busting of this limited set of patents in favor of pushing hard for a more fundamental revision of the global pharma IP rules that would benefit all of us over the long-term.
posted by PhineasGage at 12:16 PM on May 4 [4 favorites]


As I understand it, the tech industry has a licensing scheme for patents related to “critical infrastructure”. For example, this regulates Qualcomm‘s control of critical cellular transmission patents. Basically, the fees must be reasonable and anyone who pays the fee can incorporate the tech into their products.

Why can’t something similar be implemented in this case?
posted by Big Al 8000 at 4:02 PM on May 4 [1 favorite]


As I understand it, the tech industry has a licensing scheme for patents related to “critical infrastructure”. For example, this regulates Qualcomm‘s control of critical cellular transmission patents. Basically, the fees must be reasonable and anyone who pays the fee can incorporate the tech into their products.

Why can’t something similar be implemented in this case?


oh no no no
posted by praemunire at 4:27 PM on May 4 [1 favorite]


How much money has been spent on funding scientists through schools and supporting their research by various governments over the years?

You can't talk about discoveries and who profits from them in a vacuum that ignores the public funding that makes the final delivery possible. It's not like any of these vaccines came entirely on the back of industry funding.
posted by lesbiassparrow at 4:45 PM on May 4 [1 favorite]


Telling everyone that they can ignore the drug patents is the free market solution to the problem. I don't say this as a compliment. This is a problem that calls for government action and international coordination. The underlying (and probably unexamined) assumption of driving the almost exclusive focus on patents is that if we just removed these pesky government restrictions the market would step up and solve the problems basically instantly and basically for free.

Last summer in the US the Trump administration basically abdicated responsibility for PPE and ventilators and we had states competing against each other, unable to plan because supplies went from scarce to scarce and unpredictable. Fraudsters stepped up to fill in the gaps, taking orders they never intended to fill and deliveries of counterfeit masks. The same thing with vaccine raw materials, manufacturing equipment and expertise is a million times worse, since it actually reduces production.

The classic approach in social democracies would be to get government coordination in partnership with corporations to coordinate supply within a command framework, where rivals are not working at odds with one another. You don't need price signals to know that the world need vaccines, right? Especially with Trump is gone the US is doing more of that, with e.g. the Biden admin bringing in other major pharma to manufacture vaccines for their competitors. (The EU, if I understand, is somehow being more market-oriented and thus is worse off than the US.) What's absolutely missing are vocal promises to keep going and get the next billion doses out to other nations free and promises for when we can deliver. I really wish there were more energy pushing for that, and more imaginative versions of that, instead of this imagined free lunch.

I've been somewhat measured in these threads, because saying "governments of rich countries should do better" seems naive, and there's always plenty of room to criticize big companies, I'm not defending patents during an emergency, and the Indian crisis is a tragedy right now. But the patent moves would change the supply on the time frame that matters, especially not the obsession with the hard-to-make Pfizer and Moderna.

Why can’t something similar be implemented in this case?

There is drug patent pooling that lets Indian manufacturers make and sell drugs for HIV and other diseases to less developed nations. There are restrictions on where they can be sold, but (broadly speaking) beyond that you have a big incentive for efficient manufacturing and market competition to prevent large profits. So a model framework exists.

I don't think it would help short term (see above) but if we're thinking years ahead I fully expect Covid to give us a need for more shots against future strains, so we should be doing something.
posted by mark k at 5:27 PM on May 4 [2 favorites]


Why can’t something similar be implemented in this case?
Because it already has? There are already several such deals in place, with mixed but mostly positive results.
posted by schmod at 8:26 PM on May 4


Suhaib Siddiqi, former director of chemistry at Moderna, said with the blueprint and technical advice, a modern factory should be able to get vaccine production going in at most three to four months.

“In my opinion, the vaccine belongs to the public,” said Siddiqi. “Any company which has experience synthesizing molecules should be able to do it.”
posted by JackFlash at 9:29 PM on May 4


JackFlash, you are quoting as an authority someone who worked there ten years ago, for about four months, when the company was about a year old. He wasn't involved in manufacturing there nor it seems anywhere else in his career.
posted by mark k at 10:28 PM on May 4 [2 favorites]


Oh, you mean the guy who has over a dozen patents for apparatus and methods for synthesizing nucleic acids and was the director of chemistry at Moderna is less of an authority than the anonymous folks here who pull out of their ass that it would take "unlimited capital and five years." Who ya gonna believe?
posted by JackFlash at 7:05 AM on May 5 [2 favorites]


billg's SSA checks. The absolute maximum Soc Sec check in 2021 is $3,895. Of course, there's a (stupid) cap (that should be abolished) on the amount of income that is subject to the soc Sec/ FICA tax.

It's been my understanding that the Gates Foundation has done good work on malaria, and on health care in parts of Africa. Are they using their money wisely?
posted by theora55 at 7:13 AM on May 5


The US had the worst possible leadership for a pandemic, and everybody's an armchair epidemiologist now. One way or the other, we should be getting vaccine to the world and helping everybody get vaccines made, because it's the only possible moral thing to do, and because it will help keep us safe, too.
posted by theora55 at 7:15 AM on May 5 [2 favorites]




Are they using their money wisely?

If you take the lens of white saviourdom, then yes.
posted by infini at 9:31 AM on May 5 [1 favorite]


There have been a lot of news stories on NPR and elsewhere recently about India's decision to export the vaccine and the many doses that have been wasted in parts of Africa. My liberal, conspiratorial brain is disturbed by this, even though it's probably just an outbreak of journalistic hot-take fever.
posted by mecran01 at 9:51 AM on May 5


Who ya gonna believe?

This is quite a bit of gossip/inside baseball, but what the heck let's go for it:

...Mr. Siddiqi is being disingenuous in an effort to "hurt" someone now at Moderna that he feels wronged him. It's a little more complex than that (inasmuch as there are other people involved on both sides who have their own roles to play), but not by much.

It's occasionally surprising (depressing?) how much of the world is driven by interpersonal spats between executives and their various minions. It's all such desperately tedious schoolyard shit.

Obviously, YMMV, and my information is second-hand based on dinner table conversation (from someone who was present but not directly involved, but it's of course possible that they were more involved than they've told me, and that therefore they're playing their own game which I've now walked into so see "schoolyard" remark above).
posted by aramaic at 9:53 AM on May 5 [2 favorites]


wow so capitalism much efficiency

So, go show them wrong. Go do $5B in research _per year_ (plus manufacturing and approval costs (both onetime and ongoing)) and sell it for $5B. Shouldn't take more than 10 years of R&D to develop something good and useful and safe - no problem getting funding.

Doesn't matter quite so much when you can bribe the lead generic manufacturer not to manufacture, and release "new" versions of the drugs with minute changes to effectively extend the patent life.

These 2 sentences don't make any sense. You cannot extend the patent life - you can get a new patent for a new formulation. In fact, once the patent phase has expired, the original manufacturer frequently pays the generics manufacturer to make the "brand" version on their behalf. Again - it's super expensive to build / maintain the manufacturing for these - so much that eventually it's literally cheaper for the original company to just buy them from someone else.

EpiPens where mostly the patents have long since expired; yet the prices keep going up

Suggests that maybe it's not the patents that are the problem?

the guy who has over a dozen patents for apparatus and methods for synthesizing nucleic acids

Literally nothing in this statement suggests he knows anything at all about manufacturing. I mean, he might - maybe the Moderna vaccine production is extremely easy to setup. That's fair - I'm also extrapolating from what I know (which isn't vaccine production, tbh).
posted by goddess_eris at 9:55 AM on May 5 [4 favorites]


So, go show them wrong... Shouldn't take more than 10 years of R&D to develop something good and useful and safe - no problem getting funding.

Covid-19 research in particular received a lot of public funding. Not just vaccines, but antivirals like remdesivir and antibody therapies like those from Regeneron. Some research did not yield successful therapies. Remdesivir alone has received $6.5B (yes, billion) of public funding over two decades of basic research, and it has been shown to have limited benefit for the cost.

That the public underwrote a lot of this should not be dismissed, when asking about how drug companies allocate funds.

The profits that these companies make depend heavily upon structures and support provided by government and underwritten by citizenry: basic research used for discovery and other aspects of development is funded by taxpayers; governments set up regulatory regimes that provide public trust in and establish a safe marketplace for drugs; legal frameworks create monopolies from which revenue can be derived for lengthy periods of time; and — for some of these vaccines, particularly — advance purchasing agreements that guarantee revenue and profits.

The form of capitalism employed in the United States relies heavily on privatizing profits and socializing risk, and the pharmaceutical industry here reaps benefits from that same arrangement.

Tl;dr: If you're going to snark about how drug R&D is risky, you need to realize that a lot of the public shares in that risk to a not-insubstantial degree, even if most individuals are not invested directly and personally in the relevant company.
posted by They sucked his brains out! at 11:39 AM on May 5 [10 favorites]


These 2 sentences don't make any sense. You cannot extend the patent life - you can get a new patent for a new formulation. In fact, once the patent phase has expired, the original manufacturer frequently pays the generics manufacturer to make the "brand" version on their behalf.

So, either you don't know what pay-to-delay is, or you're sweeping it under the rug, but either way, it's disqualifying for serious discussion of pharma policy.

"You cannot extend the patent life - you can get a new patent for a new formulation." --Hence the word "effectively." Amazing how manipulable "new formulation" is.

Honestly, if you gotta talk this kind of talk to your regulators, I understand, but it's a little silly to bring it into serious private-human discussion.
posted by praemunire at 11:53 AM on May 5 [2 favorites]


Welp!

"The US supports the waiver of IP protections on COVID-19 vaccines to help end the pandemic and we’ll actively participate in @WTO negotiations to make that happen." - Ambassador Katherine Tai

Pretty bad week for Gates
posted by Aya Hirano on the Astral Plane at 12:35 PM on May 5 [10 favorites]


Whoa.
posted by gwint at 12:56 PM on May 5 [1 favorite]


Came here to post this. Looks like this administration is following through.
posted by blue_beetle at 12:58 PM on May 5 [1 favorite]




@CNBCnow: Pfizer, Biontech, Novavax, Moderna shares plunge to session lows after U.S. backs waiving patent protections on Covid vaccines

Maybe I'm reading too much into what might be a one day blip, but doesn't that kind of say it all?
posted by chaz at 2:33 PM on May 5


From Cory Doctorow Manufacturing mRNA vaccines is surprisingly straightforward (despite what Bill Gates thinks)

He cites this paper from Imperial College by public health officials, chemical engineers and virologists. It says

compared to conventional vaccine production, mRNA factories are:

* 99 - 99.9% smaller
* 95 - 99.7% cheaper
* 1,000% faster

If you convert a single closet in a conventional factory to mRNA production, it will make more doses than the rest of the factory combined.

Spend $20m to build one of these microfactories, inside a conventional vaccine facility, install a 5l bioreactor, and, for $100m/year, it will produce one billion vaccine doses.
posted by JackFlash at 2:56 PM on May 5


Pfizer coronavirus vaccine revenue is projected to hit $26 billion in 2021 with production surge

Just raising a wee little reminder that revenue is not profit. [I'm pro sharing and generally anti-big US pharma but talking revenue instead of profits is a frequent kind of misleading outrage generating rhetorical technique]
posted by srboisvert at 3:16 PM on May 5 [4 favorites]




JFC the relentless, inexpert fucking quarterbacking here from randos, including corey doctrow.



Spend $20m to build one of these microfactories, inside a conventional vaccine facility, install a 5l bioreactor, and, for $100m/year, it will produce one billion vaccine doses.


Not even wrong .


The AICHE paper you post is a conceptual discussion paper about stringing together several existing technologies that MIGHT scale. and it hasn't . been. done. yet.


"We have built a production process model...therefore size‐based separation of the T7 RNA polymerase from the RNA seems feasible....
Based on our techno‐economic assessment, the RNA vaccine production process can be two to three orders of magnitude smaller"

and in fact most of it's numbers about expected yield come from a vaccine technology ,saRNA, which saRNA hasn't even been in clinical fucking trials yet for COVID,

", especially for saRNA vaccines due to lower expected amount per dose. "

and finally the paper is topped off with plenty of management buzzwords just to impress

"a Quality by Design (QbD) framework aided by computational modeling, "

---

JackFlash you'd read the paper rather than just shitting out anti-pharma gibberish screeds all over this thread, you'd see that this is speculative, but hey BILLGATESEVILAMIRIGHT. .

I could go on, but the relentless fucking anti-science, anti-evidence tone of this thread makes me want to leave metafilter.
posted by lalochezia at 3:41 PM on May 5 [11 favorites]


This is why the patents must be opened.
Brazil is ground-zero for the genocidal logic of U.S. vaccine diplomacy.
Brazilians have been viewed by the United States as expendable, to prevent growth of Russian and Chinese diplomatic influence in Latin America. U.S. vaccines were withheld or offered on sovereignty threatening terms, whilst offers from Brazil’s BRICS partners were obstructed or blocked entirely under pressure from U.S. diplomats.
As collateral for any resulting legal penalties for unwanted side-effects of the vaccine on the population, Pfizer wanted sovereign assets, such as bank reserves, military bases, embassy buildings, even fishing rights.
In astonishing attempt at corporate blackmail, Pfizer was effectively telling these countries “to save your people, relinquish your sovereignty.”
posted by adamvasco at 3:48 PM on May 5


... rather than just shitting out anti-pharma gibberish screeds all over this thread

You ask for authorities and I cite authorities. These aren't randos. They are respected scholars from a respected research institution.

It seems that you are the one doing the shitting, without any documented authority.
posted by JackFlash at 3:50 PM on May 5 [1 favorite]



You ask for authorities and I cite authorities. These aren't randos. They are respected scholars from a respected research institution.


who don't say what corey doctrow or you say they are saying.
posted by lalochezia at 4:00 PM on May 5


So, folks who are concerned that making the pharma corporations share their proprietary knowledge would unfairly impact them, what is the actual negative outcome you are concerned about?

Let's be clear about capitalism and technology here: corporations that approach monopolistic levels of power start to invest advanced R&D not to make profits in a free-market, but to fundamentally structure and gatekeep markets. And arguments like Bill Gates' preserves this status quo. The lie that people are fed is the argument that by freeing Intellectual Property (an oxymoron given the public provenance of most such research) would hurt profits (read: stock options) of hardworking companies, when that is not at all the corporations' actual economic motivation for furthering these technologies. Their motivation as corporate entities is anticompetitive total market dominance.

It's also ironic that capitalism created the COVID world, and so any repudiation of capitalism in solving this mess is met with such defensiveness and rationalizations again of the kind the Bill Gates has pushed forth.
posted by polymodus at 4:05 PM on May 5 [2 favorites]


but hey BILLGATESEVILAMIRIGHT

His foundation uses considerable funding — more than most countries — to direct the course of how vaccines are made and distributed, among other priorities. The negative side effects of this have included limiting the ability of world health organizations and NGOs to do their work in an independent and evidence-based manner.

How grants are administered by this foundation guides decision-making by these same organizations; biases towards grant administration to high-income countries over developing countries (so-called "donor interests") have redirected spending by other entities.

The investments which make up the endowment of this foundation include those which have financial interests in the same laws that provide monopolies on, for example, patented and expensive HIV treatment medications. This is not only self-serving, but this particular example also shows that such behavior has real and negative impact on a major public health goal: reducing new HIV infections and treating existing cases.

Media entities that receive funding are demonstrably not able to do their job in an independent manner. The Gates Foundation has spent more than $1B on "training programs" and other policy and advocacy programs. Foundation executives are welcome to prioritize spending as they please, but re-education is ostensibly problematic for a non-profit that otherwise appears to use a significant part of its endowment on priorities other than public health.

I'm willing to entertain rational arguments that there are positive outcomes from how this organization has operated, but the negatives have been considerable, are fact-based, and they cannot simply be swept under the rug.
posted by They sucked his brains out! at 4:15 PM on May 5 [4 favorites]


I’m sorry, but referring to all public health training as “re-education” is well into tinfoil-hat and 5G COVID territory.

If you’re going to make the extraordinarily claim that the Gates Foundation is actively working to spread HIV and AIDS, you’d better provide some evidence.
posted by schmod at 6:37 PM on May 5 [4 favorites]


The investments which make up the endowment of this foundation include those which have financial interests in the same laws that provide monopolies on, for example, patented and expensive HIV treatment medications. This is not only self-serving, but this particular example also shows that such behavior has real and negative impact on a major public health goal: reducing new HIV infections and treating existing cases.

I may be misunderstanding, but are you really claiming that

1. I have an endowment for my nonprofit
2. I invest that endowment in a stock market
3. that stock market contains companies which benefit from patents
4. patents stifle distribution of medicines which can reduce HIV
5. therefore, I am in conflict with the goal of reducing HIV

By this measure, every university with an endowment and almost everyone with a 401k is aiding and abetting HIV. There are lots of fair criticisms of Gates' patent rigidity but this seems like a really big stretch.
posted by benzenedream at 8:15 PM on May 5 [3 favorites]


It seems that you are the one doing the shitting, without any documented authority

JackFlash: you just cited Cory Doctorow, who mentioned a paper that is basically a "plan" with back of the envelope calculations, for a different technology (saRNA), which hasn't been proven yet in the clinic, as a rebuttal to arguments that Moderna/Pfizer-style mRNA vaccines may be complicated to manufacture in a distributed manner.

I don't think lalochezia is the one lacking "documented authority" - you are. I don't personally know lolochezia, but from their posting history, they are one of the posters on metafilter where I see the name and expect useful and accurate scientific commentary (along with mark k., chortly, etc.). Hopefully the US does fund vaccine manufacturing distribution like a moon shot and it will take as long as it takes. It might not be in time to affect the current pandemic but might keep the next pandemic from being as terrible.

Note: I am not saying saRNA is a bad technology, or the Imperial College Engineering paper is garbage, but it is just a proof-of-concept thought experiment with some numeric estimates thrown in. For those interested in saRNA here is a real review (somewhat optimistic, but does mention some possible problems).
posted by benzenedream at 9:43 PM on May 5 [8 favorites]


I'm bowing out after this comment, but I'm glad Biden's talking about relaxing patents. I hope that's not *all* that gets done, because it really not going to have an impact quickly enough (and if it's done stupidly--without attempting to manage inputs--could have a negative effect.)

received $6.5B (yes, billion) of public funding over two decades of basic research, and it has been shown to have limited benefit for the cost

The word "received" here mischaracterizes what's in the paper by over 100x. The papers is trying to estimate two different things: direct support and overall research funds that got us to this point. The billions number is the general part of the research--"RNA dependent RNA polymerases" is a pretty broad area not applicable to just one drug or just one virus.

Both are important! I'm strongly in favor of a commons that includes support for research, I don't think it should be benchmarked just in economic terms, but we should remember it happens, and it's a "you didn't build that" reminder for anyone silly enough to say otherwise. But it's like the distinction between subsidies you give Amazon for building it's new HQ, and money you spend on the railroads and highways.

Oh, you mean the guy who has over a dozen patents for apparatus and methods for synthesizing nucleic acids and was the director of chemistry at Moderna is less of an authority than the anonymous folks here who pull out of their ass that it would take "unlimited capital and five years." Who ya gonna believe?

Well I do speak industry-ese and know the field a bit, better than Cory Doctorow or most reporters: The phrase "former director of chemistry at Moderna" does not automatically mean the head of chemistry (as you seem to think); it generally means "a chemist who had the title of director." Chemical synthesis of nucleic acids is different than chemical synthesis of oligos is different than biological production. Lab scale is different than manufacturing scale. And even if he understood what it takes to convert a factory--which again, is not in evidenced--it has nothing to do with global supply chain considerations. This is a big area with a lot of subfields and he doesn't really seem to overlap with many of them, despite having spent a few months at Moderna a long time ago. (This isn't meant to be a snark on him, by the way. It's a snark on elevating him to a world class expert because he says something you already decided is true, while holding the people actually doing the work in total contempt.)
posted by mark k at 10:29 PM on May 5 [4 favorites]


I'm really trying to say this as gently as I can, but if you're going to defend this foundation or defend arguments from authority, please consider at least reviewing some of the criticisms that have been levied against it by professionals in public health, before commenting further. I'm not stating any facts that haven't already been discussed in these circles, seriously.
posted by They sucked his brains out! at 10:31 PM on May 5 [1 favorite]


On the political front: The US has thrown its support behind a move at the World Trade Organization (WTO) to temporarily lift patent protection for coronavirus vaccines and the EU ‘ready to discuss’ waiver on Covid vaccine patents.
posted by adamvasco at 4:07 AM on May 6 [2 favorites]


just shitting out anti-pharma gibberish screeds all over this thread

back in September 2008 when the financial meltdown was at full velocity, lots of folks were demanding the heads of various bankers, brokers, legislators, etc, I recall thinking that A. I agreed in general (hell yeah, string'em all up), but B. it felt like not particularly good timing. That is, the time to rethink the command structure of your local fire department is NOT when your particular building is on fire. At that point, you've just gotta get out of the way and hope that the pros (however compromised, conflicted, corrupted) will step up and do their jobs.

This is rather how I feel about big pharma right now. By all means, yes, let's neutralize the fuckers, all the players, including the shareholders. But not right now with millions already dead, many millions more currently infected. To mix metaphors, you don't get to change your air force into a navy in the middle of a firefight. You've got to fight with what you've got, not with what you should have -- the perfect being the deadly enemy of the better-than-nothing at such moments.
posted by philip-random at 7:30 AM on May 6 [1 favorite]


To mix metaphors, you don't get to change your air force into a navy in the middle of a firefight. You've got to fight with what you've got, not with what you should have -- the perfect being the deadly enemy of the better-than-nothing at such moments.

But we have already changed horses. Moderna, a company that had never produced a single drug, let alone a vaccine, was given $2.5 billion by the government to produce a vaccine at absolutely zero cost and zero risk to the company. The government paid for everything. The initial testing, the phase 1, 2 and 3 trials, the new equipment, the production of the first 100 million doses. Even if nothing came of it, Moderna still got the money.

The model works. Instead of giving corrupt pharmaceutical companies patents, which cost the public billions of dollars each year, you instead give the companies contracts with public money and then the public owns the rights and can put them in the public domain for the public welfare. But for all that money, the government didn't get the patent rights, Moderna did. The government did the first part right but failed in the second.

The drug patent monopolies are no small thing. They cost U.S. consumers over $500 billion a year. Only about $100 million of that is actual cost of producing drugs. About $80 billion is spend on R&D. The rest is pure monopoly rents that companies can charge because of their patents. We are paying 5, 10, sometimes 100 times the real cost of the drugs.

This is not a small thing. People get all outraged that every three years or so when they buy a new PC they have to send $35 to Bill Gates for his Windows monopoly. But that pales next to the pharmaceutical industry. Every single year the average U.S. household sends $3,000 to the pharmaceutical industry for its monopoly rents. Not for R&D, not for production costs. Just for excess patent rents. You may not see this money because it is hidden in your health insurance premiums and your Medicare taxes but it is surely money out of your pocket to pharmaceutical companies. $3,000 a year per household.

So instead of sending these hundreds of billions to pharmaceutical companies for their patents, why not have the government fund the R&D with contracts, just like they did with Moderna, except the public gets to keep the rights and can produce the drugs cheaply just like generics. All of the data and "trade secrets" become open source. We've already shown that this works with Moderna. But the contract failed to follow through on the second part and make the results public domain.
posted by JackFlash at 8:51 AM on May 6 [2 favorites]


That $500 billion number (actually $490bn) is total domestic spending on pharmaceuticals.

Not all of it is patent rents – that number includes off-patent drugs as well as the actual cost to develop/manufacture the drugs.

I can agree that the number is too high, but the amount of dishonest/misleading reporting of information in this thread has been staggering.
posted by schmod at 10:00 AM on May 6 [4 favorites]


Not all of it is patent rents – that number includes off-patent drugs as well as the actual cost to develop/manufacture the drugs.

Which was exactly what I stated. I very clearly said that about $100 billion of the $500 billion was cost of production and $80 billion was for R&D. So where is the dishonesty? Go back and read what I said before making accusations of dishonesty.

About 20% of spending is for off-patent generics but it well documented that in many cases generic pricing is corrupted by the patent holding pharmaceutical companies.
posted by JackFlash at 10:17 AM on May 6


I can agree that the number is too high, but the amount of dishonest/misleading reporting of information in this thread has been staggering.

Yeah, there's been a shocking amount of misinformation and misleadingly-presented statistics in the thread, enough so that it feels like an exercise in futility to push back against it. The loud, unabashedly wrong voices have crowded out any more nuanced discussion.

I'd love to have a MetaTalk thread about this, because I've seen this pattern repeat in many other threads recently.
posted by leslietron at 11:06 AM on May 6 [10 favorites]




wankers gonna wank:
"The protection of intellectual property is a source of innovation and must remain so in the future.''
posted by Bangaioh at 12:26 PM on May 6


Biden’s Support for Vaccine Patent Waivers Faces Uphill Effort in Europe

The two European statements emphasized the challenges of winning critical E.U. support for securing the patent waivers. Many experts feel the waivers are needed to step up the manufacturing of vaccines and getting them to poorer parts of the world, where inoculations have far lagged those of richer countries. The European Union is a significant force within the World Trade Organization, where unanimous approval by member countries would be required for any proposal to waive patents.

Herd immunity is not going to happen, so having broader access to vaccine technology and modifications will be critical in controlling the disease, in the long term. Monetization efforts are going to be as much of a barrier as hesitancy.
posted by They sucked his brains out! at 12:43 PM on May 6 [3 favorites]


As someone who has zero understanding of the scientific/technical issues involved, I just wanted to say thanks to mark k, benzenedream, lolochezia, chortly, and goddess_eris for their informative comments.
posted by lumpy at 12:51 PM on May 6 [4 favorites]


Fact check: Moderna vaccine funded by government spending, with notable private donation

Social Security Works, a nonprofit organization committed to defending the Social Security program, posted a graphic on Facebook on Nov. 17, claiming, "taxpayers paid for 100% of the Moderna vaccine development," which the post says totaled $2.5 billion.... Benesch also credited a story by Axios in which the pharmaceutical company was quoted saying federal money makes up "100% funding of the program."...

The U.S. government has given Moderna Therapeutics about $2.5 billion, including federal grants for university research, for the development of the company's vaccine and to purchase doses once approved. To say that the vaccine is fully funded by the federal government discounts a [private $1 million] donation to Vanderbilt University Medical Center.


After nearly $1B in research funding, Moderna takes $1.5B coronavirus vaccine order from U.S.

Combined, Moderna has scored $2.48 billion in R&D and supply funding from the U.S. government for its program. That would make the vaccine's price per dose just under $25, less than the $32 to $37 Moderna says it's been charging small purchasers.

Socialize risk, privatize profit.
posted by They sucked his brains out! at 1:46 PM on May 6


Combined, Moderna has scored $2.48 billion in R&D and supply funding from the U.S. government for its program. That would make the vaccine's price per dose just under $25, less than the $32 to $37 Moderna says it's been charging small purchasers.

First off, this is completely nonsensical. You don’t determine the price per dose by simply dividing the total R&D cost by the size of the first order. Secondly, Moderna also raised about $2.7 billion in private investment. It started as a VC-backed startup spun out of Flagship. The initial risk was almost exclusively bourne by the private sector.
posted by leslietron at 2:06 PM on May 6 [2 favorites]


They are not dividing the R&D cost ($1B), but all of the revenue that the company received in entirety to develop this vaccine, specifically.
posted by They sucked his brains out! at 2:15 PM on May 6


So in these fantastical calculations where we "paid for them to develop the vaccine" from scratch, do we include the costs that Pfizer and Moderna had for decades of work lipid nanoparticles to deliver siRNA lipids.... that went nowhere?

Some more background:

Waiving IP


Myths of Vaccine manufacturing


More on mRNA vaccine manufacturing

posted by lalochezia at 2:59 PM on May 6 [4 favorites]


Somebody think of Pfizer
posted by Cezar Golescu at 3:36 PM on May 6 [4 favorites]


Somebody will, no worries.
posted by They sucked his brains out! at 4:12 PM on May 6 [2 favorites]


What’s the EU going to do if the Biden admin and the US decide to waive patents? I’m not sure their support is as critical as the reporter assumes.
posted by interogative mood at 7:08 PM on May 6


The WTO can hold up the decision on waiving patents globally, unless everyone gets on board. When Germany threatens to not step up, that can (and would) have global consequences for the spread of Covid-19. Perhaps not so much in the immediate term, but as the virus spreads and mutates, there will be need for boosters or modifications that will be harder to distribute, as a result.
posted by They sucked his brains out! at 7:40 PM on May 6 [1 favorite]


To learn the lessons of a year lost to Covid-19 – and to prepare for a long century of recurring health emergencies – the temporary Trips suspension must give way to a total transformation of the pharmaceutical patent system. Pausing the gears of the killing machine is not enough.
posted by adamvasco at 5:59 PM on May 7 [1 favorite]


You know things are messed up badly when The Onion has to step in:

U.S. Gives Developing Countries 60 Seconds With Vaccine Patents To Memorize Everything They Can
posted by They sucked his brains out! at 7:30 PM on May 7 [2 favorites]


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