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Vaccine development is extraordinarily expensive and that has to be paid for somehow. These IP partnerships and cooperatives had zero funding. If the Oxford gro

by simonh 6y ago

Vaccine development is extraordinarily expensive and that has to be paid for somehow. These IP partnerships and cooperatives had zero funding. If the Oxford group has made their vaccine public domain, who would have made it? None of the big pharma companies would do it for free, and they’re the only ones that have the capacity and expertise to ramp up production at massive scale, so it would have either sat there unused or small quantities of questionable quality would have eventually been made by small players, without the expertise or scale to make a significant difference quickly. It’s all about funding. If you want to replace the big pharma system fine, go right ahead. Knock yourself out, I’ve just got one question. Where’s the funding coming from? The fact is no such massive scaled up alternate funded solution exists, and it didn’t exist last April. What does exist, and did exist from the beginning of the pandemic, that could be swung into action rapidly and effectively was the existing system. It was ready and waiting to rapidly develop, test, ramp up production and deliver billions of doses of half a dozen different vaccines, with the first hundreds of millions of doses for delivery in under a year. April last years was not the time to convene committees of UN functionaries about patent cooperatives or whatever. It was time to get to work. Now the future is a different story. Maybe pharma development should be reformed. Maybe you have ideas about better ways to fund it. Fine. Last April was not the time for that, but maybe now is.

retrac 6y ago
Most medium-sized industrialized countries have capacity to manufacture something like the Oxford vaccine. We're seeing that with the technologically similar Russian Sputnik vaccine which has been widely licensed. It's being manufactured in China, Russia, India, South Korea (two sites), Italy, Germany, Spain, Brazil, and probably some others I'm forgetting. And I would disagree. There are of course institutions capable of funding such projects and acquiring the resources. They're called governments. Between funding, compulsory licensing and nationalization powers, if a nation has the theoretical ability to manufacture the vaccine, then that theoretical can become reality with the right policies. Canada did nothing until August 31st, around the time the federal government realized we were not going to be able to acquire doses from the USA/EU with priority. Then two plants got emergency funding. They will come online this fall and will likely produce 50+ million doses this year, some of the Novavax vaccine, some of another promising candidate vaccine developed domestically. Both have been ready to test since March 2020. If they had been funded then, we may already have had domestically manufactured doses available.
ianai 6y ago
Seems obvious. The government doesn’t ask people to fund national defense on a per capita basis. There aren’t companies we have to individually purchase “national defense” from like car insurance or groceries. Because that doesn’t make sense, of course. Community resistance to pandemics and other community-wide health efforts pose the same risk that an invasion from a hostile foreign power poses-mass death, inability to continue our way of life should it get out of control.
- Dracophoenix 6y ago
  >>The government doesn’t ask people to fund national defense on a per capita basis. On the contrary, people do via taxes. It's just that the government doesn't ask. It expects.
  - lucideer 6y ago
    > via taxes I don't think your reply is contradicting the gp in the way you think it is...
- simonh 6y ago
  So we should manage virus defence the same way we manage national defence. We don’t have a privatised military, so it makes sense to have a Public Health Service. As aBrit I agree completely. We have both a national health service and an army. So far so good. Vaccines are products though. They undergo research and development, manufacturing, marketing and sales. Even if you are developing them for domestic use, you’ll still want to sell them abroad so they’re still a commercial product. So in this analogy vaccines are guns and planes, which surprise surprise are overwhelmingly products manufactured and sold by commercial companies like Colt and Lockheed. Nationalisation works well for service organisations, not product development and manufacturing.
  - lucideer 6y ago
    > Nationalisation works well for service organisations, not product development and manufacturing. Citation needed. Admittedly I don't have many good counterexamples of efficient nationalised manufacturing, purely because in today's world there are SO FEW of them of any form (efficient/inefficient), but software products are a reasonable proxy. Take, for example, the healthcare.gov debacle, or the much publicized Standish Group stats of the ~83% failure rate of private software projects. Now look at some of the publically-produced civic software in the EU, or GDS in the UK (or even 18F though that's not really as clear cut and seems to be on the way out for not making enough profit or something....) People accuse the public sector of inefficiency, when all of the actual real inefficiencies therein tend to be caused by its interfaces with the private sector.
ahepp 6y ago
Why couldn't the US government buy the patents at a generous price, then give it away? Apologies if that's a naive question, I don't really understand the issues at play here. But the article seems to imply people who want to make the vaccine can't, which seems pretty ludicrous to me.
- FalconSensei 6y ago
  So, I'm not sure about vaccines, but I can say something about insulin. Lantus' patent expired, and then Basaglar came in. It's the same insulin, apart from some inactive ingredients (which just dilute it, afaik), and the fabrication process[1]. But 1 unit of lantus and 1 unit of basaglar contains the exact same amount of the same insulin formula. Basaglar costs less, some many people are changing to it. And still, a lot of people had trouble adjusting, and even those that adjusted, some report that for a few days, their glucose levels were high and not coming down. Some had to adjust the daily dose to be slightly higher. I'm not sure if that same problem would happen for mRNA vaccines, but it's important to keep in mind that the whole manufacturing process + quality control can make a difference. [1] https://www.goodrx.com/blog/lantus-vs-basaglar-effectiveness-dosing-side-effects-cost/ https://www.goodrx.com/blog/lantus-vs-basaglar-effectiveness...
seg_lol 6y ago
Are you defending the decision to prevent labs from making vaccines to stop the pandemic? Are you saying that poor countries that cannot pay should suffer their fate?
eloff 6y ago
Yeah, this article is honestly not well thought out and more of a character assassination than an a serious critique. Which one might have guessed just looking at the headline image. There's no point trying to replace the entire global pharmaceutical industry with something more open or cooperative in the middle of a pandemic when we need the existing system now. If that's your battle, it's fine, and maybe it's a good battle to fight, but this is not the time.
systemvoltage 6y ago
I think we also need to account for the fact that a pandemic of this scale hasn't happened in recent history, you cannot expect the private Pharmaceutical industry to have pivoted to give away their IP. U.S. Gov was indeed involved in subsidizing and helping vaccine companies hedge the risk. The scale of this was massive: https://en.wikipedia.org/wiki/Operation_Warp_Speed https://en.wikipedia.org/wiki/Operation_Warp_Speed Just look at the situation with SLS and the lunar gateway program from NASA. It's a complete shitshow. I would expect absolutely horrendous performance if we nationalize pharmaceutical industry, particularly vaccine program. Meanwhile, Moderna's market cap is over $60b from practically nothing last year. IMO, U.S. vaccine program is a huge success despite of the subpar response to the actual containment of the virus. PS - What's with this article's header image? Portraying someone with devil horns just shows how insecure the article is that such a crutch is needed. Just offputting IMO even if they had good points to make (they didn't).
boudin 6y ago
Healthcare is publicly funded in a lot of countries already. And I'm not sure that what's happening now proves you right. Astrazeneca is absolutly failing at ramping up its production. I'm not a professional but I'm quite sure that more labs producing the vaccine would be more efficient.
toper-centage 6y ago
What are you even talking about? It's free as in freedom, not as in free vaccines. Companies that produce an open source vaccine are still free to put a price tag on the product! This is not a digital good that you can just fork and download at home.
danielEM 6y ago
Well, the idea of excluding pharmacy market from classical economic rules isn't that bad and impossible at all. We do already have excluded army, police and in many countries educational systems and entire healthcare systems. We all agreed to take common responsibility and bill for those in taxes, as we find it so crucial for our societes. It is enough to find same for pharma market and go further, find it not nation level crucial, but world level crucial. If just most of the countries would participate in it then there could be enormous funding.
- simonh 6y ago
  I live in the UK and we operate exactly this model in our health service, it's funded by the tax payer just like the army and police, and purchases equipment and supplies from private suppliers just as the army and police do. Those suppliers include the pharma companies, just as the military procure weapons from defence manufacturers. Some of those wea[ons are based on tech development part funded by the defence department, and some drug development is part funded by the state, such as the Oxford jab. Even in the US the government bought the vaccines from private companies, just like the army buys from Lockheed, Boeing, etc. Nothing you described is an alternative, it's actually how it already works in most of the world. I genuinely don't understand, what is it about what you're proposing that's different?
  - danielEM 6y ago
    Well, you got my entire message wrong. But I get it, some things seems to be just granted. Let me explain you that I'm not talking about private suppliers of army or police. I'm talking for services that army and/or police serves itself for you (hope you get that difference that armory without army is actually worth nothing). You might think it is for free, granted or so. Nope. You receive a bill for these services in your taxes. So this isn't about what army and police outsource to private companies. Army and police are itself a kind of "gov owned companies" that serves you and that get paid for it's services and it works well enough so we don't need to go for private police and private armies and pay for it every month with your credit card ;-) Hope now you get the point. If you see any problem that would make it impossible to work same with pharma let me know. So far I think it is more than possible and if established on world level could bring even more benefits, opposite to when it is left just to private companies. I'm from Poland, we have dual healthcare system here. Public and private. And here is a thing: private healthcare can do anything that public can, no limitations, but apparently private services are focused only in certain areas of healthcare - these areas which brings most profits, not these that saves most life. That is natural for business. I don't blame anyone, I'm just saying that free market doesn't work well in this area as it won't for police or army. Free market is good for mobile phones, cars and so on, but when it comes to general health or your safety I don't think it is the most optimal way to push progress or spent your $$$.

by simonh 6y ago

retrac 6y ago

Most medium-sized industrialized countries have capacity to manufacture something like the Oxford vaccine. We're seeing that with the technologically similar Russian Sputnik vaccine which has been widely licensed. It's being manufactured in China, Russia, India, South Korea (two sites), Italy, Germany, Spain, Brazil, and probably some others I'm forgetting. And I would disagree. There are of course institutions capable of funding such projects and acquiring the resources. They're called governments. Between funding, compulsory licensing and nationalization powers, if a nation has the theoretical ability to manufacture the vaccine, then that theoretical can become reality with the right policies. Canada did nothing until August 31st, around the time the federal government realized we were not going to be able to acquire doses from the USA/EU with priority. Then two plants got emergency funding. They will come online this fall and will likely produce 50+ million doses this year, some of the Novavax vaccine, some of another promising candidate vaccine developed domestically. Both have been ready to test since March 2020. If they had been funded then, we may already have had domestically manufactured doses available.

ianai 6y ago

Seems obvious. The government doesn’t ask people to fund national defense on a per capita basis. There aren’t companies we have to individually purchase “national defense” from like car insurance or groceries. Because that doesn’t make sense, of course. Community resistance to pandemics and other community-wide health efforts pose the same risk that an invasion from a hostile foreign power poses-mass death, inability to continue our way of life should it get out of control.

Dracophoenix 6y ago
>>The government doesn’t ask people to fund national defense on a per capita basis. On the contrary, people do via taxes. It's just that the government doesn't ask. It expects.
- lucideer 6y ago
  > via taxes I don't think your reply is contradicting the gp in the way you think it is...
simonh 6y ago
So we should manage virus defence the same way we manage national defence. We don’t have a privatised military, so it makes sense to have a Public Health Service. As aBrit I agree completely. We have both a national health service and an army. So far so good. Vaccines are products though. They undergo research and development, manufacturing, marketing and sales. Even if you are developing them for domestic use, you’ll still want to sell them abroad so they’re still a commercial product. So in this analogy vaccines are guns and planes, which surprise surprise are overwhelmingly products manufactured and sold by commercial companies like Colt and Lockheed. Nationalisation works well for service organisations, not product development and manufacturing.
- lucideer 6y ago
  > Nationalisation works well for service organisations, not product development and manufacturing. Citation needed. Admittedly I don't have many good counterexamples of efficient nationalised manufacturing, purely because in today's world there are SO FEW of them of any form (efficient/inefficient), but software products are a reasonable proxy. Take, for example, the healthcare.gov debacle, or the much publicized Standish Group stats of the ~83% failure rate of private software projects. Now look at some of the publically-produced civic software in the EU, or GDS in the UK (or even 18F though that's not really as clear cut and seems to be on the way out for not making enough profit or something....) People accuse the public sector of inefficiency, when all of the actual real inefficiencies therein tend to be caused by its interfaces with the private sector.

ahepp 6y ago

Why couldn't the US government buy the patents at a generous price, then give it away? Apologies if that's a naive question, I don't really understand the issues at play here. But the article seems to imply people who want to make the vaccine can't, which seems pretty ludicrous to me.

FalconSensei 6y ago
So, I'm not sure about vaccines, but I can say something about insulin. Lantus' patent expired, and then Basaglar came in. It's the same insulin, apart from some inactive ingredients (which just dilute it, afaik), and the fabrication process[1]. But 1 unit of lantus and 1 unit of basaglar contains the exact same amount of the same insulin formula. Basaglar costs less, some many people are changing to it. And still, a lot of people had trouble adjusting, and even those that adjusted, some report that for a few days, their glucose levels were high and not coming down. Some had to adjust the daily dose to be slightly higher. I'm not sure if that same problem would happen for mRNA vaccines, but it's important to keep in mind that the whole manufacturing process + quality control can make a difference. [1] https://www.goodrx.com/blog/lantus-vs-basaglar-effectiveness-dosing-side-effects-cost/ https://www.goodrx.com/blog/lantus-vs-basaglar-effectiveness...

seg_lol 6y ago

Are you defending the decision to prevent labs from making vaccines to stop the pandemic? Are you saying that poor countries that cannot pay should suffer their fate?

eloff 6y ago

Yeah, this article is honestly not well thought out and more of a character assassination than an a serious critique. Which one might have guessed just looking at the headline image. There's no point trying to replace the entire global pharmaceutical industry with something more open or cooperative in the middle of a pandemic when we need the existing system now. If that's your battle, it's fine, and maybe it's a good battle to fight, but this is not the time.

systemvoltage 6y ago

I think we also need to account for the fact that a pandemic of this scale hasn't happened in recent history, you cannot expect the private Pharmaceutical industry to have pivoted to give away their IP. U.S. Gov was indeed involved in subsidizing and helping vaccine companies hedge the risk. The scale of this was massive: https://en.wikipedia.org/wiki/Operation_Warp_Speed https://en.wikipedia.org/wiki/Operation_Warp_Speed Just look at the situation with SLS and the lunar gateway program from NASA. It's a complete shitshow. I would expect absolutely horrendous performance if we nationalize pharmaceutical industry, particularly vaccine program. Meanwhile, Moderna's market cap is over $60b from practically nothing last year. IMO, U.S. vaccine program is a huge success despite of the subpar response to the actual containment of the virus. PS - What's with this article's header image? Portraying someone with devil horns just shows how insecure the article is that such a crutch is needed. Just offputting IMO even if they had good points to make (they didn't).

boudin 6y ago

Healthcare is publicly funded in a lot of countries already. And I'm not sure that what's happening now proves you right. Astrazeneca is absolutly failing at ramping up its production. I'm not a professional but I'm quite sure that more labs producing the vaccine would be more efficient.

toper-centage 6y ago

What are you even talking about? It's free as in freedom, not as in free vaccines. Companies that produce an open source vaccine are still free to put a price tag on the product! This is not a digital good that you can just fork and download at home.

danielEM 6y ago

Well, the idea of excluding pharmacy market from classical economic rules isn't that bad and impossible at all. We do already have excluded army, police and in many countries educational systems and entire healthcare systems. We all agreed to take common responsibility and bill for those in taxes, as we find it so crucial for our societes. It is enough to find same for pharma market and go further, find it not nation level crucial, but world level crucial. If just most of the countries would participate in it then there could be enormous funding.

simonh 6y ago
I live in the UK and we operate exactly this model in our health service, it's funded by the tax payer just like the army and police, and purchases equipment and supplies from private suppliers just as the army and police do. Those suppliers include the pharma companies, just as the military procure weapons from defence manufacturers. Some of those wea[ons are based on tech development part funded by the defence department, and some drug development is part funded by the state, such as the Oxford jab. Even in the US the government bought the vaccines from private companies, just like the army buys from Lockheed, Boeing, etc. Nothing you described is an alternative, it's actually how it already works in most of the world. I genuinely don't understand, what is it about what you're proposing that's different?
- danielEM 6y ago
  Well, you got my entire message wrong. But I get it, some things seems to be just granted. Let me explain you that I'm not talking about private suppliers of army or police. I'm talking for services that army and/or police serves itself for you (hope you get that difference that armory without army is actually worth nothing). You might think it is for free, granted or so. Nope. You receive a bill for these services in your taxes. So this isn't about what army and police outsource to private companies. Army and police are itself a kind of "gov owned companies" that serves you and that get paid for it's services and it works well enough so we don't need to go for private police and private armies and pay for it every month with your credit card ;-) Hope now you get the point. If you see any problem that would make it impossible to work same with pharma let me know. So far I think it is more than possible and if established on world level could bring even more benefits, opposite to when it is left just to private companies. I'm from Poland, we have dual healthcare system here. Public and private. And here is a thing: private healthcare can do anything that public can, no limitations, but apparently private services are focused only in certain areas of healthcare - these areas which brings most profits, not these that saves most life. That is natural for business. I don't blame anyone, I'm just saying that free market doesn't work well in this area as it won't for police or army. Free market is good for mobile phones, cars and so on, but when it comes to general health or your safety I don't think it is the most optimal way to push progress or spent your $$$.