INDIA¡¯S VACCINE MAKERS ARE PANDEMIC PROFITEERS, NO |
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INDIA¡¯S VACCINE MAKERS ARE PANDEMIC PROFITEERS, NOT HUMANITARIANS Most global media coverage has attributed the ongoing crisis to two key causes: the Indian government¡¯s mismanaged pandemic response and Big Pharma. Over the last year, Prime Minister Narendra Modi and his far-right government engaged in superspreader theatrics rather than disaster mitigation. Meanwhile, by upholding patents on Covid-19 vaccines, pharmaceutical companies in the U.S. and Europe have denied low- and middle-income countries the ability to produce lifesaving vaccines, creating a system of global vaccine apartheid that devalues non-Western lives. Amid the censure of the Modi government and Big Pharma, India¡¯s health care capitalists have gone largely unnoticed. Aided at each step by the government¡¯s free-market approach to vaccine distribution, India¡¯s very own Big Pharma has used the pandemic to strengthen market shares, grow profits, and place vaccines behind a paywall unscalable for most people in a country riven with dire systemic inequalities. ¡°The Indian vaccine ¡®market¡¯ is held in a vise-like grip of a vaccine duopoly,¡± journalist V. Sridhar, who has written about the country¡¯s vaccination failures for the Indian news magazine Frontline, told me in a message. ¡°What else would you call this duopoly but vaccine barons?¡± Join Our Newsletter ¡°Disasters are a fabulous business,¡± journalist P. Sainath writes in his recent piece on India¡¯s widening wealth inequality. ¡°There is always money to be made in the misery of the many.¡± India¡¯s Covid-19 disaster is no exception. The Prince of Profit Pune-based Serum makes 1.5 billion doses of various vaccines every year and sells them across 170 countries. Poonawalla sees Serum, with its sizable production capacity, as ¡°almost designed for [a pandemic],¡± and the company has seized on its ¡°once-in-a lifetime opportunity.¡± In 2020, Serum entered a partnership with British-Swedish company AstraZeneca through which Serum could produce the Oxford University vaccine in exchange for royalties. With the resulting vaccine ¡ª known in India as Covishield ¡ª Serum captured 90 percent of the country¡¯s vaccine market share. The company also committed up to 200 million doses for export to the global vaccine-sharing initiative COVAX. Recent analysis notes how Poonawalla¡¯s demand for raw materials ¡°placed him at the heart of several heroic imaginations.¡± This was especially true once India¡¯s Covid-19 surge became front-page news in April. Indian, global, and even socialist media picked up and amplified Poonawalla¡¯s rebuke, pointing to U.S. hoarding of raw materials as a humanitarian concern right alongside India¡¯s pressing need for oxygen and personal protective equipment. As activist and humanitarian pressure to release the raw materials mounted, Biden removed export restrictions on bags, vials, filters, and other materials. A White House spokesperson said in a statement that the U.S. had agreed to release ¡°specific raw material urgently required for Indian manufacture of the Covishield vaccine.¡± The spokesperson was mistaken, as was much of the global media. Poonawalla went on the record multiple times to clarify that his request was not for Covishield or indeed for any vaccine approved to inoculate Indians. Since January, Serum has had the capacity to produce around 5,000 doses of Covishield per minute. Rather, the raw materials Poonawalla sourced from the U.S. are for a new Covid-19 vaccine Serum is producing in commercial partnership with U.S. company Novavax. Poonawalla was able to benefit from activist outrage to secure vaccine raw materials that would do nothing to mitigate India¡¯s public health crisis. Serum declined to comment on the record for this piece. The Coronavirus Crisis But ever since Poonawalla became an early investor in the AstraZeneca vaccine, news stories have praised him as a ¡°vaccine prince¡± ¡ª a risk-embracing entrepreneur with a moral mission. The media¡¯s acceptance of how Poonawalla presents himself explains how easily he has been cited as an advocate for global public health rather than as a billionaire CEO advancing his company¡¯s commercial interests. Journalistic sympathy for Poonawalla often comes at the cost of fair reporting. For instance, the media¡¯s portrayal of Serum¡¯s vaccine exports as a charitable ¡°bid to protect the world¡± obscures the fact that Serum is charging poorer countries up to $7 for the same vaccine dose that the European Union is getting from AstraZeneca at $2. Westward Expansion ¡°We¡¯re seeing a new system of vaccine apartheid coming into place,¡± says Tobita Chow, director of Justice Is Global, an initiative that campaigns to remove Covid-19 patents. Many public health experts agree that a temporary waiver of the World Trade Organization¡¯s Trade-Related Aspects of Intellectual Property Rights, or TRIPS, provision is a necessary first step toward increasing vaccine production and access and creating a more competitive pharmaceutical industry worldwide. With sustained pressure from activists, last month the Biden administration signaled its support for a temporary TRIPS waiver, a measure initially proposed by the governments of India and South Africa. Related Serum has expanded into those frontiers. In 2012, the company acquired Bilthoven Biologicals from the Netherlands government and since then its European presence has only grown. In May, as Covid-19 ravaged India and the country¡¯s vaccine supply dried up, Poonawalla sequestered himself in his $69,000-a-week rental mansion in London as the British government announced that Serum would invest over $330 million in the U.K. to create a new sales office, expected to generate business worth over $1.4 billion. If the clinical trials mentioned in the announcement are any indication, the vaccines developed as part of this deal might target European markets. Serum¡¯s global ambitions illuminate Poonawalla¡¯s real problem with Big Pharma. It is not that Poonawalla is against the commercialization or patenting of lifesaving drugs; rather, he opposes Big Pharma insofar as it blocks his own access to Western markets. This is why, while campaigning against the hoarding of U.S. raw materials or supporting calls to waive U.S. drug patents, Poonawalla had also been working with then-President Donald Trump to escape the ¡°stupid rules and regulations¡± that prevented him from selling his products in the U.S. The TRIPS waiver might become yet another humanitarian response to India¡¯s viral surge that enriches Poonawalla. The TRIPS waiver might become yet another humanitarian response to India¡¯s coronavirus surge that enriches Poonawalla. The waiver could enable Serum to keep profiting from the AstraZeneca vaccine without paying royalties. Serum may also be able to develop a replica of the vaccine, the patent for which it could hold within India even as global patents are suspended. Several of the experts I interviewed saw the probability of such a vaccine monopoly emerging. Poonawalla has done little to dispel these fears. Even as he stresses that Serum¡¯s production capacity must increase to vaccinate the world¡¯s poor, Poonawalla also maintains that there is no need to bring other manufacturers into the vaccine market to help increase supply. Serum¡¯s primary goal isn¡¯t to equitably vaccinate the world or break down monopolies; it is to corner new markets while maintaining dominance within India. Without curbs on Serum¡¯s power, the removal of global patents would not result in ¡°freeing¡± the vaccine, only freeing streams of profit. Krishna Ella, chairman and managing director of Bharat Biotech, holds a package of the typhoid vaccine Typbar-TCV during a press conference in Hyderabad on January 3, 2018. Indian biotechnology company Bharat Biotech has said its Typbar-TVC vaccine is the world's first clinically proven Typhoid Conjugate Vaccine against typhoid fever, and that it has received prequalification from the World Health Organisation (WHO) to be administered to children from 6 months of age to adults, and says the vaccine confers long-term protection against typhoid fever. / AFP PHOTO / NOAH SEELAM (Photo credit should read NOAH SEELAM/AFP via Getty Images)Krishna Ella, founder and chair of Bharat Biotech, holds a package of the typhoid vaccine Typbar-TCV during a press conference in Hyderabad on Jan. 3, 2018. Photo: Noah Seelam/AFP via Getty Images Unlike Serum¡¯s Covishield, Covaxin is not restricted by any Big Pharma patent. The Indian government controls part of Covaxin¡¯s intellectual property rights, yet Bharat Biotech inexplicably monopolized production until a month ago, when the government finally greenlighted manufacturing of the vaccine in its own production facilities. Bharat Biotech declined to comment for this piece. Throughout the pandemic, the Modi government has refused to curb pharmaceutical profiteering. Despite using taxpayer money to provide clinical trial support and sizable production advances to Serum and Bharat Biotech, the government has failed to ensure affordable vaccines for India¡¯s people. Until May, the central government had procured all the doses for $2 each ¡ª a price at which the vaccine companies are reported to have made between 188 percent to 500 percent in profits. But they wanted more. ¡°When you¡¯ve got low supply and high demand, what happens to the price? It skyrockets,¡± Poonawalla has said in describing how U.S. drug companies insulate themselves from competition with generics. Yet Poonawalla essentially politically engineered the same reality in India. ¡°By self-admission, India¡¯s monopolistic vaccine producers were deeply unhappy with the ¡®normal profits¡¯ they earned at the regulated prices,¡± R. Ramakumar, a development economist at the Tata Institute of Social Sciences, told me in a message. ¡°They lobbied to ¡®free¡¯ prices. Not surprisingly, vaccine prices more than doubled, even tripled and quadrupled, over just one week.¡± Do you have a coronavirus story you want to share? Email us at coronavirus@theintercept.com or use one of these secure methods to contact a reporter. By distributing vaccines through the open market, the Indian government fractured its citizens¡¯ collective buying and bargaining power, giving up all leverage to capitalists. With a quarter of the country¡¯s vaccine stock reserved for private hospitals, and vaccine producers vocalizing their preference to sell to those hospitals at higher prices, India¡¯s vaccination drive was designed to favor private-sector monopolization. The resulting inequalities have been stark. Private hospitals have outcompeted cash-starved states: In May, just nine hospital chains had cornered 50 percent of all doses. While India¡¯s states pledged to vaccinate people for free, private hospitals voiced no such intention. Absent price caps, most of India¡¯s impoverished population has either been paying exorbitant amounts to get vaccinated at private hospitals or waiting for government hospitals to acquire scarce doses. By distributing vaccines through the open market, the Indian government fractured its citizens¡¯ collective buying and bargaining power, giving up all leverage to capitalists. India¡¯s vaccination plan for almost one-fifth of the world¡¯s people has been so alarming that even the country¡¯s judiciary and Modi¡¯s own allies have joined journalists, opposition politicians, and medical experts in asking: Why no price standardization or price ceiling? Why not go back to centrally procuring vaccines instead of making states compete? Why not, as Krishnan asks, use the decades-old public vaccination system that was used to eradicate polio? Why not, as experts I interviewed suggest, waive patents within India and issue compulsory licenses so that more than two big companies could make vaccines? In response to months of public outcry, last week Modi announced a partial reversal of his vaccine distribution ¡°experiment.¡± Starting June 21, the central government will procure 75 percent of the country¡¯s total vaccine stock directly from the companies, which it will give to state governments to distribute to their residents for free. The change reverses one of the most politically controversial aspects of the previous policy but still leaves plenty of room for profiteering. A quarter of India¡¯s vaccine stock will remain reserved for private hospitals and, consequently, for the rich. Even with price caps at private hospitals, vaccine manufacturers¡¯ rates of profit will reach over 1,000 percent. As Yogesh Jain, a founder of the rural health care nonprofit Jan Swasthya Sahyog, wrote on Twitter, India¡¯s vaccination capabilities will remain ¡°publicly provided, and privately guzzled.¡± The Modi government has tweaked India¡¯s profit-centric vaccine policy, but as Ramakumar says, what is needed is an overhaul. Instead of using the powers at its disposal on behalf of the people, the Indian government continues to privilege profit over lives. Employees work on the production of line for vials of Covishield, the local name for the Covid-19 vaccine developed by AstraZeneca Plc. and the University of Oxford, at the Serum Institute of India Ltd. Hadaspar plant in Pune, Maharashtra, India, on Friday, Jan. 22, 2021. Serum, which is the world's largest vaccine maker by volume, has an agreement with AstraZeneca to produce at least a billion doses. Photographer: Dhiraj Singh/Bloomberg via Getty ImagesEmployees work on the production line to make vials of Covishield at the Serum Institute of India¡¯s Hadaspar plant in Pune, Maharashtra, in India, on Jan. 22, 2021. Photo: Dhiraj Singh/Bloomberg via Getty Images ¡°The government of India has withdrawn from the central social responsibility of an enlightened welfare state,¡± Ramakumar told me. ¡°It has also opened the floodgates for a vulgar form of predatory capitalism to take over the stage amid the raging human tragedy.¡± Poonawalla has claimed that ¡°even God¡± couldn¡¯t have foreseen the gravity of the crisis, but India¡¯s pandemic disaster was long foretold. Things did not have to play out this way. India could have had medical supplies, PPE, testing kits, and vaccines ready if public health dictated production and distribution, rather than profits. Wherever vaccines have been administered on a mass scale, it has happened because at key moments of reckoning, public health advocates challenged the profit motive. But in India, profiteering itself masquerades as the public good. In India, 38 new billionaires were minted in the past year, while the combined wealth of the country¡¯s 140 billionaires went up by 90.4 percent. India¡¯s big businesses have even managed to use aid from abroad to make money ¡ª which is why private hospitals sold airlifted oxygen cylinders to desperate patients, why vaccine raw materials from the U.S. are being used for disaster profiteering, and why a global patent waiver will likely strengthen the power of Indian Big Pharma. To win a world where human life is truly valued above profit, we must realize that the small handful of very wealthy people who stand in the way of the public good are dispersed across the world ¡ª as much in Pune as in New York City. Their numbers are growing, as is their power within their home countries. In India alone, 38 new billionaires were minted in the past year, while the combined wealth of the country¡¯s 140 billionaires went up by 90.4 percent. During the pandemic, Poonawalla¡¯s net worth rose by 85 percent in five months, as tens of millions of Indians descended into poverty. This is not a coincidence, as P. Sainath writes, in ¡°a year when hundreds of millions of Indians were hungrier than they¡¯d been in decades.¡± ¡°A wealth ¡®surge¡¯ usually rides on a misery surge,¡± Sainath says. The swelling wallets of India¡¯s health care elites are directly linked to the bodies in the streets. Until we eliminate the profitability of misery, India¡¯s nightmare has no end in sight. |
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