President’s aim of widening
access to jabs confounds sector
and administration doubters
KIRAN STACEY AND AIME WILLIAMS
WASHINGTON
Before becoming US president, Joe
Biden pledged to shake up the government’s
approach to the pharmaceutical
industry by backing a move to end companies’
rights to enforce intellectual
property on Covid vaccines.
“This is the only humane thing in the
world to do,” he said during a campaign
event in July 2020.
But until the moment the decision
was announced last week, many in government
and the industry doubted that
the president would follow through on
his promise. Not only did high-ranking
members of his administration have
doubts but few pharma executives
believed a US government would really
take a position so vociferously against
the industry’s powerful lobby.
“Nobody really thought Biden was
going to take on the pharmaceutical
lobby. [They thought] he would be too
scared,” said Brandon Barford, a partner
at Washington-based policy research
company Beacon Policy Advisors. “But
before the financial crisis [of 2008] everybody
thought the financial services
industry was untouchable, then that
changed. This week showed that
pharma companies are the new banks.”
When India and South Africa
approached the World Trade Organization
in October with a proposal to suspend
intellectual property rights for all
Covid-related drugs and technology, it
was quickly shot down. Not only did the
US and EU oppose waiving the Trips
intellectual property agreement for
Covid medicines, they blocked any discussion
of it at all.
Biden’s comments on the campaign
trail opened up the possibility of a
change in policy. However, even when
Katherine Tai, the US trade envoy,
began a consultation on the issue last
month, most officials thought the US
would maintain the position adopted by
former president Donald Trump.
“There is pressure to do this from
Democratic members of Congress,” a
senior pharma lobbyist told the Financial
Times last month. “But the White
House is never going to back this.”
Over the next three weeks, Tai met
people who had an interest in the issue,from trade union leaders to vaccinemaker
chief executives. Many who were
at those meetings said it was difficult to
tell what Tai was planning, but people on
both sides of the debate came away be -
lieving she supported their arguments.
Asia Russell attended a meeting with
Tai on April 13 in her capacity as executive
director of Health Gap, an organisation
dedicated to improving access to
HIV drugs worldwide. “I do not think
she had made her mind up when she
met us,” said Russell, a campaigner for
the waiver. “But she did tell us that the
response of the government to the Covid
crisis could not be business as usual,
which we found very encouraging.”
Two weeks later Tai held meetings
with senior executives at each of the
companies that have had Covid vaccines
authorised in the US or are close to
doing so: Pfizer, Moderna, Johnson &
Johnson, Novavax and AstraZeneca.
They told her supporting a Trips
waiver would undermine the US vaccine
rollout by increasing competition for
scarce vaccine-making supplies, while
also allowing Russia and China to access
US technological breakthroughs. “We
made a powerful case and she definitely
seemed to be listening,” said one industry
figure involved in the talks.
Those who have dealt with Tai say her
inscrutability is one of her greatest
assets. “[Tai] is not a person you would
ever want at your poker game because
she’s going to kick your ass,” said a person
who participated in the consultations.
“She’s got the best poker face.”
Meanwhile high-ranking members of
the Biden administration were voicing
concerns over a waiver. Gina Raimondo,
the commerce secretary, was the most
forthright, according to people involved
in the debate, with her department’s US
Patent and Trademark Office concerned
about the long-term effect on US
intellectual property rights.
Several people also said David Kessler,
head of Operation Warp Speed, the government
programme that helped
develop the vaccines, was against the
waiver. A person involved in the consultations
said Kessler had described it as
the “third rail” for the pharmaceutical
industry — so highly charged it was not
to be touched. Kessler’s office did not
respond to a request for comment.
One of the most high-profile figures to
voice concern was Anthony Fauci, the
president’s chief medical adviser, who
told the FT he was worried a waiver
could end up tangling the US in litigation
from pharma companies. His comments
triggered a backlash from campaigners
but people in the administration say progressive
anger was not what won the day.
Instead, Tai and Jake Sullivan, the
national security adviser, argued the
waiver was a low-risk way to secure a
diplomatic victory for Biden, who had
come under fire for not exporting more
vaccines and failing to respond quickly
enough to the Covid crisis in India.
Whatever the outcome of the WTO
talks, the US pharma industry has lost
its sheen of untouchability. That could
have big consequences for policy
debates, such as how to lower US drug
costs. “There is now a broad consensus
in the Democratic party that something
needs to be done about drug prices,”
Barford said. “What the president has
just done is show it can be done.”