If vaccine apartheid exists, vaccine billionaires shouldn’t

To understand why billionaires are a sign of moral and economic failure, look no further than the Covid-19 pandemic.

Drug corporations could earn $190 billion from Covid-19 vaccine sales this year. Pharmaceutical profits have minted nine new pandemic billionaires, and helped eight existing billionaires enlarge their fortunes. Several of these are founders and private investors in three pharmaceutical corporations — Moderna, BioNTech, and CureVac — whose vaccines use mRNA technology that was largely developed from publicly funded research.

Their financial bonanzas provide a disturbing contrast with vaccine apartheid. By the end of May, only 0.3% of all vaccine doses worldwide had been administered in low-income countries.

Facing condemnation for hoarding doses, the G-7 countries, which are meeting this weekend in England, are under pressure to launch a new plan to expand Covid-19 immunization globally. One hotly contested issue is whether they will call for mandatory sharing of mRNA vaccine technologies, including a proposed waiver of intellectual property rights for Covid-19 technologies.

Pandemic billionaires are speaking out against government intervention, warning it would undermine innovation and claiming that their firms can satisfy global demand for Covid-19 vaccines.

Because the public sector was largely responsible for developing mRNA technology and sharing it with corporations, the pandemic fortunes of these founders and investors stands in stark and repugnant contrast to billions of unvaccinated people.

Moderna, BioNTech, and CureVac are each led by founders or longtime executives with a key role in company decision-making: Stéphane Bancel is Moderna’s CEO, Özlem Türeci and Ugur Sahin are BioNTech’s co-founders, and Franz-Werner Haas is CureVac’s CEO. In addition to getting head starts from publicly funded research, these companies also relied on private investment provided through venture capital or family offices (privately held companies that handle investment and wealth management for wealthy families). Venture capital investors include Flagship Pioneering, a Boston-based firm whose founder, Noubar Afeyan, also serves as Moderna’s chair, and MIG AG, a German venture capital firm that made early investments in BioNTech. Other large investors in BioNTech and CureVac were German family offices, including investments by Dietmar Hopp in CureVac and the Struengmann brothers in BioNTech.

Founders, executives, venture capitalists, and family offices all held substantial ownership stakes in the three mRNA companies heading into the pandemic. All of them had a choice at the start of the pandemic: maximize profits or maximize low-cost, global production of vaccines.

The three firms chose profit maximization, partnering with multinational companies or forging partnerships with a few contract manufacturers. This year, these companies will have sold nearly all their limited supply of vaccines to wealthy countries at high prices.

They could have instead chosen to avoid scarcity and hoarding by sharing technology, know-how, and intellectual property with other manufacturers, thereby expanding and decentralizing production. It wouldn’t be like they were giving away their intellectual property for free: sharing would allow these companies to earn royalties — and profits.

One year ago, the World Health Organization launched the Covid-19 Technology Access Pool (CTAP) to facilitate sharing of intellectual property, knowledge, data, and know-how to a common pool that could be used by manufacturers worldwide to expand the supply of Covid-19 vaccines. So far the pool remains empty. Vaccine production remains tightly controlled, highly concentrated, and insufficient to the scale of need.

This failure to share vaccine recipes and processes may have undermined global immunization efforts, but it handsomely profited founders and investors. Ever since the WHO declared the Covid-19 pandemic to be a public health emergency of international concern on Jan. 30, 2020, the share prices of Moderna and BioNTech have risen tenfold and eightfold, respectively, while CureVac’s share price has nearly doubled since going public in August 2020.

With share prices soaring, executives, founders, and investors have sold millions of shares, some becoming paper billionaires. In just two months in 2020, Abeyan sold shares totaling $1.5 billion. The Struengmann brothers added an estimated $8 billion to their wealth in 2020, while MIG AG, early investors in BioNTech, pocketed $719 million.

When these companies failed to act responsibly, governments should have stepped in. After all, governments (and philanthropies) invested substantially in the development of mRNA technology and Covid-19 vaccines. The mRNA technology itself is based on decades of publicly funded research; a key university researcher, Katalin Karikó, now works at BioNTech. The lipid nanoparticle, a critical ingredient of mRNA vaccines, emerged from publicly funded research conducted by Massachusetts Institute of Technology’s Robert Langer, who was a co-founder of Moderna. The pre-fusion spike protein used in mRNA vaccines was built by researchers at the National Institutes of Health Vaccine Research Center and Dartmouth College.

In addition, governments, foundations, and agencies have contributed more than $100 billion for development and manufacturing of medical countermeasures, including vaccines. The German government now owns a 23% stake in CureVac owing to a 300 million Euro investment.

Yet despite this substantial public subsidy, companies have not been required to share knowledge and promote equitable access. The Gates Foundation and the Coalition for Epidemic Preparedness Innovations (CEPI) both withdrew obligations to make vaccines available and affordable from pre-pandemic contracts signed with CureVac. The NIH has not exercised its leverage to ramp up worldwide manufacturing of the Moderna vaccine. Incredibly, Richard Hatchett, the CEO of the CEPI, which itself had the power to negotiate access conditions in its contracts with multinational drug companies, recently stated that the “great missed opportunity of 2020, I would even say the tragedy” of the pandemic was that funders of vaccine development did not include access provisions with funding.

Even as investors and founders’ cash in, the world is not reaching an off-ramp from the pandemic. More than 10,000 people are dying daily and low-income countries could wait decades to be fully vaccinated, even as companies plan booster and variant doses for rich countries to protect against mutations that occur in unvaccinated populations.

The G-7 must move to support and enact an intellectual property waiver, invest in worldwide manufacturing, share doses equitably (a late-breaking G-7 announcement of a donation of 1 billion doses is welcome news but is ultimately neither sufficient nor sustainable), and require corporations to share know-how. Founders and investors have been allowed to bend the course of the pandemic to their private benefit. When a few people win big, everyone else loses.

Rohit Malpani is a public health consultant based in Paris, France, and a board member for Unitaid, a global health initiative that works with partners in low- and middle-income countries.