The Sunday Magazine

COVID-19 pandemic reveals the risks of relying on private sector for life-saving vaccines, says expert

The search for a vaccine to end the COVID-19 pandemic has started a global race never before seen in the history of medical research. Matthew Herder, the director of the Public Health Law Institute at Dalhousie University, raises questions about the funding model currently in place for vaccine research and development, and about how to ensure equitable access to the vaccine once it’s ready — both within nations and among them. 

'We need to rethink the structures that encourage knowledge production in a fundamental way': Matthew Herder

A researcher at the University of Pittsburgh works on a COVID-19 vaccine candidate, a fingertip-sized patch with dissolvable microscopic needles, on March 28. (UPMC/Reuters)

There has never before been another race like it: thousands of scientists across the globe working furiously to develop a vaccine to end the COVID-19 pandemic, with billions of dollars flowing at record speed from governments, charities and the pharmaceutical industry.

Matthew Herder is the director of the Public Health Law Institute at Dalhousie University. (Nick Pearce)

This is vaccine development at an unprecedented speed. But, according to Matthew Herder, it has also revealed fundamental cracks in our market-based approach to vaccine and drug development. 

Herder is the director of the Health Law Institute at Dalhousie University in Halifax. He is a professor of pharmacology who specializes in questions around biomedical innovation, intellectual property law and the commercialization of scientific research.

Although the possibility of another coronavirus outbreak had been clear since the SARS crisis, pharmaceutical companies were slow to invest in vaccine research because of the financial risks involved, Herder told The Sunday Edition's Michael Enright.

"There is no COVID vaccine because it's not a predictable health problem for industry to address when there isn't a pandemic," he said. "We need different incentives, different reward structures to encourage companies and university researchers to develop vaccines to address these kinds of health problems."

Herder also emphasized the importance of an equitable global distribution of COVID-19 vaccines once they've been found to be safe and effective. 

"What I worry about is that access in certain parts of the world will not be based upon need, but rather where you are in [the] global power hierarchy … and the funds that you have available to you as as a nation," he said.

The problems with a market-based approach

For several years now, since the SARS crisis, governments like Canada have been pouring millions of dollars into research and development of drugs and vaccines to target coronaviruses, Herder said. 

But that public funding covers only the basic research. It falls to the private sector to move that research forward.

"Public labs, university researchers, government scientists, they do the discovery work," he explained. "The private sector figures out what is the most promising, what's the most interesting and takes it from there. It does the clinical trials and gets it through the regulatory process. And then, of course, promotes it if it gets approved."

Herder added that, in the case of a coronavirus vaccine, industry interest was lacking because the investment was seen to be too risky — especially because it was unclear if and when a pandemic would come about.

"So you sort of get this pathway to developing a drug that becomes a little bit stunted because we're relying on market-based incentives to push it along to completion."

What I worry about is that access in certain parts of the world will not be based upon need, but rather where you are in [the] global power hierarchy.- Matthew Herder

Herder believes that the existing incentive model, which relies on intellectual property and patent rights to encourage researchers and companies to develop a drug or vaccine, is itself part of the problem.

"You need incentives in place to ensure that people are motivated to take up the challenge of developing something. But I would really caution that the incentives we've long relied upon by patents are part of what's gotten us into this problem," he said.

"Patent rights don't correspond to public health needs. They correspond to things that you can get predictable returns in the marketplace for."

Re-thinking the commercialization model

In some instances, the private sector can even cause life-saving vaccines to languish on the shelf for years, Herder said.

In the case of the Ebola vaccine developed by a Canadian research team, Herder found that the lack of commercial interest led to years of lost time.

"[The] vaccine was discovered by government researchers in Winnipeg at the National Microbiology Laboratory in the early 2000s," he said. "And they did all of this work — preclinical work — showing it was up to 100 per cent effective in animal models. But there was no private sector interest."

Instead, the scientists worked tirelessly to do much of the development work themselves, even when government funds were hard to come by, Herder said.

"For years leading up to the West African epidemic, the vaccine … sat on the shelf largely," he said.

"And what we uncovered through access-to-information-secured documents was this remarkable effort — in particular by one researcher who was precariously employed at the lab, named Dr. Judie Alimonti, who really carried this project forward despite the lack of funding and lack of interest from industry at the time."

It took years for the private sector to show any interest in that vaccine, Herder added. The first firm to finally step up was a small biotech company in Iowa, which had no record of ever bringing anything to market, he said.

It wasn't until there was an Ebola outbreak that bigger industry players started to take notice.

"When the epidemic was commanding global attention, all of a sudden there was interest and a multinational company, Merck, actually got involved … and eventually brought it to market approval," Herder said. 

The story not only reveals the dangers of relying on pharmaceutical companies to develop life-saving drugs and vaccines, it also shows what public researchers are capable of, he added.

"We think this is a success story about the capacity of public sector science to do far more than just discovery work or pre-clinical work." 

I think what you're seeing is essentially a reproduction of the status quo. People are saying we have to work with these big multinationals. ​​​​- Matthew Herder

But Herder believes the COVID-19 vaccine research currently underway has relied on that same model of commercializing scientific discoveries.

"I think what you're seeing is essentially a reproduction of the status quo. People are saying we have to work with these big multinationals. They're the ones with the capacity," he said. "And while it is true that we need lots of infrastructure, and producing a vaccine on this scale is going to require a massive amount of resources, going with the status quo is how we got into this situation in the first place."

Instead, Herder believes it's time to imagine alternative ways for bringing vaccines to market.

"We need to rethink the structures that encourage knowledge production in a fundamental way," he said. 

"Absent that kind of reimagining … I fear that we will be in this situation again and again."

Global solidarity needed

The COVID-19 pandemic also requires a rethinking of how vaccines get distributed, to ensure that no one gets left behind, Herder said.

"I think what we're starting to see is a move away from global solidarity towards protectionism and nationalism," he warned.

"We're seeing that in some of the agreements that are being put into place," Herder said. "Large, richer countries [have been] entering into deals — funding the development of these interventions — with one very important string attached: we want it available for our population first."

It's a real serious issue if this pandemic is going to further exacerbate the existing inequalities between the global north and the global south.- Matthew Herder

"Most nations that are quick and able to do so are moving to protect their citizens first and foremost, which is not going to work," he added. "We're talking about a new infectious disease that doesn't respect our borders."

Instead of stockpiling, nations need to be thinking about, "What are the needs globally? Where would it make the most sense six months from now?" Herder said. "Maybe the responsible thing to do might be to ensure that wherever it's hitting the world hardest, that those folks have access to vaccines."

It's also a question of equity, he added.

"It's a real serious issue if this pandemic is going to further exacerbate the existing inequalities between the global north and the global south."

Click 'listen' above to hear the full interview.

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