Capitalism Can't End the Pandemic

The Omicron variant shows the COVID-19 pandemic is far from over. To finally end it, we need vaccine patent waivers abroad and a more diverse array of prevention measures at home.

You wouldn’t know it from the behavior of Western governments, but globally we’re in the fourth wave of the COVID-19 pandemic, with a current seven-day average for new cases over 600,000. Wealthy capitalist nations have spent the latter half of 2021 acting as though the pandemic were on its way out. But it wasn’t true before the discovery of the Omicron variant, and it certainly isn’t true now.

Instead we’re mired in an ebb and flow of cases that’s being prolonged by severely limited access to vaccines in poorer countries and perverse priorities in richer ones. The pandemic is a complex matter, but there are two human-controlled factors that have a significant impact: Western governments’ slavish devotion to their economic elites, and perverse incentives surrounding pharmaceutical intellectual property.

The longer both problems persist without intervention, the greater our risk of problematic variants resulting in yet more suffering and death.

Domestic Priorities

Back in late June, Boris Johnson met with a group of “Thatcherite free marketeers” who wanted to see pandemic-related restrictions lifted in the UK. On the day of the meeting, at which he promised to fulfill the donors’ wishes, the UK reported a seven-day average of 16,404 new cases. That number climbed to nearly 49,000 on July 19, the day he rolled back COVID restrictions.

If you think the UK government’s purpose is to serve its people, Johnson’s strategy can only be seen as irrational, since it needlessly endangered millions. Johnson’s actions only make sense if you view the nearsighted monster called capital, not the British people, as the British government’s priority. 

Like all politicians engaged in reckless restriction rollbacks during this pandemic, Johnson cited economic necessity. Their insistence has created the general impression that societies are facing a trade-off between limiting transmission and maintaining economic functioning. But this is false. One study looked at the outcomes in forty-five countries and found that, overall, countries that have contained the virus tended “to have had less severe economic impacts than those that haven’t.” 

The errant belief that containing the virus creates economic harm is often extended to suggest that economic harms have done more damage to society than the virus. This is a fantasy, but it does the trick, effectively taking the pressure off steadfast capitalist politicians who find themselves caught between the interests of their vulnerable constituents and their profit-motivated donors.  

Those priorities have been evident for far longer than the duration of the pandemic. In lacking universal health care coverage, the US stands alone among the twenty-five wealthiest nations. Instead, it relies on an opaque, largely private system where profit-seeking runs amok. That may enrich private insurers, but it doesn’t save society money. US healthcare spending more than tripled its share of GDP over the last fifty years. We spend over 50 percent more per capita on healthcare than any other OECD nation. And with what result? Even before the COVID pandemic, American life expectancy had been falling. 

A 2019 study looked at nations’ ability to handle a pandemic — capabilities like detection, prevention, response, healthcare provision, and health care worker protection — and found the US best prepared. Still, we’ve had 800,000 deaths and forty-eight million confirmed cases. And the CDC estimated that actual deaths were over 900,000 and that cases topped 146 million by September of this year. 

The disparity between what could have been and what actually was underscores the difference between the resources at a nation’s disposal and its willingness to put them to use for the common good. The American approach has prioritized vaccines while de-emphasizing non-pharmaceutical interventions like requiring masks, lockdowns, ventilating buildings, protecting workers, and other efforts to mitigate transmission. That’s not surprising: vaccines make companies money, while many other measures don’t. But while vaccination is necessary, and American vaccine rates remain too low, it can’t stop the pandemic alone. 

Andy Slavitt, a former pandemic advisor to President Biden, recently said as much, noting that vaccination shouldn’t be “talked about as the only answer even if it’s an important one.” He added that skepticism for broader measures was partly due to “prior talk from many,” including himself, “that vaccines are a panacea.” He’s now advocating that we scale up antiviral medicine and at-home antigen test production, as well as “portable ventilators, ventilated spaces & high quality well-fitting masks,” all while we continue pursuing higher vaccination rates.

While Slavitt’s new focus remains perhaps too heavily product-based, it’s good to see someone in leadership admit the need to adapt as we learn more and circumstances evolve. The complex and serious nature of the COVID-19 pandemic requires this flexibility — even when altering course will profit no one.

In discussing the new variant, WHO Director General Dr. Tedros noted that it is spreading faster than any previous variant. His following statement needs to be heard and heeded by all of humanity: “I need to be very clear: vaccines alone will not get any country out of this crisis.”

Global Shortsightedness

Importantly, Slavitt also issued a call to “Start treating COVID as a global problem not a personal threat.” He’s right, but again: treating the pandemic as a global issue is difficult when the profit motive interferes.

Channeling Gordon Gekko, Boris Johnson claimed that vaccine development occurred in record time “because of capitalism, because of greed.” What he omitted was that the Oxford vaccine was 97 percent publicly funded. He also omitted the fact that Oxford’s researchers were planning to open source their vaccine, but Bill Gates — a de facto legislator by virtue of his wealth — wouldn’t have it. Gates donated $750 million to Oxford for vaccine research, while ‘suggesting’ they team up with a pharma firm. They complied, shutting down the possibility of an open-source vaccine.

Gates further derailed the WHO’s COVID-19 Technology Access Pool (C-TAP) with the COVAX effort that ensured private firms would maintain their intellectual property (IP). C-TAP would’ve created a WHO-managed IP pool for voluntary contributions to “a global knowledge fund for the duration of the pandemic.” In contrast, COVAX gives poorer countries access to subsidized vaccines for 20 percent of their population — robbing them of the chance to make their own vaccines and compensating them with a fraction of a half-measure.

The US government has responded similarly. Investments that might have created public goods instead led to massive private gains. A review of the government’s espoused funding approach for vaccine development and the case of Moderna is enlightening.

A recent Congressional Budget Office (CBO) report outlines the two primary ways the federal government supports vaccine development. Purchase contracts are the norm. They’re triggered when certain criteria are met — like measures of efficacy and safety — but the government may step in in cases where research and development (R&D) investment has a high risk and low expected financial reward, if there’s significant potential upside for society. 

While the CBO seems to suggest choosing one of these approaches, the US used both for COVID-19 vaccine development. It guaranteed the purchase of 100 million doses from Pfizer, while Moderna’s funding was made on the terms reserved for bad financial investments. 

But even though ordinary people subsidized the development of the Moderna vaccine, we received no IP in return. Moderna’s stock price jumped 12 percent on November 29 with the Omicron variant’s discovery, leaving its market cap near $150 billion. Despite its public funding, Moderna’s intellectual property and the ensuing profits remain in private hands, and its market cap has grown precipitously.

Additionally, Pfizer’s initial research suggests that Omicron has shifted its booster from beneficial to necessary, and Moderna is working on a booster that’s specific to the variant. Where will the related production for wealthy nations leave those who are still waiting for their first dose?

Moderna wasn’t alone in profiting from the discovery of the Omicron variant. After the news broke, eight pharmaceutical executives and investors became $10 billion richer. As long as we maintain the current profit-motivated intellectual property system, bad news for humanity will be good news for a handful of capitalists.

To stop the pandemic, we need an immediate major shift in our response. Wealthy nations have a responsibility to act decisively on behalf of humanity. We need to waive COVID-19 vaccine IP and compel firms to support the transfer of knowledge and tech necessary to maximize production globally. Alarm over Omicron’s potential danger has created space for a political demand to this effect, but it won’t last long. As long as we maintain the current profit-motivated intellectual property system, bad news for humanity will be good news for a handful of capitalists.

Winnie Byanyima, the former head of Oxfam and current leader of UNAIDS, called out the problematic nature of our current approach. “This idea that you can sell a life-saving health technology the way you sell a luxury handbag is not normal. We shouldn’t normalize it, we shouldn’t respect it and we should call it what it is: immoral, greedy and wrong.” She’s right about this and humanity’s suffering will continue to compound until we change our ways. (One estimate puts the African continent into 2024 before 70% of the people will be vaccinated.)

Fortunately, unions representing nurses from twenty-eight nations saw the moment and petitioned the WTO to deliver the TRIPS Waiver, which would distribute intellectual property rights and allow poor nations to finally vaccinate their citizens, putting an end to the constant churn of new variants. And Human Rights Watch has just published a list of over 100 firms that have the potential to make mRNA vaccines for COVID-19. 

We need more organizations to join the nurses’ union and the over 100 nations that support the proposal to put pressure on the few remaining WTO members that are holding out. (Notably, the EU — a supposed bastion of democracy — is one of those holdouts, while its member states just experienced their highest caseload in the pandemic.)

This problem can’t be solved by capitalism alone, and it can’t be solved within a nation’s borders.

Germany has the opportunity to change the game. With a new chancellor in place, the time is ripe. As Scholz put it, “We are united by our belief in progress and that politics can achieve something good.” Taking Germany over to the group of nations supporting IP waivers would make “something good” the understatement of the century. Humanity’s hopes rest on his shoulders. He must deliver.

We’re all at risk until transmission is stopped everywhere. If you lack the short-sightedness of an unrestrained capitalist, you know that diversifying our response beyond vaccines and waiving vaccine patents are both just and in your best interest. We have to seize this opportunity before it’s lost.

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