Pharmaceutical chief executives leading efforts to tackle coronavirus have warned governments to step up co-ordination and provide substantial upfront funding if treatments, vaccines and testing are to be rolled out faster and fairly.
David Loew, executive vice-president of Sanofi Pasteur, the vaccine producer, said a swift commitment totalling “billions” of dollars was needed from governments to underwrite purchases of the most promising experimental vaccines even before final proof they work.
“If industry does not know if there will be a market in 18 months, [it] cannot carry all [the costs]. Industry alone can’t provide all the investment needed now for billions of doses,” he said in an interview.
Executives fear that without greater funding and scientific guidance on how to allocate supplies fairly, they will be unable to purchase sufficient raw materials, support production of existing medicines, and rapidly scale up their capacity to meet global demand.
Particular concern over poorer countries’ access to medical supplies was highlighted by G20 health ministers’ failure at the weekend to issue a declaration of solidarity after this was blocked by the US.
Seth Berkley, head of Gavi, the multilaterally-backed vaccines fund, said: “This is a global issue. We need an agreement on global access and manufacturing at risk [of uncertainty over the results] to purchase very large quantities at low prices for distribution in low-income countries.”
Mr Loew said an international group of scientists should recommend how to allocate products to where they are most needed depending on the spread of infection — otherwise everyone will suffer. “There needs to be worldwide solidarity. If there isn’t, [the pandemic] will affect certain regions harder than others and lead to migration.”
His comments came as the British government pledged to create a vaccine task force to support projects in the UK, and as the pharmaceutical industry pushed for greater EU support, citing the model of Barda, the US Biomedical Advanced Research and Development Authority, which is funding pandemic research.
The non-profit Coalition for Epidemic Preparedness Innovations has so far raised $765m towards its target of $2bn for research and development for a coronavirus vaccine. Yet far less has been earmarked for manufacturing, and little beyond reinforcing domestic capacity in a few countries.
Mr Loew’s remarks reflect broader concerns by pharmaceutical executives, who worry that coronavirus may follow the pattern of previous infectious disease outbreaks, notably Ebola and the 2009 flu pandemic. When immediate crises ended, companies struggled to maintain the development of potential drugs and vaccines for future outbreaks after governments cut funding.
“The investment required is too large for any company,” said Christophe Weber, chief executive of Takeda, the Japanese drugs and vaccines company. “Society will have to finance this huge investment. My fear is the same as after the flu pandemic, when everybody loses interest.”
While medicine producers face less significant costs to scale up production, Yusuf Hamied, head of Cipla, the Indian generic drugs company, warned that governments also need to support manufacturers by underwriting large-scale purchases of existing medicines such as hydroxychloroquine that could prove useful in tackling coronavirus.
“We can’t take all the brunt of the costs ourselves,” he said. He cited a recent increase in prices for Chinese-supplied ingredients for hydroxychloroquine, and echoed Mr Weber’s worries about a repeat of the 2009 flu scenario: he was, he says, forced to write off $53m in raw materials after the pandemic when demand plummeted for oseltamivir, the antiviral he was producing.
While manufacturing is picking up again in China, which supplies much of the world’s raw materials for medicines, Mr Hamied predicted that India would be “the weak link”, with significant production at risk because of illness.
David Ricks, chief executive of Eli Lilly and current president of the International Federation of Pharmaceutical Manufacturers and Associations, the industry body, reiterated the call for government support and insisted that fears of profiteering were misplaced.
“People should not be taking advantage. I agree 100 per cent,” he said. “That would be an unethical position in this time of need. But investors give us capital and expect a return.”
While praising US and European regulators for their efforts to work with industry to tackle the pandemic, he called for additional flexibility in streamlining approvals, including mutual recognition between agencies of each other’s decisions.
Mr Ricks said Asian regulators sometimes imposed delays because they required additional tests to be conducted in their own populations in order to reflect genetic differences. “That may not be feasible in this case except in China,” he added.
In order to avoid disrupting supply chains for other life-saving medicines, he suggested regulators might need to relax rules that slow the process of switching approved manufacturing lines from one product to another.
Other industry executives called for fairer mechanisms to decide how best to allocate limited supplies of their products. Severin Schwan, chief executive of Switzerland’s Roche, said he was regularly receiving competing requests for supplies from hospitals, mayors and regional politicians within the same country.
He called on each nation to nominate a central co-ordinating point to ensure the most equitable distribution and to reduce unnecessary stockpiles in some places that created shortages elsewhere.
The pharmaceutical industry is also concerned that some governments — including the US, India, Poland and Israel — have sought to prioritise their own access by restricting exports. “It’s important for borders to remain open,” Mr Schwan said.
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