Time is up for Big Pharma's grip on global health

Two years ago, many of us were waiting for our first Covid booster shot. We were the lucky ones. Around the world, many countries had not even been able to offer a first vaccine to their frontline health workers. We were living through an inequality in vaccine access so great that it became known as vaccine apartheid’. At the heart of the problem was Big Pharma – the giant, profit-driven corporations which take ownership over many of our medicines.  

These corporations – which include Pfizer, Johnson & Johnson and Moderna – used enormous amounts of taxpayer support to get the vaccines that bear their names ready. But then they privatised the know-how behind these vital medicines and refused to share it with the many countries that could have joined the global manufacturing effort. The result? They controlled who got vaccines and who didn’t, while making profits to the tune of $1,000 every second. 

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Vaccine inequality during the pandemic was just the most high-profile example of a problem that has been going on for years. Take tuberculosis – the world’s most deadly infectious disease, which affects 10 million people every year and killed 1.6 million in 2021 alone, mostly in the global south. A recent, searing investigation found that UK pharma giant GSK has deliberately slowed the development of a new TB vaccine over the last few years. The reason? They didn’t stand to profit enough. It’s a glaring example of how this industry repeatedly places profits over lives – with very real consequences for people around the world. 

But there are signs things are changing.   

Another TB treatment, known as bedaquiline, is made by the US company Johnson & Johnson. The company has sold the medicine for years, but their exorbitant prices have placed it out of reach for people in many affected countries. So there was excitement this year when its patents – the legal ownership which grants J&J the right to stop others from making, using or selling the drug without permission for 20 years – were due to expire in countries like India, well-known for producing cheap generic medicines for the global south. 

But then Johnson & Johnson did what so many corporations do – it made small changes to the medicine so it could apply for ‘new’  patents and extend its ownership over it. This tactic of ‘evergreening’ is one that pharma companies have used repeatedly to prolong their profits, even when millions of people stand to suffer. But campaigners  in India fought back, preventing the new patents being recognised, and they won – meaning India can now produce the drug for at least half the original cost.

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That wasn’t the only victory. In July, J&J were forced to announce they would not enforce their patents on the drug in 44 low-income countries, allowing generic versions to be distributed in numerous countries with a high burden of TB. And in September, South Africa’s Competition Commission launched an investigation into the pricing of bedaquiline in the country, on the basis that it had reasonable suspicion of exploitative or unethical behaviour. If it succeeds in finding evergreening to be unlawful, a global precedent would be set. 

South Africa is also home to the World Health Organisation’s recently opened ‘mRNA technology transfer hub’, a response to the inequality of the Covid pandemic. After Moderna and Pfizer refused to share the know-how to allow poorer countries to create vaccines, the hub was set up to create its own safe and effective vaccines using publicly available information and share the technology with others across the world. It’s a blow against the legitimacy of the current profiteering pharmaceutical model – showing a new way is possible that places health above profit.  

A third step forward took place  earlier this month in Colombia. For years, patients have had to pay $100
a month for the crucial HIV medicine, dolutegravir, sold by pharmaceutical company ViiV. Now the Colombian government has announced that it will break ViiV’s monopoly on the drug, which they calculate will mean 28 people could receive it for the same cost as one person does currently. Colombia’s action, in line with international law, can give other countries the confidence to put the healthcare of their people ahead of corporate profits.  

These fights are the latest examples of what I explored in my recent book, Pharmanomics – that what Big Pharma is running, more than medical production, more than drug invention, is monopolies. These monopolies are a vehicle not to save lives, but to make vast profits. Yet these interrelated successes show that things can and are changing. With political will and public pressure, pharma monopolies can be broken. Across the world momentum is building – a new health system is within our reach. 

Nick Dearden is director of Global Justice Now.

His book, Pharmanomics: How Big Pharma Destroys Global Health (Verso, £18.99), is out now. You can buy it from The Big Issue shop on Bookshop.org, which helps to support The Big Issue and independent bookshops.

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