The European debate on how to handle the pandemic could use a dose of honesty. The past weeks we have witnessed a reviving “vaccine-nationalism”, with EU-member states purchasing jabs wherever they can and the EU discussing to stop exports at it’s borders. We see a failing European vaccination-strategy and a complete self-defeating lack of solidarity with the global south. Two issues that connect all these dots, are the root causes of the painful failure we all observe: a lack of transparency and a unhealthy power grab of EU-policies by Big Pharma.
The secretive meeting of DG Sante Director-General Sandra Gallina with a pharmaceutical lobby-group as recently exposed by Domani is unfortunately not an isolated incident. At least since last September, many members of the European parliament and civil society actors have been calling for more transparency. In vain. Even if both Director-General Gallina and her boss EC-president Ursula Von der Leyen have been publicly stating that transparency is indeed “essential”, nothing has happened. Unless one would call the contracts with lot’s of essential information redacted a form of transparency.
One of the last blatant examples of this fake-commitment to transparency is the fact that Galina has promised a few months ago to the EP-committees of budget and budget control the breakdown numbers of which sums (of a total of around 3 billion euro) has been paid to which pharmaceutical companies and for what (R&D, production, more capacity)? Although these parliamentary committees are supposed to control the way tax payers money is being spent, they have still not received these figures. Here is the trick: the top-level of the European Commission always agrees that transparency is important, but then do the opposite.
Recently von der Leyen has said she was fed up with all the criticisms pointed to her institution. Of course also some member states share responsibility in some of the mess, but she should realize one thing: transparency is not some favour her institution does to members of parliament or public health activists. Genuine transparency around EU vaccine purchase talks would have been a powerful tool to get the EU-policies right. It would have enabled public debate & parliamentary scrutiny, revealed weaknesses in EU approach before it was too late to correct them and strengthened the hand of EU negotiators vis-a-vis Big Pharma.
This lobby power of big Pharma is no fantasy nor conspiracy theory.
For some years we at Corporate Europe Observatory have been exposing the lobby power of the pharmaceutical sector on EU policy making. In 2019 our report ‘High Prices, poor Access’ exposed how and why the pharmaceutical industry is one of the world’s most profitable, benefiting from a highly problematic model, which helps ensure many people still lack access to essential, life-saving medicines.
While this has been a major issue in the global South for decades, the crisis engulfing affordable medicines also started to spread in Europe. The emergence of extremely expensive medicines – with price tags in the tens and hundreds of thousands of euros, vastly disproportionate to the cost of developing and producing them – owes much to industry-friendly tailor-made regulation and intellectual property (IP) rules. We asked for transparency as a tool for the new European Parliament and European Commission to ensure that medicines policy is protected from the undue influence of Big Pharma.
Narrow commercial interests should not undermine public health priorities.It was clear then that the EU institutions should work towards Europe-wide cooperation for robust and independent assessments of new drugs, stop promoting expanded IP provisions through trade deals, and support discussions around better ways to finance medicines research, ensuring a public interest return on public investment.
In the name of innovation
That last point is still quite relevant. But unfortunately the current crisis shows lessons were not learned. Our report ‘More private than public’ from May 2020 showed that billions of tax payer’s money have been spent on the Innovative Medicines Initiative (IMI, which ran between 2008-2020), a large-scale public-private partnership between the European Commission and pharmaceutical trade association and lobby group EFPIA (European Federation of Pharmaceutical Industries and Associations).
EFPIA , basically in the driving seat, steered a €2.6 billion research budget through IMI, but failed to meaningfully invest in research areas where public funding is urgently needed, including long-term preparedness for epidemics (!), HIV/AIDS, and poverty-related and neglected tropical diseases.
While its stated aim is to drive innovation in pharmaceutical research and improve health, IMI was been criticised as embodying a model by which the public sector foots a large part of the bill for research, while the private sector is able to set the research agenda in its own interests, and reap the rewards. IMI will now run again as from this year under the EU’s Research programme ‘Horizon Europe’ (2021-2027).
In September last year we revealed in ‘Power and profit during a pandemic’ how Big Pharma industry lobbying was putting profit before an effective pandemic response. The investigation uncovered dozens of documents via Freedom of Information (FOI) requests,
showing how Big Pharma, despite lofty PR statements about their commitment to tackling the pandemic, had been lobbying intensively to protect its problematic, profit-maximising business-model.
A model partly based on public money with no strings attached and excessive monopoly patent rules. Big Pharma, for instance, lobbied against the joint procurement of treatments, a tool intended to prevent excessive prices. Pharma lobbyists also pushed arguments based on fear and scarcity to win lucrative advance purchase agreements (APAs) for potential new vaccines.
So should we really be surprised that Europe is currently in a mess concerning the vaccine strategy? The point is this: our fight for more transparency is not some sort of democratic gadget; It is a prerequisite for good governance, as it is essential to build public trust in the vaccines strategy.
What went wrong in the EU’s vaccine negotiations with Big Pharma: the EU appears to have simply bought vaccines and failed to negotiate strong public interest conditions, not in the least for the global South. Others have described the EU’s negotiating strategy as a “softball approach”, meaning we’re now rely on the goodwill of the companies.
The EU actually had a very strong negotiating position, negotiating jointly on behalf of 27 countries, with massive budgets for funding research and development and preparing manufacturing capacity. This in a context of an unprecedented pandemic in which companies had made pledges to put global health before profits.
It seems the negotiators failed to use the strong negotiating position that they had. The secrecy around the negotiations is another aspect of this: pro-active transparency would have helped further strengthen the EU’s hand, but the Commission chose for the exact opposite approach. As Yannis Natsis from the European Public Health Alliance (EPHA) recently said: «Secrecy was convenient for both pharma and the European Commission. Transparency sacrificed to serve top priority of contracts’ speedy conclusion, without too many questions asked…until the AstraZeneca fiasco».
Transparency around the negotiations would have enabled properly informed public debate and parliamentary scrutiny. The weaknesses in the EU negotiating approach would have become evident before it was too late to correct them. For instance the current disastrous scarcity is there because the EU recklessly relied on small number of pharma giants to develop sufficient manufacturing capacity, that mistake could have been spotted early on and a better approach could have started six months earlier.
And most pharmaceutical companies have benefited from large amounts of public money invested in R&D and spent on procurement, with little or no accountability and conditions to ensure access. Pfizer and Moderna, for example, this year expect profits from vaccines to be between $15 billion and $30 billion.
This is why since September 2020 we are having a freedom-of-information battle with the European Commission, a battle for disclosure of the vaccine deal contracts and for key documents related to the negotiations with Big Pharma, hence our two FOI requests. The Commission’s handling these requests systematically violated the legal rules on freedom of information law and we have never experienced anything as bad as this.
After a complaint we filed against the European Commission, the European Ombudsman opened an inquiry and gave the Commission a deadline which it failed to meet. Recently the Commission, acknowledged the «strong need for transparency» in the vaccine negotiations and stated that it is committed to «ensure as much transparency as possible». This reflects the AstraZeneca debacle in January, when the Commission decided it could no longer keep the contracts secret.
We now wait for hundreds of documents which will be fully or partially disclosed, but without any concrete deadline. Why? Well, the Commission is still «consulting with third parties». Given what we have seen so far, we assume that those are pharmaceutical companies. It shows once more who is control here, and it’s not the European Commission.
Transparency from the start would have strengthened the hand of EU negotiators vis-a-vis Big Pharma, as public opinion would without doubt have supported attempts to force Big Pharma to – in return for the generous public funding – agree on making the vaccines a global public good.
All of this of course assumes that making the vaccines a global public good (as promised by Commission-president Ursula Von der Leyen) was actually a policy goal in the negotiations with Big Pharma. Or just an empty promise on the political scene? Perhaps that’s the question that we are most eager to find the answer to.
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“Fin dalla sua nascita Domani ha cercato di riempire un vuoto: in Italia il dibattito pubblico è dominato da quarant’anni dalle stesse facce e dalle stesse opinioni. Per questo abbiamo cercato di trovare e dare risalto a prospettive, voci e idee più giovani e fresche. Soprattutto nelle pagine della cultura abbiamo dato fiducia a scrittori e scrittrici, artisti di ogni genere, per esporvi ed esporci a punti di vista spiazzanti, originali, per farci magari divertire, talvolta arrabbiare, sempre pensare. Se pensi che questo lavoro sia importante, aiutaci a farlo crescere con un abbonamento annuale. Così sarai parte della comunità di Domani.”Stefano Feltri