September/October 2021Vol. XXXIV No. 1

Praise the Vaccines, Producers, and Public Funding

Robert Berwick, Jonathan A. King, Robert P. Redwine

Though the death toll in the U.S. from Covid-19 has passed 700,000, the rapid and intense mobilization of vaccine producers is saving hundreds of thousands of other lives. Kudos to the staffs of Moderna, Pfizer, and Johnson & Johnson in the U.S., and other vaccine producers in Europe, Russia, China, India, and Cuba. All of the successful efforts built upon the prior public investment in biomedical research: not only the basic technology for constructing the new mRNA vaccines, but also the existence of the Protein Data Bank, making the structures of the coronavirus proteins publicly available to all, and nucleic acid databases such as GenBank, providing nucleic acid sequences. In short, almost all the fundamental technologies and almost all the datasets in those resources came from individual laboratories and investigators, supported by federal programs funded by taxpayers. And of course, the decision of the U.S. government to publicly fund the costs of the vaccines accelerated entry of the biopharma industry into the effort.

However, it is clear that the deeply  inadequate early response to the pandemic outbreak represented the failure of those programs in the period after the reports of the MERS viruses and the SARS viruses.

U.S. programs, which should have been beefed up, were in fact cut back. The White House Pandemic Office, opened to respond to such threats, was disbanded under the previous administration. MERS and SARS research priorities were downgraded. Had efforts to develop SARS and MERS vaccines proceeded vigorously, the ability to respond to the coronavirus would have been greatly enhanced.

During that period, the National Institutes of Health (NIH) budget was about  3.7% of the Congressional discretionary budget. By way of comparison, the Pentagon budget in that period was more than 50% of the discretionary budget – more than half of our income tax dollars. The Trump administration stated publicly that they were limiting budgets of agencies like the NIH in order to increase the Defense budget.

When the dimensions of the pandemic became clear, Congress passed the CARES Act, which directed about $1 billion to the NIH, $4.5 billion to the Centers for Disease Control (CDC) and Prevention, and $3.5 billion to the Biomedical Advanced Research and Development Authority for vaccine development. The Trump administration’s Project Warp Speed was also an attempt to respond to these needs, but was more a giant Band-Aid, than a major reorientation of national investment priorities and investment in the basic public health and biomedical research infrastructure to protect the world from current and future threats. The investments listed above represent merely a few cents on the dollar of the fiscal costs of the Covid-19 pandemic. Hopefully the beefing up of the President’s science advisory team being spearheaded by Eric Lander, will lead to sounder priorities.

Though the biopharma industry rose to the occasion once the government guaranteed their profits, their prior history was less laudable. Despite the effectiveness of vaccines, a recent report described the very  limited investment of the biopharma industry in vaccine development. With an effective vaccine, only a few doses are needed per individual, compared to the case of blockbuster pharmaceuticals that have to be taken daily, generating billion-dollar markets. In addition, poor populations in need, such as in Africa, cannot afford the high prices charged for drugs. Preventive vaccines, if effective, further reduce the markets for the biopharma companies, as the infection they are addressing is contained.

From this history it is clear that robust public funds remain the foundation of a robust and humane public health and prevention policy in the period to come.

The sharpest conflicts have emerged in the efforts to provide U.S. vaccines to other countries. Though the World Health Organization (WHO) and world leaders have continuously called for the sharing of vaccine technology, Moderna and Pfizer, protecting their patents, have resisted. Given that Project Warp Speed provided $2.5 billion to Moderna, and the dependence of the vaccine developments on prior NIH-funded technology, the withholding of the vaccine technology has been sharply criticized by representatives of the international community (NYTimes, 23 September). President Biden, in his address to the United Nations, stated, “We should unite around the world on a few principles; that we commit to donating, not selling – donating, not selling – doses to low and lower-income countries, and that donations come with no strings attached.”

Capturing Pandemic Teaching Experiences

The past year was almost certainly one of the most difficult for faculty, students, staff, and administration in the Post-Depression/Post WWII period, but though dispersed across the globe, we pulled together to pull through. The coming on-campus semester looks to be somewhat better, but still laced with the stresses of the continuing pandemic. Whatever further cooperation and collaboration can be developed within the campus community will aid in navigating the troubled waters ahead. The Faculty Newsletter welcomes any contributions from faculty reflecting on their experiences to date, or with recommendations for the coming period. Please email all submissions to: Good luck to all.