The Revolutionary Communist Group – for an anti-imperialist movement in Britain

Public-private partnerships: a foot in the door

NHS prescription drugs

The dominant criticism of the British state response to the coronavirus crisis has been that it is perpetually ‘too little, too late’, but when it came to development of a vaccine it was ahead of the game. The Jenner Institute at the University of Oxford reportedly began work on a vaccine for SARS-CoV-2 in mid-January 2020 as soon as the genetic information was published in China. That work would eventually result in the Oxford-AstraZeneca vaccine, a key plank of Britain’s rapid vaccination rollout, a scheme which stands in contrast to other programmes such as Test & Trace which cost billions for little tangible result.[1]

Just weeks before, on 18 October 2019, world-leading officials and administrators participated in Event 201, a pandemic preparedness exercise hosted in New York by the Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation, which is the world’s largest venture philanthropy fund and ‘one of the most influential forces in global public health and development policy’ according to the Financial Times. According to the event website, ‘The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences.’ The point of the exercise was to ensure that the state could rescue capitalism and avoid working class revolt in the face of a general economic crisis precipitated by a global public health crisis.

The Oxford-AstraZeneca vaccine is an example of just such a partnership. The Jenner Institute was established in 1995 as a partnership between British state public health institutions and the pharmaceutical giant GSK. As of 2015 it is entirely funded by the state, but retains close working relationships with GSK and other medical firms including the commercial arm of the university itself. To deliver at scale, the institute partnered with another pharmaceutical giant, AstraZeneca. As the vaccine is being sold at cost (for now), the firm does not directly profit from sales, but instead any state funds that contributed to its development have effectively been transferred to private hands by way of shareholder dividends and an increased market capitalisation. Prof Sarah Gilbert, who the BBC calls ‘the woman who designed the Oxford vaccine’ holds a stake in the vaccine now worth tens of millions of dollars.

Another example is the widespread adoption of mRNA-based vaccines such as the Moderna and Pfizer-BioNTech products. Moderna was founded in 2010 by a venture capitalist who aimed to commercialise mRNA vaccine production, which has been researched since the 1980s but never before used for the treatment of infectious disease. The technology has been used for highly-valued cancer treatment vaccines but Covid-19 was the perfect opportunity for the company to lobby for massive state investment into an infectious disease vaccine, usually a high-risk, low-return venture.[2] Moderna has received millions in US state aid since its founding including $1 billion during the pandemic, in which time its market capitalisation has grown by a factor of six to $63 billion despite it having yet to secure full-blown regulatory approval for a single vaccine or drug. The emergency-use authorisation of Moderna’s Covid-19 vaccine is a foot in the door that will lead to a lucrative public-private partnership to sustain revenues for years to come: it projects profits of $8 billion in 2021.

Looking at the programme and attendees of Event 201, there is no indication that expensive measures like PPE stockpiling and free quarantine facilities were discussed. Of the 15 attendees, only a few were representatives of state public health institutions. Most attendees were bankers or businesspeople of one stripe or another, with interlocking interests in global finance, health policy, communications, and pharmaceuticals. The US state was represented by Avril Haines, a former CIA chief who is now President Biden’s Director of National Intelligence. The business aim is clear: to make a market for pharmaceutical products during a pandemic, both by convincing states that such products are alone a ‘silver bullet’ against costly disease which require immediate and massive investment, and by convincing the working class that their health can only be protected by a consumer good handed down by a benevolent capitalist state.

Of course, although under capitalism vaccine production will only proceed if profits are expected, vaccines do have an inherent usefulness for disease prevention. Socialist Cuba has a well-established biotechnology industry which allows for coronavirus vaccines to be produced domestically and in the interests of the working class. The nation does not need to approach private pharmaceutical corporations, allowing it to retain its sovereignty in the face of increasing US-led hostility, all while keeping its people healthy. But in Britain, ‘public’ health policy and development is effectively directed by the private interests of profit-seeking ‘Big Pharma’. This may go some way to explaining why the pandemic death toll has been so high, and the wider economic impact so severe, in comparison with countries where a more holistic approach to the pandemic was taken.

Philosopher of science Jacob Stengena argues that the field of medicine – meaning everything from disease classification, to drug development, to clinical practice – is structured by the profit incentive. This causes all sorts of harmful distortions, exaggerations and blind spots in public health. ‘The current coronavirus pandemic,’ he says, ‘has displayed how little we know about some very basic but immensely important questions, such as the transmission dynamics of viruses, the influence of masks on mitigating disease transmission, and the kinds of social policies that can effectively flatten epidemic curves. But there is little industry profit to be made pursuing these research programmes.’[3]

This criticism applies to the supposedly neutral science that has led the British state response to the coronavirus crisis. The ruling class was very prepared to profit from the pandemic. If only it had been just as prepared to develop treatments, to expand capacity, and to pay the working class for time spent in quarantine.

Adam Grey


[1] Coronavirus: putting private profit before public health, FRFI 278, Oct/Nov 2020

[2] For more on the types of drugs that are profitable see Big Pharma’s drive for profits threatens ‘antibiotics apocalypse’, FRFI 261, Dec 2017/Jan 2018

[3] Aeon: “Gentle medicine could radically transform medical practice”

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