Why Embedding Health Equity & Accelerating Collaboration by Pharma Should be Core to a Pandemic Response
By Lauren Compere, Managing Director
Boston Common Asset Management
It is unprecedented that in less than a year we have progressed from clinical trials to viable COVID-19 vaccines and therapeutics from the likes of Pfizer, Moderna, Gilead, and others. This would not have been possible without accelerated innovation, industry and multi-lateral partnerships, government funding, and collaboration with the WHO, the Gates Foundation, Gavi[1], and others. Now, we must examine what is possible and assess the unintended consequences this fast track has had on health inequities and a potential further divide between those that get access to vaccines and therapeutics vs. those that do not (Less Developed Countries — “LDCs” — and some Emerging Markets).
While LDCs and Emerging Markets have access to vaccines through groups like Gavi, the timeline for access and distribution is still in question. The WHO & Gavi are among those working with the Gates Foundation to secure one billion doses for 92 of the poorest countries with a billion more for middle- and high-income countries. However, these amounts will reach less than 20% of each country’s population and funding to support these efforts has been insufficient. Primary among the various reasons for this:
· Developed countries have entered into bilateral agreements (which are confidential in most cases) with pharmaceutical companies to secure millions of vaccine doses
· Need for increased support of local manufacturing and distribution in places like Africa, Latin America and Southeast Asia
· Lack of availability of heat stable vaccines and therapeutics — a significant issue impacting available supply for LDCs and other emerging markets.
Boston Common Asset Management has been part of a coordinated campaign by ICCR[2] to engage the global pharmaceutical sector for the past nine months on enhanced action around access and accelerated development of COVID-19 vaccines and therapeutics. For nearly two decades, we have engaged pharmaceutical companies on access strategies with a focus on LDCs, tiered pricing strategies for Middle-Income-Countries, healthcare infrastructure investment, and collaboration and partnership with knowledge-share and technical transfer among generic producers to accelerate access and distribution for regions like Africa, Latin America and Asia. This includes participation in IP platforms, as well as issuing voluntary licenses for products, especially those focused on addressing pandemics, HIV-AIDS, TB, Malaria and now COVID-19. In order to accelerate industry collaboration, Boston Common has helped coordinate roundtables on issues like pricing strategies and the use of the Medicine Patent Pool to develop coordinated ways to share IP for essential medicines with ICCR.
Boston Common has had long term engagements with GlaxoSmithKline, Novartis, and Roche along with US pharma, Biogen, Gilead, Merck, Regeneron, and, previously, Bristol Meyers Squibb and Johnson & Johnson. In the past five years we have escalated our engagement, filing shareholder proposals with all of our US pharmaceutical holdings requesting transparency on US drug pricing strategies. In 2020, we led dialogues with GlaxoSmithKline and Novartis. For the 2021 proxy season, we have filed shareholder proposals with Gilead, Merck, and Regeneron on their promotion of access strategies during the pandemic, including equitable access for low-income and communities of color.
There remains a need for even further collaboration, knowledge-share and technology transfer, as well as a relaxing of, or alternative means to share IP, perhaps creating a different model for pandemic vaccines and treatments. For example, GlaxoSmithKline has committed short-term profits related to COVID-19 to be reinvested in further vaccine development. GSK is part of two global access pledges including the Gates Foundation and The Trinity Challenge — a coalition focused on protecting the world against health emergencies using data-driven research and analytics built on three pillars: Inclusivity, Collaboration and Innovation. We asked GSK to be explicit about how they are carrying out these commitments.
As an active member of the Access to COVID-19 Tools (ACT) Accelerator, GSK is aiming to bring expertise in the discovery and development of medicines and vaccines, as well as experience building manufacturing capacity and distribution networks to this partnership. In their collaboration with Sanofi in developing an adjuvanted COVID-19 vaccine, GSK plans to provide a significant portion of worldwide available supply capacity in 2021/22 to COVAX, the vaccine pillar of the ACT Accelerator.
The ICCR Call to Action for global pharma is not only focused on core access and pricing strategies, but on broader expectations around paying a fair tax and responsible lobbying practices. A cornerstone of our outreach to companies like GSK and Novartis was a focus on transparency, ensuring investors and stakeholders understand how they are managing public resources. U.S. Congress recently proposed the TRACK Bill, which would require companies to disclose financial and non-financial federal support they have received in a public database; voluntary disclosure thus enables responsible pharmaceutical companies to get ahead of regulatory risk.
As investors, we support the innovation, accelerated partnership, and collaboration coming out of this crisis and advocate for this best practice to become standard. Still, pharmaceutical companies need to embed health equity and access into new business models, continue to support partnership and collaboration, and promote transparency and accountability. This includes equitable pricing models reflecting public investment, participation in IP-share platforms, and support of local manufacturing and distribution by generic producers through knowledge share and technology transfer.
We encourage the global pharmaceutical sector to take this opportunity to reenvision a responsible business model that supports the development of resilient and inclusive economies. With the eyes of the world on their industry, pharmaceutical companies have an opportunity to re-establish trust with the public and all stakeholders. A commitment to transparency is a critical step forward. We hope with the Biden administration re-joining the WHO and the reversal of vaccine nationalism promoted by Donald Trump, the US will be seen as a global leader in promoting health equity and access.
[1] The Vaccine Alliance: a public–private global health partnership with the goal of increasing access to immunization in poor countries
[2] The Interfaith Center on Corporate Responsibility
