Fintan O’Toole: Ireland has tested positive for political cowardice

We used to imagine that as Ireland got richer, it would also become more generous. What happened last week in relation to the supply of Covid vaccines to poorer countries suggests that we’ve actually got a lot meaner.

At the beginning of this century, less developed countries were struggling to deal with the Aids crisis. New antiretroviral drugs were making HIV infection treatable, but they were far too expensive for health systems in low and middle income countries.

Back then, Ireland was one of the western countries that spoke up to say that allowing people to die merely to protect the profits of western pharmaceutical companies was intolerable. We helped to push through changes to World Trade Organisation (WTO) rules that allowed, for example, an Indian generics manufacturer to sell antiretrovirals for less than $1 a day.

It has been obvious from the start of the Covid-19 pandemic that something similar would have to be done – and done quickly – for the vaccines that control it. Basic justice (the valuing equally of all human lives) and naked self-interest (“no one is safe until everyone is safe”) made this both morally and medically imperative.

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The Government, against the evident wishes of its own people, has shamelessly sided with the pharma giants

These vaccines were all developed with public money. Moderna, for example, got $10 billion from the US taxpayer to develop and test its vaccine.

It is telling, indeed, that it was originally referred to as the “NIH-Moderna Covid-19 vaccine” – NIH standing for the public agency, the National Institute of Health, that jointly developed it.

But it then became merely the Moderna vaccine, occluding the public contribution to its development and making it into one of the most lucrative pieces of private intellectual property the world has ever seen.

Moderna sold the vaccine back to governments with a 66 per cent profit mark-up. While a generic version would cost $3 a dose, Moderna sells it internationally at an average of $21.

Pfizer, meanwhile, made a profit of $9.1 billion in 2020 – pretty good by any standards. But in 2021, its profits more than doubled to $21 billion, thanks to sales of $37 billion worth of its Covid vaccine, which was developed with funding from the European Investment Bank and the German government.

Western governments allowed this great money grab to happen because they made an implicit bargain with the big pharma companies: give us first dibs on the vaccines and we’ll turn a blind eye to your spectacular profiteering.

But enough, surely, is enough. The pharma giants have had, not just their pound of flesh, but an arm and two legs.

We know from Ireland’s stance on HIV drugs 20 years ago what our moral and political instinct on all of this would be: generic manufacturers in low and middle income countries should be given not just the formulas for the vaccines but, crucially, the know-how, the diagnostics and the therapeutics.

The key to unlock this was getting the WTO to waive its rules under what’s called the Trade-Related Aspects of Intellectual Property Rights (Trips) agreement. This waiver was formally proposed by South Africa and India, with the support of a hundred other countries, in October 2020.

This is what every medical body in Ireland wants. It’s what every Irish-based and international aid organisation has called for. It’s what both the European Parliament and the Joint Oireachtas Committee on Foreign Affairs and Defence demanded over a year ago.

Is this the price we pay for the great benefits the pharma companies have brought to Ireland?

Ireland has some clout in all of this. We are one of the most important European bases for the pharma industry. We have a seat on the United Nations Security Council, won largely on the promise to stand up for the interests of the world’s most vulnerable people.

And yet, the Government, against the evident wishes of its own people, has shamelessly sided with the pharma giants. Ireland, and in particular our Tánaiste and Minister for Enterprise, Leo Varadkar, refused to support a Trips waiver.

We helped the rich world to drag its feet, so that it took 20 months, in the midst of a deadly pandemic, for the WTO to reach a decision last week.

And Ireland helped to ensure that this decision would be morally wretched. The WTO came up with a spineless compromise: it agreed to a temporary waiver of patents but did nothing to transfer know-how and, unbelievably, postponed a decision on tests and treatments for another six months.

Varadkar welcomed this abject failure of political and ethical nerve as “a positive outcome”. Which it is – in the sense that Ireland has tested positive for moral cowardice.

Is this the price we pay for the great benefits the pharma companies have brought to Ireland? Three of the top 10 payers of corporation tax in Ireland are pharma giants. Two of them – Pfizer and Johnson & Johnson – have Covid vaccines on the global market.

It is hard to explain Ireland’s refusal to do what we know to be right for the world – and for our own ultimate safety in this pandemic – without acknowledging that we have entered into an unwritten Faustian pact. We don’t frighten the gift horses.

If this is indeed the way Ireland now operates in the world, we should at least be honest about it. If we’ve sold our soul, let’s be clear about the price.