As the number of confirmed COVID-19 cases worldwide approaches 4 million and the pandemic could be with us for months or years, we look at who can access drugs like remdesivir, being developed by pharmaceutical giant Gilead, which has the patent for the drug and is poised to make massive profits. We look at how much drugs like remdesivir will cost, and who can access them, with writer Achal Prabhala, coordinator of the AccessIBSA project, which campaigns for access to medicines in India, Brazil, and South Africa.
AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, with Nermeen Shaikh. As the global death toll from COVID-19 tops more than 265,000, and confirmed cases worldwide approach 4 million — though it’s clear they’re much higher — the head of the World Health Organization has urged the world to unite to defeat the disease.
TEDROS ADHANOM GHEBREYESUS: But just as the number of new cases and deaths is declining in some countries, it’s mounting in others. … This virus will be with us for a long time, and we must come together to develop and share the tools to defeat it.
AMY GOODMAN: This comes as new clinical trials by the National Institutes of Health of the experimental antiviral drug remdesivir show it reduced hospitalization stays for people infected by the coronavirus from something like 15 to 11 days, compared to a placebo treatment, but did not significantly improve survival.
Meanwhile, the Food and Drug Administration granted authorization Friday to pharmaceutical giant Gilead Sciences for emergency use of remdesivir to treat patients with COVID-19, paving the way for broader use. President Trump announced the news from the Oval Office, joined by Gilead’s chief executive, Daniel O’Day. This is O’Day.
DANIEL O’DAY: We want to make sure nothing gets in the way of these patients getting the medicine, so we made a decision to donate about 1.5 million vials of remdesivir.
AMY GOODMAN: Gilead’s donation is expected to be enough to treat at least 140,000 patients, depending on the number of days they need to be treated. A draft government report projects COVID-19 cases will surge to about 200,000 per day by June 1st.
Gilead started developing remdesivir in 2010 as a potential Ebola treatment and has patent exclusivity for the next 15 years. Analysts say the company’s total revenue from the drug could top $11 billion if it’s a successful treatment for COVID-19. In March, Gilead sought an orphan drug designation from the FDA for remdesivir, a class given to treatments for rare diseases, but rescinded its request after public outcry. It recently spent a company record of $2.45 million in the first quarter to lobby Congress and the White House. Some members of Congress are now asking how much consumers will pay for the drug.
For more on how much drugs like remdesivir will cost and who gets access to them, we’re joined by Achal Prabhala, coordinator of the AccessIBSA project, which campaigns for access to medicines in India, Brazil, and South Africa, wrote a piece with Nobel Prize-winning economist Joseph Stiglitz on “Patents vs. the Pandemic.” And his recent piece for The Guardian is headlined “We’ll find a treatment for coronavirus — but drug companies will decide who gets it.” He’s joining us from Bangalore, India.
Welcome to Democracy Now! So, if you could fully explain, using the case study of remdesivir, who profits, who gets access, and how important is this drug?
ACHAL PRABHALA: Thank you very much, Amy. The situation with remdesivir is very, very interesting, because it’s the first treatment to have been approved by the FDA for use against COVID-19. I think everyone agrees that it’s not a miracle treatment. The medical consensus is that it’s a great first treatment. It’s by no means the last. And we’ll see more coming out as clinical trials conclude.
Remdesivir is owned by Gilead. And I was stunned to hear Daniel O’Day, the CEO, repeat, on your show, that he will do his best to make Gilead available to everyone around the world and that he had donated a large number of treatments to the United States, because Gilead’s track record in delivering access to medicines, not just in the United States, but elsewhere, has been horrible.
The Trump administration is actually, coincidentally, suing Gilead for the unauthorized use of U.S. government patents from the CDC that are used in a drug that Gilead calls Truvada. Truvada is PrEP. It’s what many sexually active gay men can take as a preventive measure against HIV and AIDS. The drug costs $25 a month to take in India. And the price in the United States is $1,800, which obviously acts as a deterrent to buying that drug, and therefore constitutes a public health hazard.
Their track record in Brazil has been equally abysmal. They brought to market in 2013 a drug called sofosbuvir — they call it Sovaldi — which is the first-ever treatment designed against hepatitis C, which is a debilitating and fatal disease that affects many people in middle-income countries, like Brazil and the former Soviet Union. But six years after they introduced it, in 2019, the cost of the drug, it was $84,000 a year, which meant that the Brazilian government simply couldn’t afford to buy enough of it. It meant that 14% of all Brazilians who needed that drug, in what was a well-funded public health system, could get it, while the rest and many died on the way, while the Brazilian government battled Gilead for more access to this excellent cure for hepatitis C.
So, Gilead’s track record is highly suspect. And the fact is that patents and monopolies that pharmaceutical companies own have been hobbling the lives of people in developing countries and poor countries for at least three decades. It’s only in the last four or five years that there’s been a visible impact that these pharmaceutical monopolies have had in richer countries, especially those without a universal healthcare system, like the United States. And I’m glad that there is more and more action on this issue now in countries where much of the lobbying and much of the marketing and much of the stock market value of these companies are based, because that indicates that perhaps there will finally be some action on reining in these pharmaceutical monopolies, both by societies as well as the states that actually allow these monopolies to exist.
NERMEEN SHAIKH: Achal, you talked about Gilead’s record with both hepatitis C medicine, as well as HIV/AIDS, but one of them — it’s not just Gilead, of course, that has these patents and overprices the drugs, life-saving drugs. I mean, one of the most stunning examples is, of course, as you know, pneumonia, for which a vaccine has long existed, over which Pfizer Pharmaceuticals holds the patent, and still 100,000 children below the age of 5 die every year in India alone from pneumonia. So could you talk about the steps that the international community, multilateral organizations like the WHO, have taken to limit the power of pharmaceutical companies in having these patents and setting these exorbitant drug prices, that have such lethal consequences around the world, but especially in the developing world?
ACHAL PRABHALA: I’ll start with the last part of your question, which is what steps have states taken, historically, to rein in these drug prices. The answer is, very little. What steps have the U.N. organizations, like the WHO, taken? A little more. They could do a lot more.
The truth is that a lot of us hold out hope for when this pandemic will end, thinking that it’ll end when treatments and vaccines emerge, when a cure emerges. But my experience and our experience in poorer parts of the world, we know bitterly that, in fact, the fight begins once a treatment or a vaccine emerges.
The distance between Washington, D.C., and Johannesburg is about 8,000 miles. It took eight years, between 1996 and 2004, for AIDS drugs — AIDS drugs which turned a death sentence into a chronic condition — to travel that distance, which takes 16 hours by plane, while millions died simply because of monopoly prices that had to be dismantled and reined in.
The PCV vaccine that you bring up is a very, very interesting, and tragic example of the ways in which vaccines fail. It is the monopoly property of Pfizer. The newest version of the vaccine is PCV13. Pfizer calls it Prevnar in the United States. Funnily enough, it’s Pfizer’s single biggest revenue-earning product. Over the last five years, it’s brought in $5 billion in revenue every single year, which is a funny thing because Pfizer is a company that we associate with drugs like Lipitor and Viagra, but, in fact, it’s a vaccine, and it’s a vaccine against pneumonia, that is the single biggest revenue generator for this giant pharmaceutical company. Pfizer sells the vaccine at about $850 a course in the United States. They offer it through GAVI, which is the vaccine initiative, at a subsidized price to the Indian government at $10 a course. The problem is that $10 a course represents the highest price that the Indian government pays for any vaccine. It’s 20 to 30 times more expensive than any other vaccines that they procure. And as a result, the government can only afford to buy enough to treat a very small proportion of the children who need it. And as a result, tragically, there are over 100,000 deaths recorded, infant deaths, from pneumonia, which is a perfectly preventable condition. It’s been preventable since the 1980s, but it still continues. So, in fact, the journey from New York to Delhi, which is also 8,000 miles, which should take 16 hours, is actually infinite. We haven’t even made that journey as yet.
And this is instructive for COVID-19, because of any treatments and vaccines that come out of the billions of dollars that have been thrown at pharmaceutical companies, something like 75% of all money that has been pledged by rich country governments, the EU and the U.S., has gone to private corporations. Not a single dollar or euro of that money comes with any stipulations for access.
So you have people like the Gilead CEO saying nice things about access and saying, “Trust us,” which is difficult to do, given his record and his company’s record, and you have leaders of the EU saying, again, somewhat meaningless platitudes around access and making sure that poor people in developing countries will be able to access the drugs and the vaccines. But we know from history that that’s just not true.
Unfortunately, there is a very easy way to guarantee access, which is to simply strip all monopolies of any product that is created for the detection or treatment of COVID-19, but none of the agreements that the governments have signed with pharmaceutical companies — which, again, run into the billions of dollars — mention anything about patents or monopolies or access. And that should be very worrying to us.
AMY GOODMAN: Achal, I mean, there is a precedent for this: Jonas Salk and the polio vaccine, right? I mean, he famously said, when asked by Edward Murrow, “Who owns the patents?” he said, “[The people], I would say. There is no patent. Could you patent the sun?” And what a difference the polio vaccine meant for so many. Could you end by talking about AccessIBSA, your group — India, Brazil, South Africa — what this means, what you’re fighting for? And do you think you can win?
ACHAL PRABHALA: Look, I’m so happy you brought up Jonas Salk, because Jonas Salk is not just responsible for the creation of the polio vaccine, which of course changed the course of humanity. He was also responsible for the first flu vaccine, which came out of similar mid-20th century efforts in the United States, which were very publicly oriented. They were funded publicly, sometimes by actual citizens mailing in checks, and definitely by governments, who at that time, during the World War II and during the World Wars, were most keen on protecting their soldiers who were out on the battlefront.
The original flu vaccine, by the way, which billions of us have taken over many decades, is a publicly funded effort, which didn’t have any intellectual property protection, and has been run since the 1970s out of a wonderful network at the WHO in Geneva, which releases two recommendations annually that set out what strains of the flu virus should go in. It’s a collaborative effort. A hundred and ten countries, governments collaborate. And anyone then can manufacture the vaccine based on their formula.
The U.N. just set out, in one of its many complicatedly worded resolutions, that they intend every treatment —
AMY GOODMAN: We have 10 seconds.
ACHAL PRABHALA: — and vaccine for COVID-19 to get to everyone, everywhere. That can only happen if the vaccines and treatments can be manufactured by everyone, everywhere.
AMY GOODMAN: Achal Prabhala, we want to thank you so much for being with us, coordinator of the AccessIBSA project, authored a piece with Nobel Prize-winning economist Joseph Stiglitz on “Patents vs. the Pandemic,” which we will link to, as well as your Guardian story, “We’ll find a treatment for coronavirus — but drug companies will decide who gets it.”
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