By Dan McLaughlin
Thursday, December 03, 2020
Assuming that the COVID-19 vaccines work, their
development will be the biggest, most high-profile public-health success story
since the polio vaccine in the 1950s. A weary world has waited many trying
months for this. Yet in the media’s coverage, there are a lot of mixed messages
about how this happened — because the story is not one that fits comfortably
with liberal narratives. Consider the big, splashy New York Times story
by six reporters (Sharon LaFraniere, Katie Thomas, Noah Weiland, David Gelles,
Sheryl Gay Stolberg, and Denise Grady) on the Pfizer/BioNTech and Moderna
vaccines, and the Stat story
by Damian Garde and Jonathan Saltzman on the technology behind them. When you
dig into the details, the heroes are largely (1) big American pharmaceutical
corporations, (2) the Trump administration, and (3) the U.S. military. The
lessons to be drawn support the conservative view of government, business, and
their proper roles and relationships.
The tension is obvious early in the Times story,
when it announces its intended theme: “In an era of polarized politics, science
was able to break down barriers between government, countries and industry to
produce one of the few pieces of good news in a year of suffering and
division.” This is not supported by the facts. “Science” did not produce a
vaccine, in the sense of a Jonas Salk figure having a “eureka!” moment in a
laboratory some time in 2020. The Times does not bother introducing us
to any of the individual researchers who actually developed the vaccine. Nor
does it illustrate the breaking of barriers between countries, except by big
business. The facts are more stubborn.
In fact, as the Stat story illustrates, the core
concept of making messenger RNA (or mRNA) synthetically and using it to produce
vaccines has been kicking around for three decades, and the crucial
breakthrough came in 2005. While there were still some daunting scientific
hurdles to overcome, the broader problem facing synthetic mRNA was its risky,
experimental nature; only a change in the economics and available resources
would make it economically viable to invest in scaling up a major trial of an
mRNA-based vaccine to see if it would work.
When Moderna — a small but lavishly capitalized American
pharmaceutical company dedicated to synthetic mRNA solutions — set to the task
of developing a COVID-19 vaccine upon receiving the genetic code of the virus
from China in mid January, the company’s researchers “plugged that data into
its computers and came up with the design for an mRNA vaccine. The entire
process took two days.”
Two days. Moderna had hundreds of vials of its
vaccine shipped to the National Institute of Allergy and Infectious Diseases in
Bethesda, Maryland by February 24. Everything that has happened since — 1.4
million deaths worldwide, crippling lockdowns — has gone on while we were
waiting for that vaccine to be tested, approved, and distributed.
Why did two American companies — out of all those in the
race — take the global lead? Mind you, there are more American companies
involved too: The list of
companies pursuing other vaccines includes American companies Novavax, Inovio
Pharmaceuticals, Johnson & Johnson, Arcturus Therapeutics (which has
partnered with a Chinese manufacturer), Merck (which purchased an Austrian
company as well as a Maryland company and recently sold its stake in Moderna),
and Translate Bio (which is working with French drugmaker Sanofi). It was not
purely a matter of Yankee ingenuity: BioNTech is based in Germany — the woman
who runs its research team is from Hungary, and it is run by a husband-and-wife
team of Turkish-Germans — and Pfizer’s CEO is from Greece.
Three factors came together to push the Moderna and
BioNTech research teams to the front of the line. First was American
capitalism. The United States had the private-sector capacity ready to go for
this modern Manhattan Project for the same reason it was able to turn the Ford,
General Motors, and Chrysler assembly lines to tank production in 1942: our
dynamic free-market capitalist economy and, yes, its tolerance for massive
for-profit pharmaceutical businesses. Pfizer financed the bulk of the estimated
$2 billion research-and-development cost of its partnership with BioNTech out
of its own prodigious balance sheet, which brings in $52 billion in revenue a
year (although BioNTech also received
$445 million from the German government). Moderna raised over two billion
dollars in capital in eight years before going public in 2018; by late 2019,
its market capitalization was twice that of its German counterpart, BioNTech.
Pfizer’s CEO was quite blunt about turning down American government funding to
avoid the strings attached when private companies do business with the
government. This is how it should be: American business should do it on its
own, when it can.
Both Pfizer and Moderna plan to make a profit from the
vaccine — and that incentive has surely helped focus their efforts. So has the
boom in both companies’ stock prices. Johnson & Johnson has announced its
intent to distribute its planned vaccine at cost, but then, J&J is (unlike
Pfizer and Moderna) a colossal consumer-products company that has many other
ways to profit from the goodwill it generates by doing so. Pfizer is also
handling its own distribution, while Moderna and other vaccine companies plan
to use a distribution network arranged by the government.
We are endlessly told that America should be more like
the rest of the world in the health-care sector, and that we could cut drug
costs in particular by cracking down on Big Pharma’s profits. But now, once
again, the rest of the world is getting a free ride on the dynamism of
America’s health-care sector, which even for all of its government red tape is
still one of the freest in the world. American free-market capitalism will save
lives, as it has done so many times before, when nobody else could.
One way that Pfizer and Moderna plan to profit is by
selling the vaccine to the government. The federal government has contracted
with Pfizer to pay $1.95
billion for 100 million doses of the vaccine, with an option for another
500 million doses. (Moderna has its own $2.48 billion deal with the federal
government for 100 million doses.) Pfizer also has a deal
to sell 300 million doses to the EU, but for half the per-dose price
paid by Uncle Sam. Does that mean Americans are getting ripped off? No. We paid
for priority
in receiving the vaccine. And laying out that kind of taxpayer money to
guarantee Pfizer a market gave the company a further financial incentive to
develop the vaccine. But it remains true that the rest of the world depends on
the relative freedom of our system. The socialized-medicine markets of the EU
would face a more difficult health-care landscape if the American marketplace
didn’t effectively subsidize the development of so many life-saving
medications. If America adopted the European model, who would take our place as
the engine of innovation?
American money can be found all over this story.
BioNTech’s business was already benefiting from a $55 million philanthropic
grant from the Bill & Melinda Gates Foundation for work in other areas, and
we all know where Bill Gates’s money came from. Even the European companies
pursuing vaccines list their stock on U.S. stock markets. American investors
can purchase GlaxoSmithKline stock on the New York Stock Exchange, and Astra
Zeneca, Sanofi, and CureVac stock on NASDAQ.
The vaccine story is not only an American private-sector
success story, however. A second hero can be found in the most unfashionable of
places: the Trump administration and its Operation Warp Speed initiative. For
all the public wrangling between the Trump White House and the “deep state” of
the federal bureaucracy, Operation Warp Speed would never have happened if the
president had not thrown the weight of elected leadership behind
recommendations by permanent civil servants. As the Times tells it,
Donald Trump not only supported the effort, but pushed it — not least for
reasons of political self-interest — to move faster:
Operation Warp Speed was the
brainchild of Dr. Peter Marks, the top vaccine regulator for the Food and Drug
Administration. A collaboration between the Pentagon and the Department of
Health and Human Services, it was devised to support pharmaceutical and
biotechnology companies with the full breadth of the government’s expertise
from clinical trials to logistics. The goal for a vaccine was October,
according to an early memo. The president was especially enthusiastic about
that aim. At a March 2 White House meeting, as Mr. Bancel and other
pharmaceutical executives outlined their vaccine plans, Dr. Fauci cautioned
that it would be a “year to a year and a half” before doses could reach the
broader public. Mr. Trump replied, “I like the sound of a couple of months
better.”
While Pfizer did not take Operation Warp Speed’s money,
Moderna did. That financed Moderna’s research and development at taxpayer
expense and paid for it expanding its workforce by 50 percent. Government help
was not just money, and not just available to companies who took the money:
“Operation Warp Speed had created six teams of around 15 clinical trial
specialists, epidemiologists and budget experts, each assigned to a different
vaccine maker.” And heaven and earth were moved to shove aside any obstacle:
When Moderna discovered this summer
that an air handling unit for its factory could not be delivered over a weekend
because of Covid-19 limitations on interstate trucking, the major’s team
stepped in. Warp Speed officials arranged a law enforcement escort to accompany
the massive piece of equipment from the Midwest to its Massachusetts
manufacturing plant. The team again sprang into action when Moderna discovered
that a specialized pump, needed to make the first batches of vaccine for the
clinical trials, was marooned in a rail car and was not going to be delivered
on time. Federal workers tracked down the train and rummaged through it until
they found the pump.
Then, there’s the military. Liberals and progressives
like to see the government adopt a “moral equivalent of war,” but they also
prefer to see it administered by bureaucrats, scientific “experts,” and
schoolmarms. But who do you call when you need logistics expertise, iron
discipline, and a willingness to bulldoze everything in your way to reach an
objective? You call the military. The people running the daily business of
Operation Warp Speed were a former Moderna board member and a four-star general
with a logistics background. From the Times report, you can almost smell
the fresh buzzcuts:
Moderna’s team was headed by a
Defense Department official whom company executives described only as “the
major,” saying they don’t know if his name is supposed to be a secret. . . .
The operation, working out of a seventh-floor suite and a second-floor
operations center at the Health and Human Services headquarters, had a military
flavor. Its leaders discussed the book “Freedom’s Forge,” an account of how
American industry armed the military in World War II, and imposed what they
called a “battle rhythm” of meetings, including a daily 8 a.m. session on
vaccines. Dozens of military officers reported to work in uniform.
This is how government is supposed to work. It’s
supposed to be there for emergencies, rather than have a permanent, ongoing
presence. The private sector is the reservoir of money and creativity;
government drains it in need when the land is parched. The government exists to
marshal resources in a crisis; it can never do so as efficiently as private
business, but it can do so at a larger scale than any business. Government is
wasteful, but when cost is no object, time is of the essence, and it is
animated by an urgent, defined goal, its sheer driving force can exceed that of
the private sector. We can afford to act as if cost is no object at times; we
cannot afford to act that way all of the time, or we will find the reservoir
empty when we need it most. This is how the military or NASA works: Give me a
goal, and I will move the world. It is not how a perpetual health-care
bureaucracy could ever function.
Of course, the American system is not perfect, but its
flaws were not the product of too much conservatism. Moderna’s testing was
slowed for a critical juncture by demands to include more racial minorities in
the trials. For all of Operation Warp Speed’s reductions in regulatory barriers
(the FDA has never approved a vaccine in less than four years from its
development), the U.K. will likely get the vaccine first
because of a more lenient
approval process that requires less redundant review of drug-company testing
(the EU’s chief regulator has criticized
the U.K. for haste, but new,
impending post-Brexit rules will allow the U.K. to ignore such EU
complaints). Fears of having the vaccines politicized surely contributed to a
few weeks’ delay of their announcement until after the election, too, but
Republicans were not the ones threatening
to conduct
a scorched-earth
campaign
against the credibility
of a vaccine if it were publicized before the election.
The pandemic has been good news, in some ways, for
liberal and progressive narratives about the need for collective action on
health care. But when it comes to ending the crisis, those narratives need to
take a back seat to the institutions and capabilities that actually got the job
done.
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