The current consensus by scientists and public health experts is that the only way to end the coronavirus' devastating effects on America's citizens and its economy is to develop, produce at scale and widely distribute an effective vaccine against COVID-19 as quickly as possible.
There are, of course, myriad scientific challenges inherent to that imperative, among them the virus' potential mutability, our lack of knowledge about whether antibodies provide protection against reinfection (and, if so, for how long), and the time it takes to discover an effective vaccine, test it, receive regulatory approval and begin commercial production.
But there is one more problem we've rarely had to consider: By pharmaceutical companies’ own estimates, no company has anywhere near the production capacity needed to meet the demand, once those effective vaccines (or treatments) have been found.
The number of vaccine producers has been dwindling for years, because vaccines do not offer the kinds of profits that pharmaceutical companies think they deserve. And, despite their very public proclamations of support for vaccine research at moments like these, companies often pull out of such efforts before a fully viable product can be produced because of a lack of market incentives.
For instance, a number of companies reported losing money on Ebola or SARS vaccine development programs. In recent years, GSK made, then later abandoned, its commitments to Ebola vaccine development; Sanofi did much the same with Zika; and Novartis got rid of its whole vaccine development unit in 2014.
There is, then, but one viable solution: We should nationalize what remains of the American vaccine industry now, thereby assuring that any coronavirus vaccines produced can be made as widely available and as inexpensive soon as possible.
If that sounds like a drastic (or even un-American) solution, nothing could be further from the truth. We should recall that nationalizations in times of emergency in the United States are common. The tradition includes the telephone system during World War I; the thousands of coal mines, railroads, and manufacturers during World War II; gold and silver during the New Deal era; and even the savings and loan industry in the 1980s.
Furthermore, the U.S. has specific experience with critical public sector mobilizations — through public-private partnerships that specified that the private actors could not profit off the work — of vaccine development, production and distribution, including our highly successful vaccine program during World War II, one of several wartime programs that developed and improved 10 vaccines in a short period of time.
In another example, at the turn of the 20th century, the New York City Public Health Department played a pivotal role in developing the testing and immunization for diphtheria, which had reached epidemic levels and caused thousands of deaths in the city. It offered free immunization to the poor to stem the tide of the crisis.
Additionally, a legal analysis shows that nationalizing the vaccine industry could be accomplished for next to nothing, given the industry’s substantial reliance on government funding and licensing.
Furthermore, there are three major roadblocks to the development and widespread distribution of a COVID-19 vaccine that could be resolved if the sector were nationalized.
First, instead of allowing firms to compete with one another for monopoly rights to manufacture a future COVID-19 vaccine, thereby squandering limited financial and scientific resources to ensure future potential profits, the whole sector could immediately be put to work, collaboratively, in the public interest, both developing and producing the vaccines we need.
As recent history has already definitively shown, vaccine development is a textbook case of a public good that the free market simply cannot efficiently provide — and, when it comes to a coronavirus vaccine in the United States, that failure is already beginning to play out again. As a recent New York Times article noted in regards to a promising vaccine collaboration coming out of the United Kingdom: “The team has not yet reached an agreement with a North American manufacturer, in part because the major pharmaceutical companies there typically demand exclusive worldwide rights before investing in a potential medicine.”
Second, any vaccine developed in the public sector could be licensed through a global pool or developed and marketed without patents altogether, eliminating the monopoly rights pharmaceutical manufacturers enjoy in the United States. Providing one manufacturer exclusive rights to a COVID-19 vaccine could be devastating for millions worldwide, as it would take any one supplier many years to meet demand. In the meantime, entire swaths of the globe would be unable to afford sufficient vaccine supplies from for-profit manufacturers — even if they sold those supplies at cost.
But eliminating monopoly rights would ensure that every vaccine developed with public funds would be available to all at a reasonable cost, ensuring the timely and equitable access necessary for coherent public health interventions — especially with COVID-19, when time is so clearly of the essence.
Finally, rather than waiting to build production facilities from scratch after a proven vaccine is developed, nationalizing vaccine development would allow us to scale up the existing infrastructure of the American vaccine industry by pooling the existing resources of organizations that would not normally cooperate at all. Only nationalization would allow for the sort of high-level coordination required to meet the challenge of a pandemic like COVID-19, leveraging the full capacity of the sector to meet the most pressing public health needs, rather than shareholders’ desires for quick returns.
Taking the few remaining vaccine producers into public ownership could also hasten the transition to a full public option in pharmaceuticals — which we badly need in the long term to ensure public health-oriented innovation and long-term access to medicines in the U.S. and beyond.
But in the short term, it is clear that only a robust, nationalized program of vaccine development and production can meet the challenge of rapidly inoculating our population against a threat like COVID-19.