Take a leaf from World War II: beware the rise of the vaccine industrial complex

WHILE we are all applauding the roll-out of the various vaccines for Covid-19, it is time to take stock of well, stocks. The supply of the vaccine has been sparse - not just in Canada, but around the world. Stock prices for the few companies which have been able to rush through the emergency approvals for their respective vaccines have soared while the pandemic has killed millions, put hundreds of millions out of work, and reset all our lives.

Sixty years ago, just three days prior to stepping down after two terms as US President, Dwight D Eisenhower delivered his famous military-industrial complex speech, in which he warned the country of the insidious nature of relations between the US government and the suppliers of arms, munitions and other weapons systems. Like in the military industrial complex, there is the potential for a revolving door to develop between government and the pharmaceutical industry. Instead of Defence Department apparatchiks making their way to Raytheon, Halliburton and Boeing, it is appointees and senior staffers from the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institute of Health joining Big Pharma, the life sciences, genomics and other biotechnology companies.

Since the end of World War II, a strong military-industrial complex has ensured massive profits for weapons suppliers in government procurement programmes and prolonged armed conflicts around the world. Could the same be possible for the preventive medical solutions to the pandemic? After all, in order to maintain the current valuations that companies which make Covid-related vaccines and diagnostic tests enjoy, the pandemic will have to become perpetual.

With Covid-19 variants from the United Kingdom, South Africa and Brazil spreading rampantly, it is possible these vaccines will require regular updates from the pharmaceutical companies. So, like the seasonal flu, we will need yearly shots and/or boosters. Eventually, even children will have to be vaccinated to go to school - a veritable gravy train of revenues. As an example, insiders at Moderna have sold stock in the millions over the past year as the share price rose from a low of US$18 in February 2020 to a high of US$189 just last week - that is an increase in market capitalisation of over US$65 billion.

But this, however, is not solely a North American phenomenon. It is a global business as vaccine nationalism takes root in the national industrial policies being laid out by those countries leading vaccination research efforts.

It may come to pass that in order to travel in years to come, we may need a different array of vaccinations. To enter Russia, the authorities in Moscow could require that travellers have received the Sputnik V vaccine. To enter China, the Sinovac Biotech's offering could be mandatory. To enter the US, there may be a choice of solutions offered by a number of companies including Pfizer, Moderna, Johnson & Johnson, or AstraZeneca. The rest of the world may have to pick which standard they will accept in the battle of harmonisation.

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Vaccines save lives, and there is no intention here to dismiss or devalue the enormous global effort required to rapidly and safely produce a vaccine in months, when the process typically takes years.

However, the unintended consequences of creating a multi-billion dollar vaccine industry that did not exist just a year ago should not be ignored. In the previous US administration, worries emerged that politics was crowding out science.

There is a risk that science may take a back seat to economics: When faced with the potential of even greater financial rewards, randomised controlled trials and peer-reviewed studies may turn out to be afterthoughts.

To quote Mr Eisenhower at the end of his speech: "In the councils of government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist."

So will the share prices rise for those corporations that offer the general public vaccines to curb the Covid-19 pandemic. Beware the vaccine-industrial complex.

• Richard Weinstein, Jaspreet Rayat and Toby Chan are doctors and co-founders of EyeStart in Waterloo, Ontario, Canada. Dr Rayat and Dr Chan are assistant professors at McMaster University School of Medicine in Hamilton, Ontario. Professor James Cooper is Associate Dean, Experiential Learning at California Western School of Law in San Diego.