oris Johnson has attributed the UK’s vaccine success to “capitalism” and “greed”. Though these were crude remarks, if the prime minister’s words are any indication of his vision for how the UK can recover from the pandemic, there are worrying implications for the country’s policies at home and abroad. This is not the first time that Johnson has taken the wrong economic lessons from the Covid crisis. A few months ago he said in the same spirit that for “those on the left, who think everything can be funded by uncle sugar the taxpayer … there comes a moment when the state must stand back and let the private sector get on with it”. Nor is Johnson the first person to have viewed the vaccines as a private sector coup. It’s worth remembering that the “AstraZeneca” vaccine was created by scientists at the University of Oxford and developed and distributed by the pharmaceutical giant. Yet the private sector has emerged as the victor in the public celebration of Covid vaccines. In truth, an unprecedented amount of public funding has been poured into vaccine research, development and manufacturing. The leading six vaccine candidates have received an estimated $12bn (£8.7bn) of taxpayer and public money, including $1.7bn for the Oxford/AstraZeneca jab and $2.5bn for the Pfizer/BioNTech candidate. This level of investment represents a huge risk – but it’s not the only risk that the public sector has taken on. Governments have used “advanced market commitments” to guarantee that private companies that successfully produce a Covid-19 vaccine are amply rewarded with huge orders. Public funds spent on research and development are often more entrepreneurial – in the sense that governments are investing in the early, riskiest stages of health innovation, before any market is viable. This is part of the reason why companies were able to develop a Covid vaccine in record time. As a new report from the UK’s Industrial Strategy Council makes clear, the fast turnaround of Covid-19 vaccines would have been unthinkable without state involvement. Effective, “mission-oriented” government coordination – from industrial policy to investment in life sciences, strategic public procurement and public-private partnerships – has been key to the success story of Covid-19 vaccines. But there’s a major caveat to this narrative. Despite the government’s awareness of the UK’s strength in the life sciences sector, and its intention to boost it through two new sector deals, Britain’s capacity to manufacture sufficient doses is far from a given. Britain’s long-term failure to support its domestic manufacturing base is reflected in recent quarrels between the EU and UK over the supply of the Oxford/AstraZeneca jab. Prior to the crisis, the UK had been disinterested in investing in an onshore industrial base to mass-produce vaccines and other life science products. If ministers had floated a plan to invest in British vaccine factories prior to the coronavirus pandemic, they would have likely met with a less than enthusiastic reception. This is the benefit of hindsight. Yet hindsight also shows why a forward-looking, long-term industrial strategy that invests in productivity and economic growth, and at the same time targets broader challenges such as the climate crisis and future pandemics, is vital. Rather than seeing now as the moment to set out such a plan, Johnson is calling time on a sensible industrial strategy. The demise of the Industrial Strategy Council, recently announced, does not bode well for the uptake of its valuable insights. While the government has committed to doubling the UK’s public R&D expenditure to £22bn a year by 2024-25, it is proposing cuts to the budget of UK Research and Innovation (UKRI), with funding for international development projects halved. If this undermines the infrastructure that was pivotal to the UK’s vaccine success, as seems likely, then the government’s newly founded Advanced Research and Invention Agency (Aria) could risk becoming an expensive distraction. In the US, the Advanced Research Projects Agency (Arpa) model, from which Aria takes inspiration, has been a great success precisely because it’s located within a vibrant and decentralised research infrastructure backed by public investment in science, which the Biden administration is planning on boosting. That these cuts to UK research are taking place during a global pandemic sends a worrying message about Johnson’s priorities. When he talked about greed, he identified what is wrong about the system – not what merits praise. Alone, a vaccine won’t be enough to stop the coronavirus in its tracks, and the UK won’t be safe from Covid-19 until the majority of the world’s population has been vaccinated. It’s extremely difficult to see how greed will help ensure the vaccine is made available for all people, in all countries, free of charge. Addressing pharmaceutical companies’ monopoly over the science, know-how and technology, and sharing this with as many countries as possible, will be essential to scaling up and decentralising vaccine manufacturing across the world. The World Health Organization has established a voluntary Covid-19 technology access pool (C-Tap) to enable governments and companies to do just this. In addition, South Africa and India have tabled a proposal to the WHO, backed by more than 100 countries, to temporarily waive intellectual property rights for Covid-related technologies. A recent poll found that 74% of people in the UK are supportive of these positions. In response, the government has overlooked the C-Tap and blocked the temporary waiver on intellectual property. When greed is a government’s guiding philosophy, “vaccine apartheid” is all but guaranteed. Already, 56% of more than 455m doses of vaccine have gone to people in high-income countries and just 0.1% have been administered in the 29 lowest-income countries. Covax, which aims to vaccinate up to 27% of the population in 92 of the poorest countries, is unlikely to be enough on its own. Having done well with its own vaccine programme, the UK should now be on a strong footing to help deliver a People’s Vaccine for the world. The UK government’s pledge to donate surplus vaccines is a start, but this will be far from sufficient. What is needed is strong leadership and hope. Yet instead the prime minister appears to hold the anachronistic and counterproductive view that capitalism and greed are what will vaccinate the world and help rebuild it after the pandemic. Mariana Mazzucato is professor in the economics of innovation and public value at University College London, and the founding director of the UCL Institute for Innovation and Public Purpose (IIPP). Her latest book is Mission Economy: A Moonshot Guide to Changing Capitalism; Henry Lishi Li is research fellow in health innovation and policy engagement at IIPP
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