Pfizer has had an exceptionally good pandemic. Today it announced that its Covid-19 vaccine brought in $37bn billion last year, making it easily the most lucrative medicine in any given year in history. That isn’t all. For a company that was until recently the least trusted company in the least trusted industrial sector in the United States, Covid-19 has been a PR coup. Pfizer has become a household name over the last 12 months. The company was toasted on nights out in Tel Aviv, and there are cocktails named after its vaccine in bars across the world. The US president referred to Pfizer’s chief executive, Albert Bourla, as a “good friend”, and the great man parked his jet next to Boris Johnson’s at last year’s G7 summit in Cornwall. The global vaccine rollout has created levels of inequality so great that many call it a ‘vaccine apartheid’. Pharmaceutical corporations like Pfizer have led this rollout, setting the terms by which they sell vaccines and deciding who to prioritise. Ultimately, their approach affects who does, and does not, receive vaccines. Right from the start, Pfizer was clear that it wanted to make a lot of money from Covid. The company claims that its vaccine costs just under £5 per dose to produce. Others have suggested it could be much cheaper. Either way, the company is selling doses at a huge profit – the UK government paid £18 a shot for its first order, £22 for its most recent purchase. That means the NHS has paid a mark-up of at least £2bn – six times the cost of the pay rise the government agreed to give nurses last year. It has been claimed that the company initially tried to pitch their medicine to the US government for an eye-popping $100 a dose. Tom Frieden, a former director of the US Centers for Disease Control and Prevention, accused the firm of “war profiteering”. Pfizer has sold the vast majority of its doses to the richest countries in the world – a strategy sure to keep its profits high. If you look at its global distribution, Pfizer sells a tiny proportion of its vaccines to low-income countries. By last October, Pfizer had sold a measly 1.3% of its supply to Covax, the international body set up to try to ensure fairer access to vaccines. Pfizer wasn’t selling many doses to poorer countries, but neither would it allow them to produce the life-saving vaccine on their own, through licensing or patent sharing. That’s because, at the root of the Pfizer model, are a set of intellectual property rules, laid down in trade deals. These effectively allow big pharma corporations to operate as monopolies, with no responsibility to share the knowledge they own, however much society needs it. Early on, the World Health Organization (WHO) recognised that we would need to scale up production very rapidly – and that individual corporations like Pfizer simply wouldn’t have the necessary capacity. They urged companies to share vaccine recipes, creating a sort of “patent pool” known as CTAP, which would have allowed openness and collaboration. Companies would still have been paid, but they wouldn’t be able to restrict production. This sort of suspension of normal business rules during times of great need was previously common, such as with penicillin during the second world war, or sharing smallpox vaccine knowledge in the 1960s. But in this case, Pfizer’s chief went on the offensive, deriding CTAP as “nonsense” – and saying it was “dangerous” to share companies’ intellectual property. It has been claimed that 100 factories and laboratories around the world could have been making vaccines, but have been unable to do so because they cannot access patents and recipes like those held by Pfizer. Pfizer took a similar line on the new facility that has been set up in South Africa to try to get to grips with mRNA vaccines so that it can share this revolutionary medical technology with the world. Because neither Pfizer nor Moderna will share their knowhow, the scientists have had to start from scratch. News last week suggests that they’re getting there, confounding the pharmaceutical industry’s claims that you couldn’t possibly make such a vaccine in poorer countries. There are many who will argue that while large pharma companies do behave ruthlessly, we must accept it because the service they provide – inventing lifesaving medicines – is so crucial. But this doesn’t hold. Companies like Pfizer behave more like hedge funds, buying up and controlling other firms and intellectual property, rather than traditional medical research companies. The truth is, they aren’t the sole inventors of the vaccine. That was the work of public money, university research and a much smaller company, Germany’s BioNTech. As one former US government official complained, the fact we call it the “Pfizer” vaccine is “the biggest marketing coup in the history of American pharmaceuticals”. A Stat news analysis in 2018 concluded that Pfizer developed only a fraction – about 23% – of its drugs in-house. And a US Government Accountability Office report the previous year noted that the industry model is increasingly to simply buy up smaller firms that have already developed products. This allows them to monopolise that knowledge, and maximise the price of the resulting medicines. Pfizer has channeled $70bn (£52bn) to its shareholders , directly through dividend payments, and through stock-buybacks. This dwarfs its research budget for the same period. To put today’s figures in context, the world’s most lucrative drug in any single year up to this point was Humira, which treats autoimmune diseases, and which generated its owner, AbbVie, $20bn in 2018. Humira was studied by a US congressional committee, and is a classic case of how big pharma companies work today: buy up a drug that’s already been invented, patent it to the hilt, and increase the price 470% over its lifetime. Corporations like Pfizer should never have been put in charge of a global vaccination rollout, because it was inevitable they would make life-and-death decisions based on what’s in the short-term interest of their shareholders. We need to dismantle the monopolies that have handed these financialised beasts such power, and instead invest in a new network of research institutes and medical factories around the world that can actually serve the public. Nick Dearden is director of Global Justice Now