Opinion: Pfizer and Moderna’s mRNA vaccines are our best chance to end this pandemic. Break up their duopoly.
Opinion by Tom FriedenToday at 9:00 a.m. EDT
Tom Frieden, a physician, is president and chief executive of Resolve to Save Lives, an initiative of the global public health organization Vital Strategies, and former director of the Centers for Disease Control and Prevention (2009-2017).
Drug companies claim they are on track to produce a glut of coronavirus vaccines globally by 2022. Don’t believe them. Failure to ramp up production now could cost lives and prolong the pandemic. The best way to avoid that is to break up the duopoly that Moderna and Pfizer maintain over mRNA vaccines.
There are about 7.1 billion people over age 5 in the world; vaccinating 80 percent with a two-vaccine series would require more than 11 billion doses. More than 6.5 billion doses have been delivered. Simple math suggests that “only” another 4.5 billion or so doses are needed, and, with a billion doses produced per month, this need will be met by early next year.
This is wrong for at least five reasons. First, people who received less-effective vaccines or vaccines whose protection wanes, especially against variants, will need booster shots. About half of the more than 6.5 billion doses already given globally have been relatively less effective Sinopharm and Sinovac vaccines from China. This may increase the need for effective vaccines by 3 billion to 6 billion doses or more in 2022 alone.
Second, as uncontrolled spread continues, new variants could emerge that partially or completely evade vaccines. This could require more boosters or re-vaccination — potentially another 11 billion doses.
Third, manufacturers have consistently missed their production targets. The analytics company Airfinity reports that other than Chinese firms, which have generally met the targets they announced, vaccine manufacturers missed their 2020 targets by 96 percent and are missing their 2021 targets by about half.
Fourth, production of the mRNA vaccines is lagging. These vaccines are, at present, our most powerful tool to end the pandemic. They’re easier to tweak for variants, quicker to produce and less likely to suffer production delays than other vaccines.
Moderna and Pfizer produced 347 million doses in August. At this rate, it would take them nearly three years to produce 11 billion doses, and by then, additional boosters or tweaked vaccines may well be needed.
Finally, vaccines continue to be sold to countries based on ability to pay, not need. With nearly 1 billion doses distributed between them, Pfizer and Moderna have both delivered a minuscule percentage of their doses to low-income countries. Of the more than 6.5 billion doses administered globally, fewer than 4 percent have gone to people in low-income countries. Not only is this morally indefensible, it assures the pandemic will be needlessly extended and that millions more may die.
It’s certainly possible that the Chinese vaccines, as well as those from Johnson & Johnson, Novavax, AstraZeneca and others, will be produced in sufficient quantities and provide robust protection against current and future variants. It’s also possible that new vaccine-resistant variants won’t emerge. But these are high-stakes — and unnecessary — gambles. Building capacity to produce more mRNA vaccines faster is our insurance against both production delays and variants.
Both Moderna and Pfizer deserve credit for responding quickly, testing their vaccines in large clinical trials with tens of thousands of participants and providing data for regulatory approval. But the plain truth, whatever they claim, is that despite their progress increasing production, they cannot produce the quantity of vaccine needed in time. The only responsible way forward is for them to transfer their vaccine technology to other companies that can rapidly increase production.
A three-pronged approach could step up production. First, increase production of the Moderna vaccine by the pharmaceutical company Lonza, which already has some production capacity in at least 10 countries, including the United States. Second, establish an additional U.S. production hub, potentially at a site with a pharmaceutical production track record in an area that needs an economic boost. Third, create a new hub in another country, such as South Korea, to quickly manufacture billions of doses. Other hubs in other regions of the world could be developed subsequently.
Moderna claims it will take 12 to 18 months to transfer its technology. This is false. It took about six months to get the Lonza facilities producing vaccines and should take less time now.
Taxpayers supported these vaccines at almost every step of development. Taxpayer money also bought and distributed millions of doses. In exchange, the public has every right to expect companies to behave responsibly. Since they haven’t, the federal government must use all its tools, including legal action, to get them to transfer this urgently needed technology.
Technology transfer isn’t charity. Intellectual property can be protected, the companies can be appropriately indemnified, and they can receive royalties of billions of dollars for vaccines produced under their license. They could even have their existing markets protected. But they must stop hiding the quality and production details that other companies need to scale up production.
This could be a win-win. By transferring this technology, the world will be safer, millions of lives will be saved, and both companies will get more revenue. If they fail to do so, Pfizer, Moderna and the U.S. government will be responsible for the consequences.
Top 1% of U.S. Earners Now Hold More Wealth Than All of the Middle Class
By Alexandre Tanzi and Mike DorningOctober 8, 2021, 10:07 AM MDT
After years of declines, America’s middle class now holds a smaller share of U.S. wealth than the top 1%.
The middle 60% of U.S. households by income — a measure economists often use as a definition of the middle class — saw their combined assets drop to 26.6% of national wealth as of June, the lowest in Federal Reserve data going back three decades. For the first time, the super rich had a bigger share, at 27%.
The data offer a window into the slow-motion erosion in the financial security of mid-tier earners that has fueled voters’ discontent in recent years. That continued through the Covid-19 pandemic, despite trillions of dollars in government relief.
Rise of the Super Rich
Middle-class Americans now hold less wealth than the top 1% by incomehttps://www.bloomberg.com/toaster/v2/charts/509d828450aa4933bfda0eb365f9d6e6.html?brand=wealth&webTheme=wealth&web=true&hideTitles=true
Source: Federal ReserveWealth for You
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While “middle class” has different meanings to different people, many economists use income to define the group. The 77.5 million families in the middle 60% make about $27,000 to $141,000 annually, based on Census Bureau data.
Their share in three main categories of assets — real estate, equities and private businesses — slumped in one generation. That made their lives more precarious, with fewer financial reserves to fall back on when they lose their jobs.
The top 1% represents about 1.3 million households who roughly make more than $500,000 a year — out of a total of almost 130 million. The concentration of wealth in the hands of a fraction of the population is at the core of some of the country’s major political battles.
President Joe Biden is seeking to bolster working- and middle-class families with a $3.5 trillion package before Congress that includes assistance with child care, education and health care paid for with tax increases on high-income individuals.
“If the economic system isn’t working for the clear majority of the population, it will eventually lose political support,” Nathan Sheets, newly appointed chief economist at Citigroup Inc., said by email. “This observation is motivating many of the economic reforms that the Biden Administration is putting forward.”
Over the past 30 years, 10 percentage points of American wealth has shifted to the top 20% of earners, who now hold 70% of the total, Fed data show.
Financially squeezed workers helped drive support for former President Donald Trump and the populist turn in the Republican party.
Shrinkage
The middle class has seen declining shares of U.S. wealth in key areashttps://www.bloomberg.com/toaster/v2/charts/4f31b86341f24241bec6681f6cd5fe85.html?brand=wealth&webTheme=wealth&web=true&hideTitles=true
Source: Federal Reserve
Note: Middle 60% by income
A generation ago, the middle class held more than 44% of real estate assets in the country. Now it’s down to 38%.
The pandemic generated a boom in housing values that has benefited most those who owned real estate in the first place. It also led to soaring rents this year, which hurt those who can’t afford a house. The self-feeding loop created more wealth for the wealthier.
Another reason why the middle class’s wealth is eroding is because these families hold an outsized and growing portion of non-mortgage consumer debt, which typically comes with higher interest rates.
An oil company is funneling millions of dollars to local police to undermine the rights of protesters, many of them from Native American tribes and environmental groups. bit.ly/3FoedzH
Democrats negotiate over whether to shoot themselves in the foot
Opinion by Paul WaldmanColumnistYesterday at 4:02 p.m. EDT
There’s an eternal debate in Washington about how much policy matters to politics, one that reemerges in slightly different forms. Does passing a bill with popular provisions really help you win elections? Do you get punished for passing something unpopular? Does the detailed substance of policies matter, or is the political battle over them just a contest of spin?
But here’s a pointed question Democrats might consider: What if you promise you’re going to do something incredibly popular, then spend months touting it as evidence of how you’re going to help people, and then drop it from the bill you pass?
That outcome is a very realistic possibility on the Build Back Better social infrastructure plan now being negotiated in Congress.
Polls have shown that while Americans don’t really have a good grasp of what’s in the BBB bill, when you tell them, they like just about all of it, from paid family leave to universal pre-K to Medicare covering dental care. But what stands out in every poll as the most popular provision is allowing Medicare to negotiate lower prescription drug prices.
The Kaiser Family Foundation just released a new poll that goes into detail on this question, and the findings are striking:
- 83 percent of Americans favor “allowing the federal government to negotiate with drug companies to get a lower price on prescription drugs for people with Medicare and private insurance.” That includes 95 percent of Democrats, 82 percent of independents and 71 percent of Republicans.
- When presented with arguments in favor of negotiation (“Americans pay higher prices than people in other countries, many can’t afford their prescriptions, and drug company profits are too high”) and opposed to it (“it would have the government too involved and will lead to fewer new drugs being available in the future”), 84 percent found the positive argument convincing. Only 33 percent found the negative argument convincing.
- After hearing those arguments, the number of people favoring negotiation remained unchanged, though many Republicans moved from “strongly favoring” negotiation to “somewhat favoring” it.
- By an extraordinary 93 percent to 6 percent, Americans rejected the pharmaceutical companies’ argument that they need to charge high prices to fund innovative research, instead agreeing that even if prices were lower the companies would still have plenty of money to fund that research.
If there was ever a political home run of a policy change, this would appear to be it.
Right now, Medicare is barred by law from negotiating, which is a key reason Americans pay the highest drug prices in the world. The negotiation provision in the bill would have two effects: It would bring down the prices, and the savings that would produce could then be used to fund other parts of the bill.
The money involved is enormous; according to a recent Rand Corp. study, setting U.S. prices at 120 percent of what governments pay in a group of our peer countries (one of the proposals that has been made) on just 50 top drugs would save the country $83.5 billion a year — or a trillion dollars in savings after 12 years. A Congressional Budget Office analysis in 2019 said the government could save $456 billion over 10 years by having Medicare negotiate prices.
Unfortunately, that also makes it a tempting target for the Democratic centrists who want to slash away at the bill: If the negotiation provision is jettisoned, that means there’s less money to fund the social infrastructure provisions they don’t like.
There is a huge lobbying fight going on right now, with the enormously powerful drug companies pitted against the enormously powerful AARP, which supports price negotiation. The companies have some centrist House Democrats on their side, and Sen. Kyrsten Sinema (D-Ariz.) has also made clear that she opposes price negotiation, though Sen. Joe Manchin III (D-W.Va.) supports it.
But it’s one thing to say you don’t like a particular provision, and another to threaten to kill the entire bill if it’s included. After all, everyone has to compromise here.
Right now no one knows whether price negotiation will make it into the final bill. Members are exploring different ways to scale the proposal back that might meet with the approval of the centrists and drug industry allies.
But if it does fall by the wayside, every Democrat will suffer. It’s not just that reducing the price of medicines is absurdly popular. It’s also that Democrats have promised this over and over. If the bill passes without it, a lot of voters are going to decide that Democrats failed them, all the other things the bill does notwithstanding.
Opinion: How the Biden administration can help Haitian migrants without sending the wrong message
Opinion by the Editorial Board
Feverish Republican claims that the Biden administration had swung open the nation’s doors to the Haitians who gathered last month beneath a bridge at the border in Texas are fiction. In fact, most have been deported to Haiti or, to escape that fate, have crossed back into Mexico.
That outcome satisfies no one. Not the Republicans eager to frighten their base with the specter of a border overrun by migrants, nor the Democrats who denounced the administration’s policy as cruel, failing to acknowledge the political, logistical and humanitarian risks of lax border enforcement.
The numbers belie the Republican claim that Haitians have been admitted into the country wholesale. Since mid-September, when thousands of migrants began gathering under a bridge in Del Rio, in southern Texas, the administration has deported at least 7,500 of them, on some 70 flights to Haiti. Thousands more have crossed the Rio Grande back into Mexico. A few thousand asylum seekers who were admitted, generally families with children, were the minority.
The State Department’s special envoy to Haiti, Daniel Foote, resigned last month in what he said was a protest over the deportations. Last week, a senior State Department official, Harold Koh, the top political appointee in the department’s legal office, also condemned the deportations in a 3,000-word memo.
Mr. Koh, a former dean of Yale Law School, argued that the administration has acted illegally in retaining a pandemic-related health policy known as Title 42, carried over from the Trump administration, to summarily expel Haitians — although a federal appeals court has upheld that policy. He urged officials to notify migrants aboard deportation flights of their destination; exert more effort to send them to third countries where migrants may have family ties or legal status; grant asylum to migrants judged to have a “reasonable possibility of fear”; and suspend Title 42 deportation, “especially” to Haiti.
It’s easy to sympathize with the impulse behind Mr. Koh’s prescriptions, particularly concerning Haiti, now seized by economic meltdown, paralyzing criminality and political chaos. There’s no question that Haitian deportees, some of whom have been sent to Haiti after an absence of a decade or more and have no prospect of a decent life there, should be treated humanely; that has not uniformly been the case.
As for the more lenient asylum standard that Mr. Koh proposes, the trouble is that it would swiftly incentivize huge numbers of new migrants to make the perilous trek toward the southern border. That’s not a theoretical problem; it was proved this year. The surge in Haitian migrants in September was driven in large part by the administration’s increasingly sparing use of Title 42, particularly for Haitians, over the first eight months of this year.
Americans broadly sympathize with the admission of refugees and asylum seekers, but a precondition of that support is a modicum of order in admissions. Surges like the one last month in Del Rio inevitably generate a backlash in popular support, not to mention political repercussions. That won’t help the administration’s pro-immigration agenda.