Dan Werb is the author of The Invisible Siege: The Rise of Coronaviruses and the Search for a Cure. He is an assistant professor in the Division of Infectious Diseases and Global Public Health at the University of California San Diego and in the Dalla Lana School of Public Health at the University of Toronto.
When a cluster of unexplainable pneumonia cases emerged in Hong Kong and the nearby Chinese city of Guangzhou in November, 2002, the world stood rapt. From a few dozen cases, the epidemic grew to include hundreds; as the numbers mounted, so did the deaths. The new pathogen had all the hallmarks of being pandemic-ready: It could transmit itself efficiently across human populations, it killed more than 10 per cent of those that were infected and it was a virus the world had never seen before.
That virus was severe acute respiratory syndrome, or SARS, the first pathogenic human coronavirus ever detected – and a close relative of SARS-CoV-2, the cause of the COVID-19 pandemic. When SARS first spread to Canada in the spring of 2003, Bob Brunham, a vaccinologist and the director of the BC Centre for Disease Control, helped lead a team that first mapped its genome. But after having seen the virus spread unchecked to every global hemisphere in a matter of months, he decided mapping it wasn’t enough.
If humanity was to ever keep up with emerging pathogenic abominations such as SARS, a leap in vaccine development was urgently needed. It was an audacious gambit because, at the time, the timeline for getting a vaccine to market was measured in decades, not years – making them a poor strategy for fast-moving epidemics. Vaccine production was also totally cornered by pharmaceutical companies, which were the only ones with the estimated US$100-million that was the minimum amount needed to get a viable product to market.
But Dr. Brunham had a plan. He had long been a proponent of a model of scientific discovery called “open science,” which eschewed patents – and profits – and sought to develop cures that could help the most people possible, rather than only those who could pay for them. The SARS Accelerated Vaccine Initiative, a network of publicly funded Canadian laboratories dedicated to testing SARS vaccine candidates, was his moonshot. Not only would it buck the for-profit system by making all of its findings completely open to all, but he was convinced this decentralized approach could bring a SARS vaccine to market in less than two years.
Dr. Brunham’s approach allowed scientists all over the world to use his publicly released SARS genome maps to design tests to detect the virus and bring the epidemic to heel. In a curious moment of scientific synchronicity, three days later, the scientist-entrepreneur Craig Venter (a former collaborator of Dr. Brunham’s) made his own announcement: His years-long, for-profit effort to map the entire human genome had been completed, and he intended to patent it and charge scientists for its use.
Those twin developments offered starkly different visions for the future of science. The first would lead to a world in which a Canadian-led open science movement would sidestep the ruthlessness of the market and radically democratize global access to vaccines. The second would lead to untold profits and restrict discoveries to the select few who could pay for them.
But as the story of the COVID-19 vaccines has made obvious, Dr. Brunham was on the losing side: A system of open science to share medical discoveries to all who need them was steamrolled in the face of profitmaking. He failed to bring an open-science SARS vaccine to market, although this was through no fault of his own. His team had developed three promising candidates and was poised to start human clinical trials as soon as a new wave of SARS cases surged. But the SARS virus just simply wasn’t well adapted enough to continue spreading through human populations, and he was left waiting for a wave of infections that never materialized.
Subsequently, the pharmaceutical industry further consolidated its monopoly on scientific discovery. Scientists, whether in academia, biotech or the pharmaceutical industry, now take it for granted that any discoveries they make will be patented, commercialized and released onto the market to maximize profits rather than access. Between 2003 and 2020, global pharmaceutical revenues grew from roughly US$500-billion to US$1.3-trillion a year, an increase of more than 150 per cent.
Because there is little market incentive to produce vaccines for viruses that haven’t proved troublesome for high-income countries, only one vaccine was brought to market in the 50 years before the COVID-19 vaccines of 2020. Dr. Venter’s vision of the inevitability of for-profit science largely won the day. With it grew an increasingly moribund industry that prioritized sure-fire moneymakers over vaccines that, while not promising revenues, could end diseases affecting millions of people in low- and middle-income countries.
This could not have come at a worse time. More novel pandemic-ready pathogens emerged in the first two decades of the 21st century compared with the entirety of the 20th century. And while each of these new pathogens – including MERS, Zika and Chikungunya – reinforced the fact that humanity was accelerating toward a pandemic, the market incentive to produce vaccines became weaker than it had ever been. What’s more, the for-profit model for vaccine production all but ensured that even if a vaccine were developed, access would largely depend on who had the resources to pay for them.
Fast forward to the present and the worst fears that vaccinologists such as Dr. Brunham had about restricted access to vaccines have come true. Two years into the pandemic, Canada – one of the wealthiest countries on the planet – is offering third-dose COVID-19 vaccine boosters to its citizens, who are among the most highly vaccinated in the world. Meanwhile, only about 10 per cent of people in low-income countries have been given the minimum two doses.
The irony is that, in the wake of the COVID-19 pandemic, Canada has been scrambling to position itself as a bastion of open science. In February, 2020, the Canadian government published, with great fanfare, a “Roadmap for Open Science” that would make government-funded research open and accessible to all, no strings – or patents – attached. One of the key goals of that roadmap is to accelerate scientific discovery so that the fruits of Canadian science can be exported far and wide. That was followed up in a September, 2020, announcement that Canada would donate $220-million to COVAX, an international consortium that used early vaccine purchases by wealthy countries to support delivery of doses to low- and middle-income ones.
Sadly, that commitment to the twin goals of open science and global vaccine equity quickly came crashing down to earth. In February, 2021, Canada used a clause in its agreement with COVAX to take 1.9 million doses from the global pool. It was an audacious move diametrically opposed to the spirit of vaccine equity. It also directly reduced the number of vaccines available for poorer countries. Meanwhile, Canada has failed to meaningfully invest in open-science initiatives.
That’s not for lack of options: The Viral Interruption Medicines Initiative, led by Canadian open science visionary Aled Edwards, has been lobbying the federal government for support. Dr. Edwards and his team have proposed developing a patent-less network of scientists to develop broad-based antiviral treatments that can prime the human body against attacks from known viruses and those that may emerge in the future. It’s an audacious and forward-thinking plan that Canada has so far failed to embrace.
It’s also the kind of initiative that could put our country at the forefront of open science discovery, at a time when the limits and cruelty of the for-profit approach to pandemic prevention have never been more glaring.
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