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EXECUTIVE SUMMARY
If there is a single word that describes the course of the COVID-19 pandemic, it is speed. Over the course of ten months, millions of positive cases and over one million deaths have disrupted the world’s health systems and economies. But if the spread of the virus has been fast, the efforts to find new tools to fight COVID-19 have not lagged behind. Since the beginning of 2020, no less than USD 9 billion have been invested in the research and development of treatments diagnostics and vaccines. As a result, there are around 200 vaccine candidates, over 400 diagnostic tests and more than 300 potential treatments in the pipeline, all targeting a pathogen that was unknown just one year ago.1 However, as vaccines are starting to get market authorisation, the technical and scientific barriers have started to look less challenging than the political and economic obstacles, which threaten global equitable access not only to COVID-19 vaccines, but also to therapies and diagnostic tests. The overall lack of a public health orientation and the strong profit-driven governance of the biomedical R&D system have had negative consequences on the efficiency of the system and on the health of the population, since many people still have no access to essential innovations.2 The collective shock of COVID-19 and the challenge of responding to the pandemic offers an opportunity to reform and strengthen the pharmaceutical R&D system and to redesign it to meet the needs of the 21st century. This paper discusses the limitations of the current pharmaceutical R&D system in the context of the COVID-19 pandemic, analysing the investments made in the development of COVID 19 health related technologies and describing the international governance mechanisms proposed to improve global equitable and affordable access to those innovations. Critically, it explores the possibility of a new biomedical R&D incentives model based on conditional public investments and procurement practices that would remodel the governance and would change the direction of the system. It would do so by prioritising engagement with companies which fulfil criteria that ensure that health and social needs are met and by redefining the relationships between stakeholders in both the public and private sectors. The development of a Preferred Supplier Model (4S) is consistent with the debates around the public sector’s capacity to shape markets through not only its procurement power, but also through its power as an investor in order to improve health, social and environmental outcomes. In addition, it is fully aligned with the mandate of the Sustainable Development Goals.
COVID-19 and the Reform of the Biomedical R&D System: A Proposal for a Preferred Supplier Model. An ISGlobal discussion paper.
