In Owning the Sun (Counterpoint, Mar. 2022), journalist Zaitchik chronicles how the pharmaceutical industry transitioned from, he says, “ethical to post-ethical, allowing public resources to be cannibalized by giant private interest.” He spoke with PW about how the system left the United States ill-prepared to fight the Covid-19 pandemic, and what better alternatives to the current system might be.
How did you become interested in the history of monopoly medicine?
I was writing about pricing scandals, contemporary prescription drug fights in Congress, and state-level fights over the cost of drugs breaking a Medicaid budget because companies charge monopoly prices. While taking deep dives into pharma five years ago, I occasionally came up against historical references. They were flashes of earlier paradigms that didn’t line up with the world we know today. I realized the current system is very new.
How did the Covid-19 pandemic foreground patent issues in the pharmaceutical industry?
When the pandemic hit it was like suddenly being thrown into the last inning of game seven of the World Series. Does the world have a right to produce these medicines, or do these private companies have a legal and moral argument for monopolizing that knowledge? The AIDS crisis has its own chapter because it was the first pandemic post-WTO. With Covid, the same issues and actors were about to line up. We would have a vaccine, funded by public dollars, controlled by a private actor who would keep most of the world from the knowledge. Early in the pandemic there were signs it was going to be different. This was airborne, “nobody’s safe until everybody’s safe,” so maybe they’d rein in the companies. There was this hanging moment of enormous possibility. The old script ended up taking over.
What would be a better way forward?
You could have a White House saying, “The NIH contributed most of the money for this mRNA platform. We’re going to train technicians around the world to make this stuff.” Because if you can scale it up quickly, so can they. If you want to be a contractor and make a little profit, you’re welcome to, but your company isn’t going to mint new billionaires like Moderna did. Another possibility is a unified Global South that asserts itself the way it did for a while in the postwar decades of the 1950s through the ’70s, when they demanded the right to use the tech of wealthy countries as a matter of justice.
How do you hope readers respond to the information in your book?
We should go back to reacquainting ourselves with the novelty and weirdness of this system. We should allow ourselves to understand that it feels wrong because it is wrong, and it wasn’t long ago that everybody knew that. Unless you can imagine it being different, it’s going to be hard to get involved to change it. I storified that history so people could see we’d once had a more wise and humane understanding of how medicine should be treated as a public good, a global knowledge commons that nobody has a right to obstruct or own. The idea that you can make a medicine and say, “This is mine, and you can’t make it even though it costs 20 cents to make, and your people are going to die for my right to monopolize it,” would have been a dystopian idea to an American scientist into the mid-century.