In the time of a public health emergency such as COVID-19, notions of ‘enforcement’ and the exhortation to act ‘responsibly’ come to the fore. The vaunted value of ‘freedom’ becomes secondary to concepts such as solidarity. The preservation of future liberties is perversely premised on renouncing freedoms today. Those who are in scant possession of some freedoms (such as the economically disadvantaged, and those with physical and mental vulnerabilities), need particular respect and care. In a global public health crisis our duties towards society take precedence over ‘I’. There is no ‘I’ in ‘global health emergency.’ But there is an ‘S’ in ‘despair’that demands solidarity and collaboration.

The major actors in a health crisis are states, government agencies, and global institutions such as the WTO, WHO and UN. However, there is a ‘C’ for ‘Corporate’ in ‘pandemic’. Pharmaceutical corporations in the age of pandemic: quo vadis?

A functioning economy is of course vital for the well-being of societies; President Trump has famously tweeted that “we cannot let the cure be worse than the problem itself”,^[1]i.e. a damaged economy can create misery and death that could outnumber the deaths coming from the coronavirus.

Be that as it may: more important now is to take a positive and proactive view of the pharmaceutical sector in the COVID-19 pandemic: to reflect on the lessons that have been internalized from the outbreak of the HIV/AIDS pandemic in the eighties,[2] to look at what responsibilities industry is being asked to accept, and to consider what responsibilities the pharmaceutical sector should proactively seek out and embrace.

Back in 1962, Milton Friedman famously wrote that the social responsibility of business in a free economy is to use its resources and engage in activities designed to increase its profits so long as it stays within the rules of the game.^[3] However, the privilege of working in the pharmaceutical industry is precisely that the ‘game’ engaged in is contributing to improving access to the highest attainable standard of health (which has long been declared by the UN and WHO to be a human right). Access to drugs (or its lack), is one recurrent barrier in the quest for the realization of this human right.

By the start of the 20^th century the reality of ‘Corporate social responsibility’ (CSR) has been adopted by the pharmaceutical sector. The UN Global Compact – the biggest global voluntary initiative on CSR  – has snowballed since its inception in 2000. The WTO adopted in 2001 a Declaration on Trade-Related Aspects of Intellectual Property Rights Agreementand Public Health in response to concerns that patent rules might restrict access to affordable medicines in developing countries in their efforts to control diseases of public health importance. The Declaration affirmed the sovereign right of governments to take measures to protect public health, giving primacy to public health over private intellectual property rights. ^[4],[5]

The contested 2003 draft UN “Norms on the Responsibilities of Transnational Corporations and Other Business Enterprises with Regard to Human Rights” tried to establish a wide-reaching principle that although states have the primary responsibility, transnational corporations and other business enterprises have “within their respective spheres of activity and influence” the obligation to promote, secure the fulfilment of, respect, ensure respect of and protect human rights.^[6]

How is the conduct of the pharmaceutical sector in the ‘Age of Pandemic’ faring? Are all proportional actions being taken that lie in its spheres of activity and influence? The commercial pharmaceutical research sector is responding with speed to leverage expertise in vaccine development, develop antiviral therapies, develop and market tests to detect the novel virus and to detect antibodies, undertake drug repurposing trials, as well rushing the manufacture of ventilators. The preparedness of China to share accurate and complete coronavirus data with the WHO, academia and the commercial pharmaceutical sector has become a central requirement.

The COVID-19 Therapeutics Accelerator was launched in March 2020 by the Gates Foundation, Wellcome, and MasterCard. The accelerator comprises 15 major pharmaceutical companies that commit to collaborating to develop and manufacture vaccines, diagnostics and treatments for COVID-19: the 15 companies have agreed to share their proprietary libraries of molecular compounds.

The Pharmaceutical Research and Manufacturers of America informs us that they are coming together to achieve the eradication of COVID-19.^[7] A major focus of their “Biopharmaceutical Industry Principles on Beating Coronavirus” is the commitment to ‘share’, ‘collaborate’ and ‘work with’ governments and fellow companies. The industry will furthermore coordinate with governments and insurers to ensure that treatments and vaccines will be available and affordable for patients. Many corporations are engaging in offering financial support and in-kind donations to organizations and patients around the globe.

There are a number of concrete issues requiring immediate decision: how to treat ongoing studies; how to maintain best standards of care caring for patients in trials; coping with a wide range of supply and logistics challenges; maintaining the delivery of life-saving medicines to patients around the world etc.The importance of positive collaborations with regulators in order to safely fast-track research and approval processes in a pandemic  is highlighted; this seems to be working well with COVID-19.

Members of the sector are optimizing and sharing excess manufacturing capacity, and looking to shift production to support those active in fighting the COVID-19 pandemic. Ethical decisions may be increasingly required as to how limited resources are distributed in a fair and just manner, with choices possibly being necessary between competing essential health care needs.

All top 10 pharmaceutical corporations have issued statements underlining their commitment to fight COVID-19. All echo an approach of sharing data, tools and insights, and taking an open-source platform approach rather than its customary proprietary stance.  Indeed, AbbVie is reported as deciding not to enforce patents (foregoing thereby higher-level income streams) for its HIV therapy Kaletra, a candidate COVID-19 repurposed drug. This position is surely much more appropriate in a global health pandemic, compared to governments being forced to obtain compulsory licenses.

To conclude, the pharmaceutical sector in the age of pandemic; feeling the pain, loving the responsibility? Reasons for optimism are evident. The future lies in the sector embracing organizations such asthe Medicines Patent Pool, a non-governmental organization backed by the United Nations that supports access to drug treatment through a voluntary licensing mechanism for low- and middle-income countries.^[8] Developing a strategic position in the extremely challenging and unusual situation of a global health pandemic requires the reassessmentof corporate social responsibility to encompass global solidarity. Friedman opined in 1962 that “few trends could so thoroughly undermine the very foundations of our free society as the acceptance by corporate officials of a social responsibility other than to make as much money for their stockholders as possible. This is a fundamentally subversive doctrine.”^[9]

Dear Reader, the author declares herself as being a convinced and happy subversive influence.